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No. 2 (2026)

GENERAL THERAPY QUESTIONS AND REVIEWS

Diagnostic Capabilities for metabolic Syndrome in Psychiatric Practice: A Systems Analysis of Russian Clinical Guidelines

https://doi.org/10.48612/psyph/9kkf-repp-tzp3

Published 2026-06-30

  • N.V. Semenova
    • ,
  • A.Y. Goncharenko
    • ,
  • V.L. Kozlovsky
    • ,
  • S.V. Lyashkovskaya
    • ,
  • V.V. Freize
    • ,
  • M.V. Anokhina

N.V. Semenova
V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology of the Ministry

A.Y. Goncharenko
V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology of the Ministry

V.L. Kozlovsky
V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology of the Ministry

S.V. Lyashkovskaya
V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology of the Ministry

V.V. Freize
V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology of the Ministry

M.V. Anokhina
V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology of the Ministry

Abstract

Relevance. Metabolic syndrome (MS) is a key factor determining the high level of cardiovascular morbidity and mortality in patients with mental disorders. In psychiatric practice, the risk of developing MS is significantly increased due to patients' lifestyle characteristics and the side effects of psychopharmacotherapy. Despite the existence of international guidelines for cardiometabolic monitoring, the degree of integration of MS screening into national clinical guidelines (CGs) in the field of psychiatry remains insufficiently studied.

Aim — to conduct a systematic analysis of current Russian clinical guidelines in the field of psychiatry in order to assess the feasibility of diagnosing metabolic syndrome based on the examination methods they provide.

Materials and methods. Fifteen clinical guidelines (CGs) for psychiatry, including guidelines for adults, children, and older adults, available in the Rubricator of Clinical Guidelines of the Ministry of Health of the Russian Federation, were analyzed. The presence of five key components of MS (anthropometry/waist circumference (WC), hypertension (HTN), hyperglycemia, hypertriglyceridemia, low high-density lipoprotein cholesterol) was assessed. The diagnostic coverage completeness index (DCCI) was calculated. Descriptive statistics and Pearson's chi-squared test were applied.

Results. No CG contains a direct algorithm for diagnosing MS. Anthropometry (Body Mass Index /body weight) and blood pressure measurement are included in 100 % of the documents; however, WC measurement is absent from all CGs. Blood glucose is specified in 73 % (11/15) of the guidelines, primarily as a pre-treatment screening. A full lipid profile is mandatory in only 20 % (3/15) of cases — for schizophrenia and bipolar affective disorder (BAD). A complete diagnostic set enabling MS verification was found in only 3 CGs (20 %): schizophrenia (adults and children) and BAD. A statistically significant association was found between the presence of requirements in CGs for monitoring metabolic side effects of psychopharmacotherapy and the completeness of diagnostic coverage (χ2 = 12.7, p < 0.001).

Conclusion. Russian clinical guidelines (CGs) for psychiatry lack a comprehensive and systematic approach to metabolic syndrome screening. Clinical guidelines for substance use disorders were not included in the analysis. A key gap is the omission of waist circumference and the inconsistent assessment of lipid profiles for most nosologies. There is a clear need to harmonize CGs with international standards to improve the somatic health of patients.

Keywords

metabolic syndrome, clinical guidelines, schizophrenia, bipolar disorder, antipsychotics, cardiometabolic risk, screening, psychiatry

PDF (Русский)

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