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Metabolic syndrome in antipsychotic-naïve patients with first-episode psychosis: a systematic review and meta-analysis

Published online by Cambridge University Press:  08 September 2021

Nathalia Garrido-Torres Open the ORCID record for Nathalia Garrido-Torres [Opens in a new window] ,
Idalino Rocha-Gonzalez ,
Luis Alameda ,
Aurora Rodriguez-Gangoso ,
Ana Vilches ,
Manuel Canal-Rivero ,
Benedicto Crespo-Facorro Open the ORCID record for Benedicto Crespo-Facorro [Opens in a new window]  and
Miguel Ruiz-Veguilla
Nathalia Garrido-Torres
Affiliation:
University Hospital Virgen del Rocio-IBIS, Spanish Network for Research in Mental Health (CIBERSAM), Sevilla, Spain
Idalino Rocha-Gonzalez
Affiliation:
University Hospital Virgen del Rocio-IBIS, Spanish Network for Research in Mental Health (CIBERSAM), Sevilla, Spain
Luis Alameda
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital (CHUV), CH-1008Lausanne, Switzerland
Aurora Rodriguez-Gangoso
Affiliation:
University Hospital Virgen del Rocio, Sevilla, Spain
Ana Vilches
Affiliation:
University Hospital Virgen del Rocio, Sevilla, Spain
Manuel Canal-Rivero
Affiliation:
University Hospital Virgen del Rocio-IBIS, Spanish Network for Research in Mental Health (CIBERSAM), Sevilla, Spain
Benedicto Crespo-Facorro*
Affiliation:
Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, Spanish Network for Research in Mental Health (CIBERSAM), Sevilla, Spain
Miguel Ruiz-Veguilla
Affiliation:
Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, Spanish Network for Research in Mental Health (CIBERSAM), Sevilla, Spain
*
Author for correspondence: Benedicto Crespo-Facorro, E-mail: benedicto.crespo.sspa@juntadeandalucia.es
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Abstract

Background

It is unclear what the prevalence of metabolic syndrome (MetS) in drug-naïve first-episode of psychosis (FEP) is, as previous meta-analyses were conducted in minimally exposed or drug-naïve FEP patients with psychotic disorder at any stage of the disease; thus, a meta-analysis examining MetS in naïve FEP compared with the general population is needed.

Methods

Studies on individuals with FEP defined as drug-naïve (0 days exposure to antipsychotics) were included to conduct a systematic review. A meta-analysis of proportions for the prevalence of MetS in antipsychotic-naïve patients was performed. Prevalence estimates and 95% CI were calculated using a random-effect model. Subgroup analyses and meta-regressions to identify sources and the amount of heterogeneity were also conducted.

Results

The search yielded 4143 articles. After the removal of duplicates, 2473 abstracts and titles were screened. At the full-text stage, 112 were screened, 18 articles were included in a systematic review and 13 articles in the main statistical analysis. The prevalence of MetS in naïve (0 days) FEP is 13.2% (95% CI 8.7–19.0). Ethnicity accounted for 3% of the heterogeneity between studies, and diagnostic criteria used for MetS accounted for 7%. When compared with controls matched by sex and age, the odds ratio is 2.52 (95% CI 1.29–5.07; p = 0.007).

Conclusions

Our findings of increased rates of MetS in naïve FEP patients suggest that we are underestimating cardiovascular risk in this population, especially in those of non-Caucasian origin. Our findings support that altered metabolic parameters in FEPs are not exclusively due to antipsychotic treatments.

Keywords

Metabolic syndromefirst episode psychosisantipsychotic naïvephysical health
Type
Review Article
Information
Psychological Medicine , Volume 51 , Issue 14 , October 2021 , pp. 2307 - 2320
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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