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The prevalence of metabolic syndrome in people with severe mental illness: a mediation analysis

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Abstract

Background

People with severe mental illness (SMI) generally have high rates of metabolic syndrome (MetS). Proposed explanations remain conjectural. Relatively little is known about Mets in SMI in Southern Europe, an area with generally healthy dietary traditions.

Purpose

To establish prevalence rates of MetS in an Italian sample, and testing hypotheses about putative reasons for the excess in the SMI group.

Methods

We compared the prevalence and correlates of MetS in inpatients with SMI and controls randomly chosen from patients undergoing routine maxillofacial surgery. We employed formal tests of mediation.

Results

The MetS prevalence rate was 26.1 % in the SMI group and 15.9 % in the comparison group. After controlling for age, people with SMI were three times more likely to have MetS than their non-SMI counterparts. Smoking and a family history of cardiovascular disease were strongly related to MetS in both groups. However, these factors could not explain the excess of MetS in the SMI group, and we found no effect of antipsychotic dose.

Conclusions

SMI remained prominent in increasing the likelihood of MetS in this low prevalence population, and putative determinants of MetS were common to people with SMI and to controls. Explanations for high MetS rates in SMI may lie in health behaviours other than smoking.

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Acknowledgments

Our thanks to all the patients and staff from the Mental Health Inpatient Unit and the Maxillofacial Surgery Unit, San Gerardo University Hospital (MB-I).

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Mental Health Sciences Unit, Faculty of Brain Sciences, University College London, London, UK

    Giuseppe Carrà & Paul E. Bebbington

  2. Department of Surgery and Interdisciplinary Medicine, University of Milano Bicocca, Milan, Italy

    Francesco Bartoli, Daniele Carretta, Alberto Bozzetti & Massimo Clerici

  3. Department of Mental Health, San Gerardo Hospital, Monza, Italy

    Cristina Crocamo

  4. Department of Surgery and Interdisciplinary Medicine, University of Milano Bicocca, Via Cadore 48, 20900, Monza, MB, Italy

    Francesco Bartoli

Authors
  1. Giuseppe Carrà
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  2. Francesco Bartoli
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Correspondence to Francesco Bartoli.

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Carrà, G., Bartoli, F., Carretta, D. et al. The prevalence of metabolic syndrome in people with severe mental illness: a mediation analysis. Soc Psychiatry Psychiatr Epidemiol 49, 1739–1746 (2014). https://doi.org/10.1007/s00127-014-0835-y

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  • DOI: https://doi.org/10.1007/s00127-014-0835-y

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