Metabolic Syndrome and Illness Severity Predict Relapse at 1-Year Follow-Up in Schizophrenia: The FACE-SZ Cohort

J Clin Psychiatry. 2018 Sep 18;79(6):17m12007. doi: 10.4088/JCP.17m12007.


Objective: Predicting relapse is a major challenge in schizophrenia from a clinical and medico-economic point of view. During recent decades, major psychiatric disorders have been found to be extensively associated with metabolic disorders, even before the illness onset, with a prevalence estimated to be 35% in this population. However, no study to date has, to our knowledge, explored the potential impact of metabolic syndrome (MetS) on relapse.

Methods: From 2010 to 2016, 185 patients (mean age = 32 years) with a DSM-IV-TR diagnosis of schizophrenia were included in the FondaMental Academic Centers of Expertise for Schizophrenia (FACE-SZ) cohort and followed up for 1 year. Multivariable logistic regression was performed to estimate the adjusted odds ratio for relapse.

Results: Thirty-seven percent of stabilized outpatients with schizophrenia (mean illness duration = 11 years) experienced a relapse at least once during the 1 year of follow-up. MetS strongly predicted relapse at 1 year, independently of illness severity, insight into illness, and treatment characteristics (including medication compliance). Patients with MetS at baseline had a 3 times higher risk (95% CI, 1.1-8.4) of experiencing a new episode of psychosis during the 12 months of follow-up.

Conclusions: Further studies should determine if reducing or preventing MetS could help to protect subjects with schizophrenia from relapse.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antipsychotic Agents / therapeutic use
  • Case-Control Studies
  • France / epidemiology
  • Humans
  • Logistic Models
  • Longitudinal Studies
  • Medication Adherence
  • Metabolic Syndrome / blood
  • Metabolic Syndrome / complications*
  • Recurrence
  • Risk Factors
  • Schizophrenia / complications*
  • Schizophrenia / drug therapy
  • Severity of Illness Index
  • Young Adult


  • Antipsychotic Agents