Significant physical co-morbidity is recognised as prevalent among patients with severe mental illness. UK guidelines for treatment of both schizophrenia (NICE 2009; Clinical guideline 82) and bipolar disorder (NICE 2006; Clinical guideline 38) provide recommendations for screening physical health problems. Despite the evidence base, physical health screening in this population is inconsistent. The Dundee Health Screen Clinic was set up to monitor cardiovascular and metabolic problems by providing health checks and offer exercise and dietary advice along with smoking cessation groups. This survey demonstrates the prevalence of metabolic syndrome in this sample, associated risk variables and prescribed antipsychotics.

Metabolic syndrome prevalence was assessed among 240 new patients attending the Dundee Health Screening clinic from Nov 2005-Aug 2008. The health screen designed included demographic details, clinical investigations, a lifestyle history and a record of prescribed medication.

Metabolic syndrome (defined by the International Diabetes Federation (IDF) criteria) prevalence was 39.7%, with a higher propensity among those prescribed atypical versus typical antipsychotics. Predictors of metabolic syndrome suggested that BMI, a 10-year risk of CHD and diabetes are significantly associated with metabolic syndrome. 135 patients had dyslipidaemia with only 5.9% receiving lipid-lowering agents. Only 13 out of 94 patients with hypertension had received antihypertensive treatment.

This study identifies significant unmet medical need in the health screening of the severely mentally ill. Health screening programmes are required for this high risk population with early intervention and appropriate medical follow up to minimise cardiovascular risk and its associated morbidity and mortality.