Metabolic syndrome among Tunisian psychiatric patients receiving antipsychotics: Prevalence and associated factors
Y. Ben Othmene, A. Aissa, S. Aouadi, M. Gardabou, R. Hosni, A. Ouertani, R. JomliIntroduction
Psychiatric patients have a higher mortality rate than the general population, predominantly from cardiovascular disease associated with metabolic syndrome (MetS).
This problem arises from combined genetic, biological, behavioral and iatrogenic factors.
Objectives
This study aimed to determine the prevalence of MetS among Tunisian psychiatric patients treated with antipsychotics and its associated factors.
Methods
A cross-sectional descriptive and analytical study, conducted between January and June 2025, involving Tunisian psychiatric patients at the Avicenne Psychiatry Department of Razi Hospital. Data were collected using a file and two Arabic-translated questionnaires:
The International Physical Activity Questionnaire (IPAQ): categorizing physical activity into: Inactive, Minimally active and HEPA-active.
The Mediterranean Diet Adherence Screener (MEDAS): with two categories: moderate to weak adherence ≤7; good to very good adherence ≥8.
MetS was defined according to NCEP ATP III criteria.
Results
Fifty-two patients were included with 71% being male. Their mean age was 38 [19-62] years. Overall, 69% were single, 23% married and 8% separated. Most participants (79%) had not completed secondary education and 63% were professionally inactive. Smoking was prevalent among 75% of the participants while 8% reported alcohol consumption.
The majority (77%) had no underlying medical conditions. Psychiatric diagnoses included schizophrenia (42%), bipolar I disorder (35%), bipolar II disorder (4%), schizoaffective disorder (13%) and other psychiatric conditions. Most patients (73%) were on atypical antipsychotics and 17% received concurrent typical and atypical agents. Among those on atypical antipsychotics, 62% were prescribed olanzapine or clozapine.
Good adherence to the Mediterranean diet was observed in 40% of participants.
Regarding physical activity, 38% were inactive, 31% minimally active and 31% HEPA-active.
Thirty–eight percent met the criteria for MetS.
A higher body-mass index (BMI) was significantly associated with the presence of MetS (p=0.014).
Longer exposure to antipsychotic medication was also associated with MetS but this was not statistically significant when adjusted for BMI.
No protective factors were identified.
Conclusions
This study showed that higher body-mass index was significantly associated with MetS, while neither Mediterranean diet nor physical activity showed a protective association.
These findings highlight the importance of careful monitoring of antipsychotic treatment and the implementation of weight management strategies in psychiatric care.
Disclosure of Interest
None Declared