Abstract:
Background
A high prevalence of metabolic syndrome and its components in patients with psychotic dis orders may increase the risk for cardiovascular diseases. Unfortunately, relatively little work
in this field has emerged from low-resourced contexts. This study investigated the preva lence, correlates, and treatment patterns of metabolic disorders in patients with psychotic
disorders in Western Kenya.
Methods
300 patients with psychosis and 300 controls were recruited at Moi Teaching and Referral
Hospital in Eldoret, Kenya. Data on demographic characteristics, weight, height, abdominal
circumference, blood pressure, blood glucose, lipid profile, and treatments were collected.
Categorical and continuous data were compared between the patient and control groups
using Pearson’s chi-squared tests and t-tests, respectively. Variables found to be signifi cantly different between these groups were included in logistic regression models to deter mine potential predictors of metabolic syndrome.
Results
Compared to controls, patients with psychosis were found to have a higher mean random
blood glucose [5.23 vs 4.79, p = 0.003], higher body mass index [5.23 vs 4.79, p = 0.001],
higher triglycerides [1.98 vs 1.56, p<0.001], larger waist circumference [89.23 vs 86.39, p =
0.009] and lower high density lipoprotein [1.22 vs 1.32, p<0.001]. The odds of developing
metabolic syndrome were increased with age [OR = 1.05, CI: 1.02–1.07] and presence of a
psychotic disorder [OR = 2.09 [CI 1.23–3.55]; and were reduced with female gender [OR
0.41, CI 0.25–0.67], among those who were never married [OR 0.52, CI 0.28–0.94] and
among the widowed/separated/ divorced marital status [OR 0.38, CI 0.17–0.81]. While themajority of patients received treatment with olanzapine, there was no association between
olanzapine use and metabolic syndrome and its components. More than half of the patients
in this study sample were not receiving treatment for the various components of metabolic
syndrome.
Conclusion
In the study setting of Eldoret, metabolic syndrome and its components were more prevalent
among patients with psychotic disorders than in controls; and a clear treatment gap for
these disorders was evident. There is a need for efforts to ensure adequate screening and
treatment for these physical disorders in resource-limited settings
