The prevalence of metabolic syndrome is increased 2-3 fold in people with severe mental illness (SMI) yet monitoring of physical health in the individuals is poor, despite clear guidance from NICE.

To assess whether monitoring of metabolic complication of people with SMI had occurred within the last year. To assess the prevalence of undiagnosed metabolic syndrome in SMI

100 patients with SMI involving both community and in-patient settings were audited. The prevalence of metabolic syndrome was assessed in 50 previously unmonitored patients.

In the audit, the 100 psychiatric notes had details of the following assessments: blood pressure (n=32), glucose (n=16), lipids (n=9) and weight (n=2). Twenty-six of 50 (52%) patients were subsequently found to fulfil the IDF definition for metabolic syndrome. Three had previously undiagnosed diabetes based on fasting glucose concentration. Metabolic syndrome was associated with increasing age (p=0.03) but not clinical setting, diagnosis, antipsychotic medication, gender, smoking status, alcohol or illicit drug use. 22% of patients had a family history of diabetes.

There is a high prevalence of undiagnosed metabolic syndrome in people with SMI. Improved screening of metabolic complications should lead to better identification and treatment of this clinical problem.