Metabolic Syndrome in First Episode Schizophrenia, Based on the National Mental Health Registry of Schizophrenia (NMHR) in a General Hospital in Malaysia: A 10-Year Retrospective Cohort Study.

Albert Muh Haur Lee,Jesjeet Singh Gill,Ong Hui Koh,Salina Abdul Aziz,Chong Guan Ng

doi:10.3390/ijerph15050933

Abstract

Schizophrenia has been linked with various medical comorbidities, particularly metabolic syndrome. The number of studies on this aspect is lacking in Malaysia. (1) Objective: To investigate metabolic syndrome rates and its associated factors. (2) Method: This is the first 10-year retrospective-outcome study of patients with first episode schizophrenia in Malaysia. Out of 394 patients diagnosed with first episode schizophrenia and registered with the National Mental Health Registry of Schizophrenia (NMHR) in the General Hospital Kuala Lumpur (GHKL) in 2004–2005, 174 patients consented to participate in the study. They were interviewed using a Schizophrenia outcome questionnaire and the International Physical Activity Questionnaire (IPAQ). The diagnosis of metabolic syndrome was made using the National Cholesterol Education Program—Third Adult Treatment Panel (NCEP ATP III). (3) Results: All patients’ weight, body mass index, fasting blood sugar, and blood pressure are significantly increased. Sixty-three subjects (36.2%) developed metabolic syndrome while 36 (23.2%) were hypertensive, and 41 (28.1%) were diabetic. Use of fluphenthixol depot (CI = 1.05–5.09, OR: 0.84, p = 0.039), reduced physical activity (CI = 0.13–1.00, OR: −1.04, p = 0.049), and substance use disorder (CI = 1.40, 13.89, OR: 1.48, p = 0.012) were significantly associated with metabolic syndrome based on univariate analysis. In further multivariate analysis, comorbid substance abuse was the only significant factor associated with metabolic syndrome after adjusting for physical activity and intramuscular depot. (4) Conclusion: Patients with schizophrenia are at high risk of metabolic syndrome. It is important to address substance use problems as an important risk factor of this comorbidity.

Highlights

Schizophrenia is a major mental disorder that alters the patient’s perception, thought, affect, and behavior
According to the World Health Organization (WHO), it is one of the major mental illnesses that leads to the global burden of disease [1], as the 14th most moderate and severe disability and 6th in the list for the most causes of years lost due to disability (YLD) [1]
Out of the 394 patients registered in 2004–2005, there were 37 patients who had passed away and 117 of them were lost to follow up and not traceable in the record

Summary

Introduction

Schizophrenia is a major mental disorder that alters the patient’s perception, thought, affect, and behavior. According to the World Health Organization (WHO), it is one of the major mental illnesses that leads to the global burden of disease [1], as the 14th most moderate and severe disability and 6th in the list for the most causes of years lost due to disability (YLD) [1]. There is research reporting that patients with schizophrenia have a shorter life expectancy, as much as 6–7 years shorter [2]. Examined the overall mortality among the cohort and found that after excluding for suicide, the mortality rate is twice as high as the general population among patients with schizophrenia. Res. Public Health 2018, 15, 933; doi:10.3390/ijerph15050933 www.mdpi.com/journal/ijerph

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