The Prevalence of the Metabolic Syndrome in Ghanaian Psychiatric Patients on Antipsychotic (First versus Second Generation) Treatment in the Kumasi Metropolis

Abstract

Metabolic syndrome (MetS), a predominant public health problem linked to cardiovascular and other morbidities, has acquired a significant precedence in clinical settings and patients with severe mental illnesses who are at higher risk for deviant components of this syndrome due to their illness and its treatment require careful and regular monitoring in this regard. Even though MetS has been established to be more prevalent among psychiatric patients than among any other population group, no data exist on its prevalence in Ghanaian psychiatric patients. This study seeks to find the prevalence of the MetS, in Ghanaian psychiatric patients on antipsychotics (first or second generation) compared to newly diagnosed psychiatric patients. This cross-sectional study of patients attending psychiatric department of the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana between February 2009 and July 2010.  A total of 200 psychiatric patients comprising 100 newly diagnosed antipsychotic naïve patients and 100 patients on antipsychotic medication were sampled for the study. Prevalence of MetS diagnosed using the World Health Organization (WHO), International Diabetes Federation (IDF) and the National Cholesterol Education Programme, Adult Treatment Panel III (NCEP ATP III) criteria for defining MetS was employed.The prevalence was significantly higher among psychiatric patients on treatment in comparison with the treatment naïve group using NCEP ATP III (21.0% vs. 2.0%; p < 0.0001) and IDF (29.0% vs. 2.0%; p < 0.0001) criteria but not WHO (13.0% vs. 14.0%; p = 0.8372). Irrespective of the criteria used, the prevalence of MetS was higher among patients on second generation versus first generation antipsychotic medication (i.e. 44.4% vs. 18.7% for NCEP ATP III; 22.2% vs. 12.1% for WHO and 56.6% vs. 27.5% for IDF), however these did not reach a significant levelPrevalence of MetS was not only highly prevalent among Ghanaian patients treated with antipsychotic drugs, it was also higher among patients on second generation versus first generation antipsychotic medication.

Keywords: Diabetes, hypertension, dyslipidaemia, mental illness, antipsychotics.