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Metabolic Syndrome in Patients With Major Depressive Disorder

(PSYCHIATRIC TIMES) - It has long been recognized that certain metabolic conditions are associated with cardiovascular disease and increased risk for morbidity and mortality.1,2 These alterations in metabolic functions often occur in clusters, a presentation known as metabolic syndrome.3,4 There is ongoing debate about how best to conceptualize and define metabolic syndrome, but most authorities now accept that central obesity or visceral adiposity, altered glucose and lipid metabolism, and hypertension are critical health indicators.4-6

Although most studies have focused on the risk of metabolic syndrome for patients with schizophrenia exposed to atypical antipsychotics, other psychiatric patients appear to be at risk for metabolic disturbances as well.7-9 Major depressive disorder (MDD) may be of particular interest because it is much more common than schizophrenia and is treated with a broad range of psychotropics.

Contributing factors
In a recent study presented at the 160th Annual Meeting of the American Psychiatric Association, we examined the prevalence of metabolic syndrome and each of the 5 criteria for this syndrome (Table 1) in psychiatric inpatients aged 18 through 64 years with a clinical diagnosis of MDD (N = 912).10 These findings were compared with data from a similar sample of patients who had schizophrenia (N = 255). Table 2 pre­sents demographic data. A total of 30.3% (n = 296) of the MDD sample had psychotic features, and 19.2% (n = 175) had recurrent de­pression. Alcohol or other substance abuse/dependence was comorbid in 57.3% of the patients with MDD and in 39.6% of the patients with schizophrenia. Table 3 lists the psychotro­pics that were being prescribed at index admission.

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