Prevalence of the metabolic syndrome in patients with schizophrenia treated with antipsychotic medication

Hert, Marc De; Winkel, Ruud van; Eyck, Dominique Van; Hanssens, Linda; Wampers, Martien; Scheen, André; Peuskens, Joseph

doi:10.1016/j.schres.2005.12.855

Cited by 270 publications

(194 citation statements)

References 44 publications

(5 reference statements)

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“…However, cohort effects are most likely to reduce differences between patients to the null in the present study, as the prevalence of diabetes and obesity has been rising rapidly in children, adolescents and young adults worldwide [51,52]. Second, this study was restricted to one site, indicating that the interpretation of the results needs to be done with caution, since large regional differences in metabolic parameters have been reported in the literature [53] Third, patients were not equally spread over the different agebands, with especially a low number of patients in the oldest age-band (n = 20) which could have biased our findings in this specific age-band. Fourth, insufficient patients were included in the present study to allow a dichotomization according to gender over the different age-bands, although a significant influence of gender on the occurrence of metabolic abnormalities was found in the present study and was also reported in the literature [54,55].…”

Section: Methodological Issuesmentioning

confidence: 95%

Prevalence of the Diabetes, Metabolic Syndrome and Metabolic Abnormalities in Schizophrenia over the Course of the Illness: a Cross-Sectional Study

Hert¹,

Winkel²,

Eyck³

et al. 2006

Drug Safety

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Section: Methodological Issuesmentioning

confidence: 95%

Prevalence of the Diabetes, Metabolic Syndrome and Metabolic Abnormalities in Schizophrenia over the Course of the Illness: a Cross-Sectional Study

Hert¹,

Winkel²,

Eyck³

et al. 2006

Drug Safety

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“…15 Other study, in Finland, only assessed patients at the age of 30-32 years old and found a prevalence of 19.4%; the difference could be explained by the significantly younger age of that group. 16 We found only one study in the literature on patients with bipolar disorder, with a prevalence of MS of 30%.…”

mentioning

confidence: 92%

“…In various countries, studies with patients who have schizophrenia or schizoaffective disorder found indexes that varied between 28.4% and 62.4%. [8][9][10][11][12][13][14][15] Saari et al found a lower index (19.4%) for individuals with schizophrenia, who belong to the Northern Finland 1966 Birth Cohort. This was, however, 3.7 times higher than the control group.…”

mentioning

confidence: 99%

The prevalence of metabolic syndrome among psychiatric inpatients in Brazil

Teixeira¹,

Rocha²

2007

Rev. Bras. Psiquiatr.

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A b s t r a c t Objective: Metabolic syndrome is a highly prevalent disorder among the general population. Studies show an even higher prevalence among psychiatric patients. The objective of this study is to assess the prevalence of metabolic syndrome among inpatients of a psychiatric ward of a general hospital in Brazil and correlate it with their respective psychiatric diagnoses and with the antipsychotics and mood stabilizers used. Method: 170 inpatients (mean age: 45.6 years) were evaluated according to the National Cholesterol Education Program criteria for metabolic syndrome, with a modification of the criteria for blood pressure and fasting glucose. Results: The prevalence found was 29.4%, being higher in women (43.6% versus 20.8%, p = 0.002). The prevalence stratified by psychiatric diagnostic was 48.1% for depression, 38.3% for bipolar disorder, 31.8% for schizophrenia and schizoaffective disorder, 5.1% for alcoholism, and 23.1% for "other mental disorders". The prevalence for alcoholism was significantly lower than the prevalence rates associated with other diagnostic categories (p = 0.035). After using the multivariate analysis, female gender and use of lithium remained as factors associated with a diagnosis of metabolic syndrome. Conclusions: The prevalence found was 29.4%. Gender (female) and use of lithium were factors significantly associated with the diagnosis of metabolic syndrome.Descriptors: Metabolic syndrome X; Mental disorders; Schizophrenia; Bipolar disorder; Depression Resumo Objetivo: A síndrome metabólica é um transtorno de alta prevalência na população em geral. Estudos demonstram prevalência ainda maior em pacientes psiquiátricos. O objetivo deste trabalho é avaliar a prevalência de síndrome metabólica em pacientes internados em uma enfermaria psiquiátrica de um hospital geral no Brasil e correlacioná-la com os diagnósticos psiquiátricos e com o uso de medicamentos antipsicóticos e moduladores do humor. Método: Cento e setenta pacientes (idade média: 45,6 anos) foram avaliados de acordo com os critérios do National Cholesterol Education Program para síndrome metabólica, modificados nos critérios pressão arterial e glicemia de jejum. Resultados: A prevalência encontrada foi de 29,4%, sendo mais elevada em mulheres (43,6% versus 20,8%, p = 0,002). A prevalência estratificada por diagnóstico psiquiátrico foi de 48,1% para depressão, 38,3% para transtorno bipolar, 31,8% para esquizofrenia e transtornos esquizoafetivos, 5,1% para alcoolismo e 23,1% para "outros transtornos mentais". A prevalência para alcoolismo foi significativamente menor, se comparada às prevalências associadas às demais categorias diagnósticas (p = 0,035). Após análise multivariada, o sexo feminino e o uso de lítio permaneceram como fatores associados ao diagnóstico de síndrome metabólica. Conclusão: A prevalência de síndrome metabólica encontrada foi de 29,4%. O sexo feminino e o uso de lítio foram fatores significativamente associados ao diagnóstico de síndrome metabólica.

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“…In addition to diabetes per se, milder glucose dysregulation has been described in numerous patients receiving atypical antipsychotics, such as impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) assessed during an oral glucose tolerance test (OGTT) [9][10][11]. A higher risk of developing a metabolic syndrome, which includes IFG in its various definitions, has also been stressed in recent studies [12][13][14][15]. Both diabetes and metabolic syndrome may contribute to the higher incidence of cardiovascular disease (CVD) in patients with schizophrenia and schizoaffective disorders.…”

Section: Introductionmentioning

confidence: 99%

“…Recently, there has been an increased awareness of the physical needs of patients with mental illness and several psychiatric clinics, including ours, have set up physical health screening [11,18]. Such screening has unmasked a substantial degree of pathology, especially metabolic disturbances considered as CVD risk factors, including diabetes mellitus [10,11,15]. Recent guidelines proposed a careful metabolic monitoring in patients with schizophrenia and schizoaffective disorders, especially those receiving atypical antipsychotics [1,[19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Abnormal glucose metabolism in patients treated with antipsychotics

Scheen

Hert

2007

Diabetes & Metabolism

148

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Second-generation (atypical) antipsychotic medications are of great benefit to a wide variety of people with psychiatric disorders, especially patients with schizophrenia. However, one constellation of adverse effects is an increased risk of obesity, diabetes, and metabolic syndrome. Increasing numbers of reports concerning impaired glucose tolerance, diabetes, and ketoacidosis have raised concerns about a possible association between abnormal glucose metabolism and treatment with atypical antipsychotics, although the question is still debated because of the presence of many confounding factors. A close relationship between drug-induced weight gain and risk of diabetes has been reported, emphasizing the role of insulin resistance. However, some cases of diabetes developed independently of weight gain, rather rapidly and possibly progressing to ketoacidosis, thus arguing for a severe impairment of insulin secretion. Another debated question is whether diabetes risk is a class action or a differential action. Although not fully scientifically proven yet, available evidence suggests that clozapine and olanzapine have a higher propensity to induce diabetes and metabolic syndrome compared with other atypical antipsychotic drugs, risperidone and quetiapine. Despite more limited available data, amisulpride, aripiprazole and ziprazidone showed less likelihood of precipitating diabetes. Interestingly, reversibility of drugrelated diabetes has been reported with aripiprazole. The choice of atypical antipsychotic medication for a specific patient depends on many factors, but the likelihood of developing diabetes should become an important consideration. When prescribing an atypical antipsychotic, a commitment to careful baseline screening and follow-up monitoring is essential in order to mitigate the risk of developing diabetes and associated complications.Keywords: antipsychoticsa; schizophrenia ; diabetes ; impaired glucose tolerance ; metabolic syndrome ; review RésuméLes antipsychotiques de seconde génération, appelés aussi antipsychotiques atypiques, ont apporté une aide précieuse dans la prise en charge de nombreux patients psychiatriques, en particulier ceux avec schizophrénie. Cependant, ils semblent associés à une constellation d'effets indésirables métaboliques, avec un risque accru d'obésité, de diabète et de syndrome métabolique. Un nombre croissant de publications à propos de cas de diminution de tolérance au glucose, de diabète et d'acidocétose chez des patients traités avec des antipsychotiques atypiques plaident pour une association causale possible entre une anomalie du métabolisme du glucose et le traitement par antipsychotique atypique, même si la question reste controversée suite à la présence de nombreux facteurs confondants. Une relation étroite entre la prise de poids induite par la médication et le risque accru de diabète a été rapportée, insistant sur le rôle de l'insulinorésistance. Pourtant, certains cas de diabète se développent indépendamment de toute prise pondérale, avec une évolution...

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Prevalence of the metabolic syndrome in patients with schizophrenia treated with antipsychotic medication

Cited by 270 publications

References 44 publications

Prevalence of the Diabetes, Metabolic Syndrome and Metabolic Abnormalities in Schizophrenia over the Course of the Illness: a Cross-Sectional Study

Prevalence of the Diabetes, Metabolic Syndrome and Metabolic Abnormalities in Schizophrenia over the Course of the Illness: a Cross-Sectional Study

The prevalence of metabolic syndrome among psychiatric inpatients in Brazil

Abnormal glucose metabolism in patients treated with antipsychotics

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