The magnitude of undiagnosed diabetes and Hypertension among adult psychiatric patients receiving antipsychotic treatment

Patients with severe mental illness (SMI) are at increased risk of developing non-communicable diseases that could cause significantly lower life expectancy when compared to the general population. This study aimed to assess the magnitude and predictors of undiagnosed type-2 diabetes and hypertension among adult patients with SMI on antipsychotic treatments.

A hospital-based cross-sectional study was conducted on 237 psychiatric patients from January to June 2019 at Hawassa University Comprehensive Specialized Hospital, Hawassa, Southern Ethiopia. All relevant information was collected using a structured interviewer-administered questionnaire with a systematic random sampling technique. A total of 4–5 mL of overnight fasting venous blood was collected from each patient. Serum lipid profiles and fasting blood sugar (FBS) were measured using the A25™ BioSystem Random Access chemistry analyzer. To identify predictors of hyperglycemia and raised blood pressure, multiple linear regression analysis was done using SPSS version 23. Statistical significance was set at p value < 5%.

From 247 patients with SMI approached, 237 (58.2% male and 41.8% females) were take part in the study giving a response rate of 95.9%. The overall 31.2% (95%CI: 24.1–37.6) and 27.8% (95%CI: 23.2–33.4) of patients had hyperglycemia and raised BP. The magnitude of prediabetes and type-2 diabetes was 24.9% (95%CI:19.4–30.4), and 6.3% (95% CI: 3.4–10.1), respectively. While the magnitude of prehypertension and hypertension was 23.2% (95%CI: 17.3–29.5) and 4.6% (95%CI: 2.1–8.0), respectively. In multiple linear regression analyses: age, HDL-cholesterol, physical activity and Triglyceride/HDL-cholesterol ratio were positively correlated with FBS. While, HDL-cholesterol, waist circumference, physical activity, total cholesterol/HDL-c ratio, and body mass index were positively correlated with systolic and diastolic blood pressures.

The findings indicate a need to assess blood glucose and blood pressure at baseline before the commencement of any antipsychotic therapy and during therapeutic follow up to manage any increasing trends. Moreover, close monitoring of patients with severe mental illness on antipsychotic therapy is exclusively recommended.