Metabolic abnormalities have
become an issue of growing concern in patients with
serious mental illness (SMI) (Osborn et al. 2006), and a
strong link between SMI and the prevalence of poor
physical health is indicated (Scott & Happell 2011).
These metabolic abnormalities such as diabetes, central
adiposity, hypertension and dyslipidaemia are known
as metabolic syndrome (MetS) (International Diabetes
Federation (IDF) 2006) (Appendix I) and can in turn
lead to an increased risk of cardiovascular disease (CVD)
(Usher et al. 2006). Treatment of schizophrenia can further
increase the likelihood of a client developing MetS (De
Hert et al. 2006a). Antipsychotic medications, particularly
second-generation antipsychotics (SGA) increase the risk of
MetS (Lieberman et al. 2005, Nasrallah et al. 2006). A
meta-analysis found that almost one in three of unselected
people with a diagnosis of schizophrenia meet criteria for
MetS, one in two patients are overweight, one in five
patients appear to have substantial hyperglycaemia and at
least two in five patients have lipid abnormalities (Mitchell
et al. 2013).
People with a diagnosis of schizophrenia are almost
twice as likely to have metabolic risk factors and die
approximately 20 years younger than the general population
(Osborn et al. 2007). This review highlighted a gap in
the literature in this specified area. Therefore, it contributes
by highlighting practical strategies for mental health nurses
(MHN) in assessment and ongoing monitoring of metabolic
abnormalities in clinical practice and identifying the
need to have knowledge, awareness and training in detecting
and managing metabolic risk factors.
The literature suggests that they are subtle differences
between the terms metabolic abnormalities and MetS, therefore,
the terms are used interchangeably in the context of
this paper.