Síndrome metabólico y riesgo cardiovascular en pacientes con diagnóstico de esquizofrenia, trastorno esquizoafectivo y trastorno bipolar

Abstract

Introduction: patients with severe mental ilness such as schizophrenia, schizoaffective disorder and bipolar disorder die at least 20 years earlier than general population. Despite preventive strategies, cardiovascular disease is the first cause of death. Objectives: analyse the percentage of patients with a high body mass index, metabolic syndrome and their cardiovascular risk at 10 years in patients with a diagnosis, based in DSM-IV criteria for schizophrenia, schizoaffective disorder or bipolar disorder. These patients were hospitalized because and acute condition of their mental ilness in the Brief Hospitalization Unit of Hospital Universitario de Móstoles between November of 2014 and June of 2015. Material and methods: in 53 patients, 34 with a diagnosis of schizophrenia, 16 with a diagnosis of bipolar disorder and 3 with a schizoaffective disorder, weight, size abdominal perimeter measures and blood pressure were collected. The body mass index was assesed. Blood tests were taken and we use sugar, triglycerides, total cholesterol and HDL cholesterol levels as paramethers for the ATP III and Framingham criteria. We also review the clinical history of the patients and lifestyle and use of toxic substances were registered. Results: 51% of the patients were men and 49% were women. The average age was 40. 38% of the patients were overweighed, 22% obese and 4% had morbid obesity. 26% of the patients had metabolic syndrome, the clinical evolution of the majority of these patients was of more tan 10 years and they also have been treated with different antypsychotics and antidepressants. Using the Framingham criteria, 11% of the patients had a cardiovascular risk higher than 10% in the next 10 years. Conclusions: overweight and its consequences in patients with a severe mental ilness are intimately related with their lifestyle, disparities in the access to health resources, the clinical evolution of the disease and pharmacotherapy. Strategies to promote physical health in these patients in the spanish health sistme are insufficient.