The high prevalence of undiagnosed metabolic complications in people with severe mental illness

Abstract

Background:

The prevalence of metabolic syndrome is increased 2-3 fold in people with severe mental illness (SMI) yet monitoring of physical health in the individuals is poor, despite clear guidance from NICE.

Aim:

To assess whether monitoring of metabolic complication of people with SMI had occurred within the last year. To assess the prevalence of undiagnosed metabolic syndrome in SMI

Methods:

100 patients with SMI involving both community and in-patient settings were audited. The prevalence of metabolic syndrome was assessed in 50 previously unmonitored patients.

Results:

In the audit, the 100 psychiatric notes had details of the following assessments: blood pressure (n=32), glucose (n=16), lipids (n=9) and weight (n=2). Twenty-six of 50 (52%) patients were subsequently found to fulfil the IDF definition for metabolic syndrome. Three had previously undiagnosed diabetes based on fasting glucose concentration. Metabolic syndrome was associated with increasing age (p=0.03) but not clinical setting, diagnosis, antipsychotic medication, gender, smoking status, alcohol or illicit drug use. 22% of patients had a family history of diabetes.

Conclusion:

There is a high prevalence of undiagnosed metabolic syndrome in people with SMI. Improved screening of metabolic complications should lead to better identification and treatment of this clinical problem.