Screening for the metabolic syndrome in Australia: a national survey of psychiatrists' attitudes and reported practice in patients prescribed antipsychotic drugs

Objective: To investigate current reported psychiatric practice in relation to screening for the metabolic syndrome in patients prescribed antipsychotic drugs within Australia. Method: A postal survey of all Fellows of the Royal Australian and New Zealand College of Psychiatrists. A 28-item questionnaire inquired into different aspects of screening and monitoring for metabolic syndrome in patients on antipsychotic medication. Results: Of 3123 questionnaires sent, 955 were returned. Of respondents, 55% had no established metabolic monitoring protocol or guidelines in their work place, with 13% saying they did not know what to monitor to detect metabolic syndrome. Altogether, 76% reported there was no reliable system in place to remind them when to monitor. Fewer than 50% of respondents routinely check weight, fasting glucose or lipids in their patients on antipsychotics and under than 30% checked blood pressure. Waist circumference was routinely checked in fewer than 7% of patients. Basic monitoring equipment was reported unavailable in more than 50% of clinical settings. However, more than 80% of respondents considered monitoring for metabolic syndrome to be their responsibility and 83% felt they had a medicolegal obligation in this respect. Conclusions: Routine screening for metabolic syndrome in patients on antipsychotic agents, by Australian psychiatrists, is inadequate. Interventions to improve screening rates need to be developed, implemented and evaluated.