Screening for metabolic syndrome in long-term psychiatric illness: Audit of patients receiving depot antipsychotic medication at a psychiatry clinic

• Autores: Carminda O´Callaghan, Aaron Y.L. Liew, Mohd Shazli Draman Yusof, Richard Duffy, Eugene G. Breen, Brendan Kinsley, Brendan D. Kelly
• Localización: European journal of psychiatry, ISSN 0213-6163, Vol. 25, Nº 4, 2011, págs. 213-222
• Idioma: inglés
• DOI: 10.4321/s0213-61632011000400004
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• Resumen

  • Background and Objectives: Metabolic syndrome (visceral obesity, dyslipidaemia, hyperglycaemia, hypertension) is a substantial public health problem, especially amongst individuals receiving antipsychotic medication.

    Methods: We studied routine screening practices for metabolic syndrome amongst psychiatry outpatients receiving injected depot anti-psychotic medication at a clinic in Dublin, Ireland.

    Results: Our initial audit (n = 64) demonstrated variable levels of documentation of criteria for metabolic syndrome in outpatient files; e.g. weight was recorded in 1.6% of files, serum high density lipoprotein in 12.5%. As our intervention, we introduced a screening check-list comprising risk factors and criteria for metabolic syndrome, based on the definition of the International Diabetes Federation. Re-audit (n = 54) demonstrated significantly improved levels of documentation; e.g. weight was recorded in 61.1% of files. Notwithstanding these improvements, only 11 (20.4%) of 54 patient files examined in the re-audit, contained sufficient information to determine whether or not the patient fulfilled criteria for metabolic syndrome; of these, 3 patients (27.3%) fulfilled criteria for metabolic syndrome.

    There was, however, significant additional morbidity in relation to individual criteria (waist circumference, serum triglyceride level, systolic blood pressure and serum fasting glucose).

    Conclusions:We recommend enhanced attention be paid to metabolic morbidity in this patient group.