Prevalence and determinants of metabolic syndrome in patients with schizophrenia: A systematic review and meta-analysis of Indian studies.

Introduction: Several authors have studied prevalence of metabolic syndrome (Met-S) in schizophrenia patients. Studies conducted in Indian scenario have shown conflicting results. Community based studies reported extremely low prevalence of metabolic syndrome in contrast to hospital based studies reporting higher rates. In this systematic review we summarize results of studies conducted in India and discuss possible reasons for these discrepancies.

Methods: Literature search was conducted with keywords metabolic, schizophrenia and India in PubMed, Google Scholar, and Science Direct database. Studies assessing prevalence of metabolic syndrome using IDF or NCEP-ATP III criteria, conducted in hospital and community setting were included.

Results: Fourteen studies conducted in hospital setting and two studies conducted in community were included for analysis. Pooled prevalence of Met-S in patients with schizophrenia was 29.83%. Pooled prevalence in community based studies was 10.81% significantly lower than in hospital based studies 33.05%. Overall meta-analysis of studies with case control design showed an OR 3.03 for prevalence in cases compared to controls. Except in one study conducted in a rural community, all other studies reported higher prevalence of Met-S in schizophrenia patients compared to controls. Drug-naïve patients had a pooled prevalence of 11.86%.

Conclusion: In India, prevalence rates of Met-S in schizophrenia patients are comparable to the rates reported in western studies. Community based studies highlight a significantly lower prevalence compared to hospital studies. More community based studies will enhance our understanding of prevalence and determinants of Met-S in patients with schizophrenia.