Endocrine Abstracts

Introduction: Mortality among patients with schizophrenia and psychotic disorders(SAPD) is two to threefold higher than in the general population and is widely attributed to cardiovascular and metabolic morbidity.

Objectives: We aim to highlight the metabolic profile of Mediterranean patients diagnosed with SAPD.

Methods: We conducted a descriptive and analytical cross-sectional study involving 55 patients who attended the psychiatry department at Gabes regional hospital, Tunisia, from 2019 to 2020. SAPD were diagnosed according to the DSM-5. MetS was defined based on the 2005-IDF criteria.

Results: The mean age was 46.8±11.1 years with a male predominance(74.5%). The majority were single(54.5%), from rural areas(52.7%), low-educational backgrounds(65.5%), and low-socioeconomic status households(74.5%). Addictive behaviors were reported in 49.1% mainly tobacco(45.5%). Suicidal behavior was noticed in 9.1%. Schizophrenia and schizoaffective disorder were the leading diseases in 72.8% and 16.4%, respectively. Obesity was the most common metabolic comorbidity in 30.9%. Dyslipidemia, diabetes, and hypertension were recorded in 20.0%, 14.5%, and 1.8%, respectively. The prevalence of MetS was 29.1%. MetS was significantly associated with female gender (P=0.046) and atypical antipsychotics prescription (P=0.018).

Conclusions: Patients with SAPD are five times more prone to develop MetS than healthy patients. Increased insulin resistance was substantiated in antipsychotic-naive patients. Besides common genetic predispositions to both MetS and schizophrenia suggested by some researchers, this population often has a poor lifestyle, little physical activity, and an unhealthy diet. That could be partially related to negative symptoms of psychotic disorders and drug-induced sedation. Second-generation antipsychotics seem to increase the risk of insulin resistance, obesity, and diabetes by the antagonism at serotonin 5-HT2c receptors.