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Abstract The study was carried out on patients who met the criteria for the study 151 children and adolescents diagnosed by the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5). They were divided into two groups, the second-generation antipsychotic-treated group (n=72, 47.68%) and the control group (n=79, 52.32%), who were patients who did not receive second-generation antipsychotic treatment. Second-generation antipsychotics are associated with a significant excess of physical comorbidities such as metabolic dysregulation and cardiovascular disease leading to increased mortality. This research work was designed to find a correlation between the duration of second-generation antipsychotic use in children and adolescents and the increase in metabolic syndrome disturbance indices, including weight gain, waist circumference, hypertension, hyperlipidemia and diabetes mellitus. It was hypothesized that children and adolescent patients treated with second-generation antipsychotics for a long duration are more exposed to a disturbance in body mass index, waist circumference, blood lipid, fasting blood sugar, and blood pressure. The rate of MtS was 27.81% (Fig. 4;) among SGAs-treated children and adolescents than the control group or who did not develop MtS. However, those rates had moderate prediction and correlation with different MtS indices. This finding is significant, given the young age of the studied population (4-17 years). In addition, the high prevalence of MtS in the current study is comparable to other studies on children using second- |