Prevalence of metabolic syndrome among psychiatric patients in the Middle East, North Africa, and Türkiye region: a systematic review and meta-analysis

Metabolic syndrome (MetS) is a major contributor to increased morbidity and mortality among individuals with severe mental illness (SMI) and other psychiatric disorders globally. However, its burden in the Middle East, North Africa, and Türkiye (MENAT) region remains insufficiently characterized. This study aimed to estimate the pooled prevalence of MetS in psychiatric populations across MENAT to provide a regional estimate and inform clinical and public health planning. We conducted a systematic review and meta-analysis of studies reporting the prevalence of MetS in adults with SMI (including schizophrenia spectrum disorders, bipolar disorder, and severe depression) and other psychiatric diagnoses across the MENAT region. Six databases were systematically searched from inception to August 2025. The included studies were published between 2008 and 2024. Random-effects models were used to estimate pooled prevalence, and heterogeneity was evaluated using the I 2 statistic. Subgroup analyses were conducted by country, study design, patient setting, sample classification (SMI vs. mixed psychiatric samples), psychiatric diagnosis, and diagnostic criteria, and meta-regression was used to examine continuous moderators. Publication bias was assessed using funnel plots and Egger’s regression test. A total of 29 studies were included in the analysis. The review was registered in PROSPERO (CRD420251117574). A total of 16,133 participants were included (mean age 36.96 ± 10.49 years). Most studies focused on schizophrenia spectrum disorders (17/29), followed by bipolar disorder (5/29), with the remainder including mixed or other psychiatric diagnoses. The pooled prevalence of MetS among SMI and other psychiatric patients was 32.0% (95% CI 27.9–36.4%). Subgroup analyses by sample classification showed comparable prevalence within SMI samples (30.7%, 95% CI 26.2–35.6%). Female sex was significantly associated with higher MetS prevalence in meta-regression analyses. Prevalence estimates varied by diagnostic criteria, with higher rates observed using International Diabetes Federation (IDF) criteria (38.9%) compared with Adult Treatment Panel III (ATP III) criteria (28.9%). Adults with SMI, as well as mixed psychiatric cohorts, in the MENAT region experience a high burden of MetS. These findings highlight the importance of integrated care models and routine metabolic monitoring within psychiatric services to reduce cardiometabolic risk.