The Effect of Positive Lifestyle on Reversal of Metabolic Syndrome in Patients with Schizophrenia Followed-up for Two Years

Özet

Objective: The risk of metabolic impairment is higher in patients with schizophrenia due to long disease period, increasing age, unhealthy lifestyle, antipsychotic medication use, and genetic factors. Among these risk factors, unhealthy lifestyle and antipsychotic medication use are factors that can be changed by external interventions. Main objectives of our study were to retrospectively analyse the parameters of metabolic syndrome (MetS) in patients with schizophrenia whose metabolic parameters have been monitored for at least 2 years and whose medications and clinical conditions were stable, to detect new cases of MetS and cases with reversal of MetS, and to examine the factors that predict the incidence and reversal of MetS. Methods: The sample group of the study comprised patients who were followed and monitored at the Psychotic Disorders Outpatient Clinic of Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery as outpatients between January 1st, 2014 and January 1st, 2017 and were admitted with schizophrenia diagnosis in accordance with the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). We present a retrospective analysis of longitudinal data addressing socio-demographic characteristics, metabolic parameters, positive lifestyle features in these patients. MetS was defined by the criteria defined by ATP-III A. The Positive and Negative Syndrome Scale, Schedule for Assessment of Insight, Clinical Global Impression Severity of Illness were also administered retrospectively. The interviews of the patients conducted in 2014 were regarded as the “first evaluation” and their interviews conducted 2 years after the first evaluation were regarded as the “final evaluation.” Results: Three hundred and fifty patients had a mean age of 42.6 were included in the study. The rate of MetS was 20% in the first evaluation and 25.4% in the final evaluation. Increase in the prevalence of MetS between the first and final evaluation was not significant. Two-year incidence were found as 13% with a rate of 30% for reversal of MetS. The logistic regression analysis revealed that the increase in age and less positive lifestyle had a significant predictive effect in incident cases and the only significant variable that predicted the reversal was the positive lifestyle. Conclusions: In conclusion, the present study is important in terms of showing the variability of metabolic parameters of the patients with schizophrenia. Thus, the outcomes of interventions can be better understood by detecting new cases of MetS along with reversed cases. Finally, our study is important in terms of showing that positive lifestyle characteristics contribute to the reversal of MetS.