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Abstract
Metabolic syndrome is a combination of medical disorders that increase the risk of developing cardiovascular disease and diabetes; it affects one in five people, and prevalence increases with age (Allen, 1998; Ford et al., 2002).
In summary, the current trends in psychiatry and mental health are proposing a comprehensive and holistic approach to the understanding of mental illnesses & their treatment. There is growing evidence that severe mental illnesses are associated with significant physical co-morbidities (Davidson et al., 2001; Mitchell and Malone, 2006) that lead to increase risk of premature mortality in many psychiatric patients (Dembling et al., 1999; Saha et al., 2007).
The challenges in advancing mental health are therefore linked to the physical well being of these individuals and better understanding and more awareness about physical needs of these patients (Druss et al., 2001).
Metabolic syndrome incidence & prevalence are increasing over time in general population but patients with mental illnesses are more prone to developing metabolic disorder than others due to causes in the illness as well as the side effects of antipsychotic drugs. It is true that antipsychotic medication will continue as an essential treatment strategy for the well being of mentally ill but there is a need to look at the side effects of these drugs and their potential & detrimental effects on physical health as well (Remington, 2006).
There is also a need for doing more research about health promotion, quality of life, life style guidance and dietary advice for this group of patients. During the last few decades enough evidence has emerged for predisposition of the severely mentally ill for unhealthy life style that leads to physical inactivity, smoking, weight gain, obesity, cardiovascular diseases and many other health hazards (Brown et al., 1999).
This of course sets an agenda for future action and requires ongoing reviews in pharmacological & non pharmacological interventions for mental illnesses. A number of guidelines have been proposed looking at effective pharmacological treatment of different mental illnesses, making choices for appropriate drugs and advice about physical healthcare and life style managements for the mentally ill (Lehman et al., 2004).
Keeping in view the importance of Metabolic Syndrome and related physical health problems, it is expected that clinicians will focus more attention to its diagnosis, treatment and prevention and will also give due consideration to the current drug treatment guidelines in this area. The need to provide some form of management in improving the life style for these patients is also universally accepted & the current evidence does provide clear guidelines and directions for more awareness for programmes needed to promote and support physical well being of the patients with severe mental illnesses (Ganguli and Brar, 2005).
In the current cross-sectional case control study 20 cases of drug naïve 1st episode psychotic patients who were admitted to the institute of psychiatry Ain shams faculty of medicine; diagnosed by ICD10 symptom checklist and undergone semi structured clinical interview as the one used by institute of psychiatry were matched with an equal number of healthy regarding age, sex and social class.
Each was subjected to laboratory investigations to measure his/her baseline values of lipid profile (TG, HDL-C), diabetes (FBS, OGTT), as well as waist circumference, BMI and blood pressure monitoring.
And the same investigations were done for the control and all values were compared based on IDF definition as regard percentage of each value as well as its mean, standard deviation and the P-value for each.
Results were in favor that waist circumference, BMI, OGTT are statistically significant with P-value 0.012, 0.022 and 0.043 respectively.
Denoting that these elements are present in cases if compared to control group even before administrating antipsychotic medication, which supported the hypothesis of the current study. On the other hand the rest of the components of metabolic syndrome as TG, HDL-C, blood pressure either systolic or diastolic were statistically insignificant with P-value 0.968, 0.387, 0.064 and 0.297 respectively, denoting as a