Prevalence and Predictors of Metabolic Syndrome Among Patients Attending an Outpatient Clozapine Clinic in Australia

Brunero, Scott; Lamont, Scott; Fairbrother, Greg

doi:10.1016/j.apnu.2008.06.007

Cited by 45 publications

(52 citation statements)

References 37 publications

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“…[813–17] The rate of 46–47% found in the current study was very similar to some of these studies,[81417] although much higher rates (62–64%) have also been found. [1516]…”

Section: Discussionmentioning

confidence: 99%

Metabolic syndrome among patients receiving clozapine: A preliminary estimate

et al. 2011

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Objective:To study the prevalence of metabolic syndrome in patients receiving clozapine.Materials and Methods:For this study, 100 patients attending the psychiatry outpatient clinic of a tertiary care hospital who were receiving clozapine for more than three months were evaluated for the presence of metabolic syndrome using the International Diabetes Federation (IDF) and modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP-III) criteria.Results:Forty-six patients fulfilled IDF criteria and 47 met modified NCEP ATP-III criteria of metabolic syndrome. There was significant correlation between these two sets of criteria used to define the metabolic syndrome (Kappa value –0.821, P < 0.001). Among the individual parameters studied, increased waist circumference was the most common abnormality, followed by abnormal blood glucose levels and elevated triglyceride levels. All these abnormalities were seen in more than half (52-61%) of the patients. When the sample was divided into two groups, i.e., those with and without metabolic syndrome, patients with metabolic syndrome had significantly higher body mass index and had spent more time in school. Logistic regression analysis revealed that these two variables together explained about 19% of the variance in metabolic syndrome (adjusted r2 = 0193; F = 12.8; P < 0.001).Conclusion:The findings of the present study suggest that metabolic syndrome is highly prevalent in subjects receiving clozapine.

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“…[813–17] The rate of 46–47% found in the current study was very similar to some of these studies,[81417] although much higher rates (62–64%) have also been found. [1516]…”

Section: Discussionmentioning

confidence: 99%

Metabolic syndrome among patients receiving clozapine: A preliminary estimate

et al. 2011

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“…[1] It has long been known that clozapine is associated with weight gain [3] and more recently it has also been shown that there is an increased risk among clozapine users for developing metabolic syndrome. [4][5][6][7] It has been suggested that clozapine may have a direct effect on glucose regulation, independent of weight gain, [8] and Koller et al [2] suggested a causal relationship between clozapine treatment and diabetes.…”

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confidence: 99%

Undiagnosed metabolic syndrome and other adverse effects among clozapine users of Xhosa descent

et al. 2014

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Background. Clozapine use is known to be associated with significant side-effects, including prolongation of the QT-interval, agranulocytosis and metabolic syndrome. However, few data exist on the prevalence of clozapine side-effects in patients of Xhosa descent. Objective. To gather data from Xhosa patients with schizophrenia to establish the prevalence of clozapine side-effects in this population. Methods. Twenty-nine Xhosa patients with schizophrenia (as per the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR))who had been receiving clozapine treatment for >1 year on an outpatient basis were selected for inclusion. All patients were participating in a genetics study in the Cape Metropolitan area. The participants were evaluated for the presence of side-effects (tests including an electrocardiogram, white blood cell count (WCC) and fasting blood glucose). Results. The prevalence of metabolic syndrome was 44.8% (95% confidence interval (CI) 26.7 -62.9) and of undiagnosed diabetes mellitus 13.8% (95% CI 1.24 -26.34). There was a significant association between metabolic syndrome and body mass index (BMI) (p<0.01). The mean (SD) WCC was 7.8 × 10 9 /L (2.8), with 3.4% of the subjects having a WCC <3.5 × 10 9 /L. Sedation (82.8%; 95% CI 69.0 -96.5), hypersalivation (79.3%; 95% CI 64.6 -94.1) and constipation (44.8%; 95% CI 26.7 -62.9) were common. The mean QT-interval was 373.8 (35.9) ms and 10% had a corrected QT-interval >440 ms. There was an association between the duration of clozapine treatment and QT-interval (with Bazett's correction). Conclusion. The high prevalence of metabolic syndrome and undiagnosed diabetes mellitus in this sample points to a need to monitor glucose levels and BMI on a regular basis. A larger study should be done to accurately quantify the differences in prevalence of side-effects between population groups. MethodsPatients with schizophrenia (as per the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)) of Xhosa descent being treated as outpatients and using clozapine as the primary treatment modality were selected from a large genetics study done in the Cape Metropolitan area.[12] Sixty (8.1%) of the 738 Xhosa participants with schizophrenia in the genetic study were taking clozapine at time of assessment. A convenience sample of 29 (48%) of the 60 participants was analysed for this study. Participation was voluntary. Informed written consent was obtained from all participants. The study was approved by the Health Research Ethics Committee of Stellenbosch University. The prerequisites for the study were that the subjects needed to be schizophrenia patients of Xhosa descent (defined as 4/4 grandparents reported as of Xhosa descent) who had been receiving clozapine for >1 year and be outpatients at time of assessment.Demographic, age, treatment duration and treatment dose data were collected by means of a structured questionnaire. A family history of cardiovascular disease (including hypertension) and a smoking history were obtained. Two self-reported q...

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“…This also is supported by Buhagair et al (2011), Brunero andLamont (2010), and Hultsjö (2012) who report that individuals with severe mental illness have a more positive view of their physical health and give less priority to health behaviors than those with no mental illness. This is disturbing, as the risk of serious physical health problems is high in this population group Brunero, Lamont, & Fairbrother, 2009). The fact that conceptions of ill-health are related to mental stress rather than physical health risks, and the priority given to mental wellbeing over physical health means it is necessary for practitioners to understand the symptoms and mental well-being of the individual before any lifestyle intervention is designed (Leutwyler, Wallhagen, & McKibbin, 2010).…”

Section: Discussionmentioning

confidence: 98%

Health Behaviors as Conceptualized by Individuals Diagnosed with a Psychotic Disorder

Hultsjö

Blomqvist

2013

Issues in Mental Health Nursing

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The purpose of this study is to describe health behaviors as conceptualized by individuals diagnosed with a psychotic disorder. Data were collected by qualitative interviews (n = 20) and were analyzed using phenomenography. Mental well-being took priority over physical health and guided health behaviors. Social relations were significant, and when they proved insufficient, health care professionals were utilized as a substitute. Some relied on religion, complementary treatments, and folk beliefs for health. Interventions not dependent on mental well-being, and assisting individuals to participate in appropriate networks could have advantages. Interventions adapted to the individual's financial situation and cultural values are useful as issues related to these areas can obstruct implementation of health behaviors. Implementing the findings of this study in nursing research and education will prepare nurses to meet the varying health needs of different individuals.

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Prevalence and Predictors of Metabolic Syndrome Among Patients Attending an Outpatient Clozapine Clinic in Australia

Cited by 45 publications

References 37 publications

Metabolic syndrome among patients receiving clozapine: A preliminary estimate

Metabolic syndrome among patients receiving clozapine: A preliminary estimate

Undiagnosed metabolic syndrome and other adverse effects among clozapine users of Xhosa descent

Health Behaviors as Conceptualized by Individuals Diagnosed with a Psychotic Disorder

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