Metabolic syndrome among Tunisian psychiatric patients receiving antipsychotics: Sex based comparison
Y. Ben Othmene, A. Aissa, A. Helaoui, M. Gardabou, R. Hosni, A. Ouertani, R. JomliIntroduction
Metabolic syndrome (MetS) is common in psychiatric patients and can be amplified by antipsychotic treatment. Beyond medication and lifestyle factors, studies suggest possible sex differences in vulnerability to MetS.
Objectives
This study aimed to determine the prevalence of MetS in antipsychotic-treated psychiatric patients, stratified by sex, examining links with lifestyle and medication.
Methods
A cross-sectional descriptive and analytical study, conducted between January and June 2025, 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
Forty-five patients were included with 67% being male. The mean age was 36.7 [19-62] years for men and 42.5 [23–60] years for women.
Among men, most participants (87%) were single, 87% were smokers and 10% consumed alcohol. While 83% had no underlying medical conditions, psychiatric diagnoses included schizophrenia (50%), bipolar I disorder (43%) and schizoaffective disorder (7%). Most (67%) were on atypical antipsychotics and 27% were on concurrent treatment with both typical and atypical agents. The median duration of antipsychotic treatment was 84 months.
Regarding physical activity, 37% were inactive, 40% were minimally active and 23% were HEPA active. Forty-three percent had good adherence to the mediterranean diet.
Among women, 47% were married, 40% were smokers and 7% consumed alcohol. Four women were menopausal.
No medical history was found in 53% of cases. Psychiatric diagnoses included schizophrenia (20%), bipolar disorder (I and II) (30%), schizoaffective disorder (20%) and other mental illnesses. While 80% were on atypical antipsychotics, 7% were on concurrent treatment with both typical and atypical agents. The median duration of antipsychotic treatment was 42 months.
In terms of physical activity, 47% were inactive and 53% were HEPA active. Thirty-three percent had good adherence to the mediterranean diet.
The overall prevalence of MetS was 33%. Prevalence was 27% in men and 47% in women (OR = 2.40).
There was no statistically significant difference in MetS prevalence between men and women (p = 0.18).
Conclusions
This study indicates a higher prevalence of MetS among antipsychotic-treated Tunisian women, though not statistically significant, suggesting possible sex-specific vulnerability. These results call for further research to clarify determinants of MetS and guide targeted prevention.
Disclosure of Interest
None Declared