Edith Kwobah1, Nastassja Koen2,3,4, Ann Mwangi5, Lukoye Atwoli6, Dan J Stein2,3,4. 1. Department of Mental Health, Moi Teaching and Referral Hospital, Eldoret, Kenya. 2. Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. 3. South African Medical Research Council [SAMRC], Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa. 4. Neuroscience Institute, University of Cape Town, Cape Town, South Africa. 5. Department of Behavioral Sciences, Moi University School of Medicine, Eldoret, Kenya. 6. Department of Mental Health, Moi University School of Medicine, Eldoret, Kenya.
Abstract
BACKGROUND: A high prevalence of metabolic syndrome and its components in patients with psychotic disorders may increase the risk for cardiovascular diseases. Unfortunately, relatively little work in this field has emerged from low-resourced contexts. This study investigated the prevalence, 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 significantly different between these groups were included in logistic regression models to determine 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 the majority 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.
RCT Entities:
BACKGROUND: A high prevalence of metabolic syndrome and its components in patients with psychotic disorders may increase the risk for cardiovascular diseases. Unfortunately, relatively little work in this field has emerged from low-resourced contexts. This study investigated the prevalence, 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 significantly different between these groups were included in logistic regression models to determine 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 the majority 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.
Authors: Marc De Hert; Dan Cohen; Julio Bobes; Marcelo Cetkovich-Bakmas; Stefan Leucht; David M Ndetei; John W Newcomer; Richard Uwakwe; Itsuo Asai; Hans-Jurgen Möller; Shiv Gautam; Johan Detraux; Christoph U Correll Journal: World Psychiatry Date: 2011-06 Impact factor: 49.548
Authors: Fahad D Alosaimi; Mohammed Abalhassan; Bandar Alhaddad; Nasser Alzain; Ebtihaj Fallata; Abdulhadi Alhabbad; Mohammed Z Alassiry Journal: Gen Hosp Psychiatry Date: 2016-12-19 Impact factor: 3.238
Authors: Alex J Mitchell; Davy Vancampfort; Kim Sweers; Ruud van Winkel; Weiping Yu; Marc De Hert Journal: Schizophr Bull Date: 2011-12-29 Impact factor: 9.306
Authors: Shukri F Mohamed; Martin K Mutua; Richard Wamai; Frederick Wekesah; Tilahun Haregu; Pamela Juma; Loise Nyanjau; Catherine Kyobutungi; Elijah Ogola Journal: BMC Public Health Date: 2018-11-07 Impact factor: 3.295
Authors: Dandara Almeida Reis da Silva; Ludmila Santana de Almeida; Livia Lugarinho Correa; Rodrigo Fernandes Weyll Pimentel; Antonio Marcos Tosoli Gomes; Ana Gabriela Travassos; Adriana Mattos Viana; Monique Magnavita Borba da Fonseca Cerqueira; Marcio Costa de Souza; Anderson Reis de Sousa; Paulo José Bastos Barbosa; Julita Maria Freitas Coelho; Lucelia Batista Neves Cunha Magalhães; Argemiro D'Oliveira Júnior; Jorge Lopes Cavalcante Neto; Charles Souza Santos; Luiz Carlos Moraes França; Juliana de Lima Brandão; Livia Fajin de Mello Dos Santos; Helena Ferraz Gomes; Ellen Marcia Peres; Thais Regis Aranha Rossi; Kairo Silvestre Meneses Damasceno; Millena Conceição das Mercês; Sandra Lúcia Fernandes; Eline de Almeida Soriano; Isolda Prado de Negreiros Nogueira Maduro; Tatiana Santos Brandão; Amanda Cardoso Menezes; Amália Ivine Costa Santana; Magno Conceição das Merces Journal: Int J Environ Res Public Health Date: 2022-08-17 Impact factor: 4.614