People with severe mental illness such as Schizophrenia, Bipolar Disorder and Schizoaffective Disorder have a significantly increased risk of developing alterations in glucose and lipid metabolism compared to the general population, leading to weight gain, dyslipidemia, insulin resistance and diabetes. As a result, they have a two-fold increased risk of morbidity and mortality for cardiovascular disease and a life expectancy reduced by 15 years compared to the general population. Metabolic Syndrome, a cluster of risk factors such as abdominal obesity, hyperglycemia, hypertension and dyslipidemia leading to cardiovascular morbidity and mortality, has been widely investigated in patients with SMI. Numerous studies have been carried out worldwide, reporting a 58% higher risk in patients with SMI compared to the general population. The increased risk is explained by several factors more prevalent in people with SMI, such as the adoption of unhealthy lifestyles, some biological common grounds between mental and metabolic conditions, and, eventually, the use of psychopharmacological medications such as several antipsychotics, mood stabilizers and antidepressants. In this paper we will review the risk of metabolic syndrome in patients with SMI. Finally, given the mounting evidence of a specific risk, the issue of metabolic syndrome in women with SMI and the impact of related factors will also be discussed.

Keywords: severe mental illness; metabolic syndrome; cardiovascular risk; gender differences.