The metabolic syndrome (MetS) is associated with elevated risk of diabetes and cardiovascular morbidity. However, little is known of the sensitivity, specificity and predictive value of individual criteria in patients with schizophrenia. We studied the prevalence of MetS using the International Diabetes Federation (IDF) and adapted National Cholesterol Education Program (NCEP-ATPIII) criteria in the Northern Finland 1966 Birth Cohort population. In addition, the sensitivity, specificity and predictive values for individual criteria were determined. Both adapted NCEP-ATPIII and IDF criteria for MetS identified the same cases (29% of all schizophrenia patients). Among the IDF criteria, hypertriglyceridemia had the highest sensitivity, correctly identifying 77.8% of the patients. Reduced HDL cholesterol was the most specific criteria, with 95% specificity equalling a positive likelihood ratio of 9.78. Thus both the IDF and NCEP-ATPIII criteria may be equally useful in identifying MetS.