The Prevalence of Risk Factors for Metabolic Syndrome Among People with Serious Mental Illnesses

Background and Purpose. People diagnosed with schizophrenia spectrum disorders in the United States live on average 25 years less than people without these illnesses (Saha, Chant & McGrath, 2007). One important factor in this group's early mortality rate is the development of metabolic syndrome, a group of risk factors for diabetes and heart disease composed of elevated blood glucose; elevated blood pressure; increased body mass index (BMI ); and two components of hyperlipidemia, low scores on high density lipoproteins (HDL) and high scores on triglycerides. To date, studies of metabolic syndrome in this population have focused on it as a side effect of atypical antipsychotic medications (e. g., Newcomer, 2007). However, no study has compared people with serious mental illnesses taking atypicals with similar groups on earlier generation antipsychotic medication. We examined the following research question: Does taking an atypical antipsychotic medication increase risk factors for metabolic syndrome among public mental health clients with serious mental illnesses? Methods. We reviewed the clinic records of 81 adults with serious mental illnesses who received service at an urban public mental health clinic in a U. S. Southwestern state. Measures were most recent BMI, blood pressure, cholesterol, and blood glucose. The sample had a mean age of 53.9; 76% were men and 79% were Caucasian. Eighty-five percent had a schizophrenia spectrum disorder and the balance were diagnosed with a bipolar disorder. Fifty-nine percent had been prescribed an atypical antipsychotic medication. Results. We found that taking an atypical antipsychotic medication significantly increased risk for developing metabolic syndrome on triglycerides (Χ²= 3.529, p. = .05). For other components of metabolic syndrome, taking an atypical did not significantly increase risk in the group studied. However, the prevalence of risk factors was high in both groups. Using prevalence rates from the Fourth National Health and Nutrition Examination Survey (Ervin, 2009), the prevalence of all risk factors was higher than reported in the age-adjusted general population. For BMI, we found 65% of the sample at risk compared to 53% of the general population. For hypertension, we found 84% of the sample was high compared to 40% in the general population. For blood glucose, 50% of the sample had either high blood glucose or were currently diagnosed with Type II diabetes compared to 39% of the general population. For triglycerides, 47% of the sample had high levels compared to 31 % of the general population. For HDL, 39% of the sample had low levels compared to 25% of the general population. Conclusion and Implications. The high prevalence across all risk factors for metabolic syndrome suggests that all consumers with serious mental illness should be screened for risk factors, and risk-reduction interventions should be available to them. Social workers working in mental health wellness and recovery programs, including those working toward integrated physical and mental health care, are in a good position to organize and promote this change.