Objectives: Nonalcoholic fatty liver disease (NAFLD) is a notable chronic liver disease due to metabolic syndrome, which has yet to be explored in long-term hospitalized schizophrenia patients. In this study, we intended to study the prevalence of NAFLD and related risk factors for patients with schizophrenia who were long-term hospitalized.

Methods: All of 182 patients with schizophrenia were recruited from a public psychiatric hospital in Taiwan. Abdomen ultrasonography was carried out for each patient. In addition to age and sex, covariates including medical diagnoses, (e.g., hypertension, hypertriglyceridemia, hypercholesterolemia, and diabetes), obesity, one-year cumulative dose of antipsychotics before the entry of this study, and abnormal liver function were included in the logistic regression model. Results: The mean age ± standard deviation was 50.3 ± 9.2 years. The mean duration ± SD of hospitalization was 8.7 ± 5.0 years. Males accounted for 60.4% (110/182). The percentage of NAFLD was 70.8% (129/182). In multivariate logistic regression, patients’ odd ratios (95% confidence interval) for a diagnosis of hypertriglyceridemia were 4.3 (1.11 - 16.7, p < 0.05) and for a finding of obesity 15.8 (3.82 - 65.6, p < 0.01), were significantly to have NAFLD. But patients with chronic hepatitis B were not significant to have NAFLD [OR (95% CI) = 0.17 (0.05 - 0.6)].

Conclusion: The prevalence of NAFLD was high in patients with long-term hospitalized schizophrenia in this study. We suggest that patients with long-term hospitalized schizophrenia need to receive timely, comprehensive, and prompt assessments for the presence of NAFLD as well as that intervention for their NAFLD is mandatory for maintaining well-being and quality of life in them.

Tso-Jen Wang is the Superintendent of Yuli hospital, Ministry of Health and Welfare, Taiwan, ROC., and an Assistant Professor of  Graduate Institute of Rehabilitation Counseling, National Chunghua University of education, Taiwan, R.O.C. He is also an International Fellow of American Psychiatric Association since 2016.