Search

Metabolic abnormalities and metabolic syndrome (MetS) increasingly have been linked to depression. The authors studied examined inpatients 35 years and older with major depressive disorder (MDD) to determine the prevalence of component metabolic abnormalities and the full MetS with age, treatment, and comorbid dementia. Data analysis involved retrospective cross-sectional review from a nonprofit psychiatry inpatient service of all discharges 35 years and older with a diagnosis of MDD during a 3 year period (April 1, 2003 to March 31, 2006) (N=1718). Metabolic measures included waist circumference, lipid measurements, glucose, and hypertension diagnosis. Abnormal metabolic measures and MetS were highly prevalent in both young and old patients with MDD: one or more component was present in 87.6% of older (65-99 years old) and 79.9% of younger patients. Full MetS was present in 31.5% of older and 28.9% of younger patients (not significant, P=0.85). Metabolic abnormalities were not associated with atypical antipsychotics after controlling other variables. One-quarter (n=79, 24.9%) of older inpatients had a dementia co-diagnosis. Older patients with MDD and dementia had greater risk of elevated glucose while younger patients were more often hypertensive. Longitudinal studies are needed to determine the relationships of MDD with or without dementia with these highly prevalent abnormal metabolic measures and MetS., (Copyright 2010 Wiley Periodicals, Inc.)

Objective: The metabolic syndrome has been recognized as a major health risk for patients taking atypical antipsychotics. Few studies, however, have examined large samples of psychiatric patients to explore the prevalence of the signs and symptoms associated with this condition., Method: The investigators retrospectively identified all inpatient admissions at the study site who were treated with antipsychotics during 2003 (N = 1691) and extracted demographic and clinical data (including measures associated with the syndrome: body mass index > 30 kg/m2, dyslipidemia, diagnosis of hypertension or diabetes). Stepwise logistic regression was used to identify variables associated with each correlate of the syndrome., Results: In the majority of this sample (69.3%), at least 1 correlate of the metabolic syndrome was present. The odds that a patient would have 1 or more of these measures were approximately 8 times greater for those receiving clozapine than for those receiving another anti-psychotic medication. These patients also had increased odds (odds ratio = 2.5) of having hypertension or diabetes. In the subsample of patients with documentation for all 5 correlates of the metabolic syndrome (N = 362), 18.8% had > or = 3 of 5., Conclusion: The prevalence of at least 3 correlates in psychiatric inpatients receiving antipsychotics is probably an underestimate, because diagnosis was substituted for the blood pressure and glucose measures. Nonetheless, these findings support the call for routine screening for metabolic symptoms in patients receiving antipsychotics. The risk for these symptoms may be particularly high in some subgroups identified, such as patients older than 50 years and those taking clozapine or multiple antipsychotics.