Objective: Adolescents with mental disorders are at increased risk for overweight, obesity and subsequent metabolic syndrome. However, data regarding risk factors of weight gain during psychiatric hospitalization of adolescents is limited and inconsistent. The aim of this study was to investigate the socio-demographic, clinical and pharmacological risk factors of weight gain during psychiatric treatment in order to improve prevention of subsequent metabolic syndrome.
Methods: We conducted an historical prospective study of 146 adolescent patients (mean age 15.2 ± 1.9 years, 52.7% males), consecutively admitted for day treatment in an adolescent day unit (length of stay 141 ± 76 days). Anthropometric measurements and laboratory analyses of fasting glucose and lipid levels were conducted as part of the routine medical care at admission and discharge. Psychiatric diagnoses, medication histories and socio-demographic data were obtained from the electronic medical records system.
Results: A significant increase in age- and gender adjusted body mass index (BMI) (i.e., z-score) was observed (0.5±1.2 vs. 0.7±1.1 at admission and discharge, respectively, p<0.001). Male subjects were more prone to weight gain than females (OR=3.5, 95%CI=1.2-10.3) and BMI z-score at admission was inversely associated with weight gain (R2=0.2, p<0.0001). Surprisingly, age at admission, psychiatric diagnoses, length of stay and number of medications were not associated with weight gain. Despite weight gain, fasting blood glucose and lipid profile did not change significantly during the study period.
Conclusions: Hospitalization of adolescents in a psychiatric day unit may be associated with a significant weight gain, especially in male subjects and those with normal weight at admission. Efforts should be aimed to reduce weight gain among youth with psychiatric disorders during treatment to avoid a subsequent metabolic syndrome.
