A comparison of schizophrenia outpatients treated with antipsychotics with and without metabolic syndrome: Findings from the CLAMORS study

Objective: To compare clinical, laboratory, lifestyle, and sociodemographic parameters and cardiac risk in antipsychotic-treated patients with and without metabolic syndrome (MS). Methods: A multicenter cross-sectional study in which 117 psychiatrists recruited antipsychotic-treated outpatients meeting DSM-IV criteria for schizophrenia, schizophreniform or schizoaffective disorder. MS was diagnosed when 3 or more of the following criteria were met: waist circumference > 102 cm (men)/>88 cm (women); serum triglycerides >= 150 mg/dl; HDL cholesterol <40 mg/dl (men)/ <50 mg/dl (women); blood pressure >= 130/85 mmHg; fasting blood glucose >= 10 mg/dl. The 10-year cardiovascular (CV) risk was assessed by the Systematic COronary Risk Evaluation (SCORE) function (CV mortality) and the Framingham function (any-CV-event). Results: 1452 evaluable patients (863 men, 60.9%), aged 40.7 +/- 12.2 years and with a mean duration of illness of 15.5 +/- 10.8 years (mean +/- SD), were included. MS was present in 24.6% [23.6% (men), 27.2% (women); p = 0.130]. Overall 10-year risks were 0.9 +/- 1.9 (SCORE) and 7.2 +/- 7.6 (Framingham). Coronary heart disease (CHD) 10-year risk was higher in MS patients: 6.6% vs 2.8% showed high/very-high CV mortality risk (SCORE >= 3%), and 44.2% vs 12.9% high/very-high CV event risk (Framingham >= 10%) (p < 0.001). MS patients also had more psychopathology (PANSS) and greater severity (CGI). Conclusions: MS is highly prevalent in antipsychotic-treated patients and is associated with increased cardiovascular risk and psychopathology. (C) 2008 Elsevier B.V. All rights reserved.