Concordance of standard and modified NCEP ATP III criteria for identification of metabolic syndrome in outpatients with schizophrenia treated with antipsychotics: a corollary from the CLAMORS study

Abstract

Objective: To analyze the concordance between standard and modified NCEP-ATP-III criteria for identification of metabolic syndrome (MS) in outpatients with schizophrenia.

Method: We used the sample from a cross-sectional study carried out to ascertain the prevalence of MS in schizophrenia. Kappa agreement and the symmetry Kendall's tau-b coefficients were calculated in a post-hoc analysis, a long with McNemar test and logistic regression models.

Results: The study enrolled 1,452 consecutive outpatients. MS was found in 24.6% (95%CI: 22.4%-26.8%) using the standard criteria and in 25.5% (23.2%-27.7%) using the modified criteria. Agreement was high; kappa 0.81 (p<0.0001) and tau-b 0.81 (p<0.0001), with a McNemar value of 0.2325. Kappa coefficients varied between 1.0 and 0.76 in subgroups according to sex, age-group, severity of disease, and duration of therapy.

Conclusions: MS in outpatients with schizophrenia may be assessed by either the standard or the modified NCEP ATP III criteria without losing reliability.