Biochemical Disturbances in Mental Disorders

Meduna, L. J.; Gerty, Francis J.; Urse, V. G.

doi:10.1001/archneurpsyc.1942.02290010048004

Cited by 41 publications

(3 citation statements)

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“…In addition, several lines of evidence suggest that SGAs may have exacerbated existing somatic health issues in schizophrenia. Metabolic disturbances, such as diabetes and slow blood sugar uptake, had already been observed and described in the “the mentally insane” of the pre-AP era ( 87 – 89 ). Likewise, the first report on AP-induced obesity, shortly after chlorpromazine had been introduced ( 90 ), states that “increase in weight, often considerable, has (previously) been reported with such diverse treatments as insulin shock, cardiazol, and electric convulsive therapy.”…”

Section: Possible Causes Of Increased Risk For Cvd-related Deaths In mentioning

confidence: 95%

Increased Mortality in Schizophrenia Due to Cardiovascular Disease â€“ A Non-Systematic Review of Epidemiology, Possible Causes, and Interventions

et al. 2014

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Background: Schizophrenia is among the major causes of disability worldwide and the mortality from cardiovascular disease (CVD) is significantly elevated. There is a growing concern that this health challenge is not fully understood and efficiently addressed.Methods: Non-systematic review using searches in PubMed on relevant topics as well as selection of references based on the authors’ experience from clinical work and research in the field.Results: In most countries, the standardized mortality rate in schizophrenia is about 2.5, leading to a reduction in life expectancy between 15 and 20 years. A major contributor of the increased mortality is due to CVD, with CVD mortality ranging from 40 to 50% in most studies. Important causal factors are related to lifestyle, including poor diet, lack of physical activity, smoking, and substance abuse. Recent findings suggest that there are overlapping pathophysiology and genetics between schizophrenia and CVD-risk factors, further increasing the liability to CVD in schizophrenia. Many pharmacological agents used for treating psychotic disorders have side effects augmenting CVD risk. Although several CVD-risk factors can be effectively prevented and treated, the provision of somatic health services to people with schizophrenia seems inadequate. Further, there is a sparseness of studies investigating the effects of lifestyle interventions in schizophrenia, and there is little knowledge about effective programs targeting physical health in this population.Discussion: The risk for CVD and CVD-related deaths in people with schizophrenia is increased, but the underlying mechanisms are not fully known. Coordinated interventions in different health care settings could probably reduce the risk. There is an urgent need to develop and implement effective programs to increase life expectancy in schizophrenia, and we argue that mental health workers should be more involved in this important task.

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Section: Possible Causes Of Increased Risk For Cvd-related Deaths In mentioning

confidence: 95%

Increased Mortality in Schizophrenia Due to Cardiovascular Disease â€“ A Non-Systematic Review of Epidemiology, Possible Causes, and Interventions

et al. 2014

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“…GWAS has proven valuable beyond just gene discovery in psychiatry, in that it allows the study of relationships between sets of traits in terms of genetic correlation (7), as well as GWAS informed methods for causal inference (8,9). An area of continued interest is the interplay between circulating biochemical factors and the pathophysiology of psychiatric disorders (10)(11)(12)(13). These studies have endeavoured to find biochemical traits readily detectable in blood, that, in theory, could be diagnostic or prognostic biomarkers for a given psychiatric disorder.…”

Section: Introductionmentioning

confidence: 99%

Genetic estimates of correlation and causality between blood-based biomarkers and psychiatric disorders

Kiltschewskij

Geaghan

Carr

et al. 2021

Preprint

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There is a long-standing interest in exploring the relationship between blood-based biomarkers of biological exposures and psychiatric disorders, despite their causal role being difficult to resolve in observational studies. In this study, we leverage genome-wide association study data for a large panel of heritable biochemical traits measured from serum to refine our understanding of causal effect in biochemical-psychiatric trait parings. In accordance with expectation we observed widespread evidence of positive and negative genetic correlation between psychiatric disorders and biochemical traits. We then implemented causal inference to distinguish causation from correlation and found strong evidence that C-reactive protein (CRP) exerts a causal effect on psychiatric disorders, along with other putatively causal relationships involving urate and glucose. Strikingly, these analyses suggested CRP has a protective effect on three disorders including anorexia nervosa, obsessive-compulsive disorder, and schizophrenia, whilst being a risk factor for major depressive disorder. Multivariable models that conditioned CRP effects on interleukin-6 signalling and body mass index suggested that CRP-schizophrenia relationship was not likely mediated by those factors. Collectively, these data suggest that there are shared pathways that influence both biochemical traits and psychiatric illness, including factors such as CRP that are likely to constitute a causal effect and could be targets for therapeutic intervention and precision medicine.

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“…[4] Genetic factors leading to insulin resistance [5] can also contribute to the patients' predisposition to metabolic disorder, and currently there is debate as to whether these disorders are part of the disease process itself through increase of stress factors and inflammatory responses. [6] It remains controversial as to whether pharmacokinetic variations within individuals results in variability in response to treatment. [7] Up to 50% of patients with schizophrenia may develop metabolic syndrome.…”

Section: Introduction Clinical Background -Metabolic Syndrome and Antipsychotic Drug Interactionsmentioning

confidence: 99%

Metabolic Syndrome in Patients with Severe Mental Illness Undergoing Psychiatric Rehabilitation Receiving High Dose Antipsychotic Medication

Ravindranath

2012

Indian Journal of Psychological Medicine

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Background:To review evidence of chronic antipsychotic medication and the association with metabolic syndrome in mentally ill patients. This evidence was used to analyse a cohort of patients with severe mental illness and to deduce a correlation between the prevalence of metabolic syndrome and their dose regimens.Materials and Methods:Twenty-four male patients undergoing Psychiatric rehabilitation underwent a review of current medication and assessment of risk factors for metabolic syndrome. Assessment criteria was based upon National Cholesterol Education Programme expert panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III) (NCEP ATP III) criteria, incorporating waist circumference, raised triglycerides, reduced high density lipoprotein, raised blood pressure and fasting blood glucose. PubMed, Nature and Science Direct databases have been used to compile the medical and scientific background on metabolic syndrome and antipsychotic medication and the effect on patients particularly on high dose.Results:Out of 24 patients, 10 patients (41.7%) were receiving high dose antipsychotics (HDA) and four were on maximum dosage limits of 100%. 8.3% (2/24) patients were receiving only one first generation antipsychotics (FGA), 37.5% (9/24) patients were receiving only one second generation antipsychotic (SGA), 45.8% patients (11/24) were receiving two or more SGA only, and only one patient was receiving two or more FGA. One patient was receiving a combination of FGA and SGA. PRN (“as needed”) therapy was not included in this study as their usage was limited. Clozapine was mostly prescribed in these patients (10/24, 41.6%). Four out of the 24 patients refused blood tests therefore were excluded from the following results. In the patients evaluated, 55% (11/20) had confirmed metabolic syndrome. In these patients with metabolic syndrome, 45.4% (5/11) were on HDA and 27.3% (3/11) were on maximum British National Formulary (BNF) limits of 100% of dosage. Four out of the nine remaining patients not diagnosed with metabolic syndrome were on HDA.Conclusions:Evidence supports the association between antipsychotic medication and metabolic syndrome. The data extrapolated from this cohort of mentally ill patients demonstrates that there is an increase in risk factors for metabolic syndrome and weight gain in the majority of patients on antipsychotic medication. The data however does not support any further predisposition to metabolic syndrome in these patients taking HDA. It also cannot be assumed antipsychotic medication is independently associated with the prevalence of these abnormalities.

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Biochemical Disturbances in Mental Disorders

Cited by 41 publications

References 2 publications

Increased Mortality in Schizophrenia Due to Cardiovascular Disease â€“ A Non-Systematic Review of Epidemiology, Possible Causes, and Interventions

Increased Mortality in Schizophrenia Due to Cardiovascular Disease â€“ A Non-Systematic Review of Epidemiology, Possible Causes, and Interventions

Genetic estimates of correlation and causality between blood-based biomarkers and psychiatric disorders

Metabolic Syndrome in Patients with Severe Mental Illness Undergoing Psychiatric Rehabilitation Receiving High Dose Antipsychotic Medication

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