EPA-1696 – Metabolic outocomes among schizophrenia and bipolar disorder patients

Abstract

PurposeAs weight-gain and metabolic abnormalities during treatment with psychotropic drugs are of great concern, we evaluated effects of psychoeducation and medical monitoring on metabolic changes among severely mentally ill patients.Materials and MethodsDuring repeated, systematized psychoeducation about physical health among 66 consecutive patients diagnosed with DSM-IV schizophrenia (SZ; n=33) or type-I bipolar disorder (BD; n=33), we evaluated (at intake, 1, 2, 3, and 6 months) clinical psychiatric status, treatments and doses, rated drugs- attitude of patients, and recorded physiological parameters.ResultsAt intake, BD vs. SZ patients were receiving 3–7-times more psychotropic medication, with correspondingly higher initial body-mass index (BMI: 29.1 vs. 25.6 kg/m2), 12-times more obesity, and significantly higher serum lipid concentrations. During 6-month follow-up, ratings of drugs- attitude of patients improved, polytherapy decreased in BD, and BMI decreased slightly, as serum lipid concentrations declined continuously (e.g., total cholesterol+triglycerides: BD by 3.21 > SZ by 1.75%/month). Declining lipid levels were associated with: [a] older age, [b] BD diagnosis, [c] being unemployed, [d] higher antipsychotic dose, [e] lower initial BPRS scores (all p≤0.001).