Psychological trauma occurring during adolescence is associated with an increased risk of greater waist circumference in Early Psychosis patients treated with psychotropic medication
Abstract:Background
It has been suggested that exposure to Childhood Trauma [CT] may play a role in the risk of obesity in Early Psychosis [EP] patients; however, whether this is independently of age at exposure to CT and the medication profile has yet to be investigated.
Methods
113 EP-patients aged 18–35 were recruited from the Treatment and Early Intervention in Psychosis Program [TIPP-Lausanne]. Body Mass Index [BMI], Weight Gain [WG] and Waist Circumference [WC] were measured prospectively at baseline and after … Show more
“…14,17,18,[22][23][24][25]29 . Twelve studies 11,12,13,[15][16][17][19][20][21]25,26,29 showed a significant association between ACE and obesity, with four studies 13,17,25,29 reporting an association between parental loss or separation and obesity, while other studies reported that SA 17,19,22,8,9,23 and PA 15 were associated with obesity.…”
Section: Resultsmentioning
confidence: 98%
“…12 Nineteen studies described the sample and together they included 13,976 participants (including 5656 healthy controls). The studies were done in USA, 15,20,24 Canada, 22,28,29 UK, 16 Italy, 12,13,27 Switzerland, 12 Poland, 1,17,23 Norway, 11,21 Spain, Netherlands, Germany, 24 Belgium, and France, 14 Brazil, 19 Turkey, 18 Australia, 26 and India. 25 Figure 1.PRISMA flow diagram.…”
Section: Resultsmentioning
confidence: 99%
“…846 were excluded at the title and abstract level and 62 studies that met the inclusion criteria were retrieved and assessed at full text level. Twenty articles 1,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] (Figure 1) published between 2011 and 2021 met the criteria for our final review. The majority of these studies (n = 12) were cross-sectional, 14,[17][18][21][22][23][24][25][26][27][28][29] while seven were case-control studies, 1,11,13,15,16,19,20 and one study was prospective, monitoring the weight gain in the participants for a year.…”
Objective A history of adverse childhood experiences (ACE) is common among people with severe mental illness (SMI), and they are also associated with physical health problems, including metabolic syndrome (MetS) in general adult populations. We aimed to evaluate and synthesise the evidence relating to the association between ACE and MetS and/or its components in patients with SMI. Methods We systematically searched multiple databases (MEDLINE, PubMed, PsycINFO, EMBASE, Emcare, Cochrane Library, Health Technology Assessments, Joanna Briggs Institute, and Maternity and Infant Care database) and reviewed studies that described an association between ACE and MetS or its components in SMI adult patients. Results Twenty studies were reviewed. Most studies described a significant association between ACE and at least one to three components of MetS, with obesity being the most studied and, therefore, showing a more consistent association compared to the other MetS components. ACE and the components of MetS did not remain significant, in most of the studies, after adjusting for confounders. None of the studies showed an association with MetS as a whole entity. Conclusion Adults with SMI with a history of ACE are more likely to demonstrate health problems such as MetS and cardiovascular disease-related risk factors.
“…14,17,18,[22][23][24][25]29 . Twelve studies 11,12,13,[15][16][17][19][20][21]25,26,29 showed a significant association between ACE and obesity, with four studies 13,17,25,29 reporting an association between parental loss or separation and obesity, while other studies reported that SA 17,19,22,8,9,23 and PA 15 were associated with obesity.…”
Section: Resultsmentioning
confidence: 98%
“…12 Nineteen studies described the sample and together they included 13,976 participants (including 5656 healthy controls). The studies were done in USA, 15,20,24 Canada, 22,28,29 UK, 16 Italy, 12,13,27 Switzerland, 12 Poland, 1,17,23 Norway, 11,21 Spain, Netherlands, Germany, 24 Belgium, and France, 14 Brazil, 19 Turkey, 18 Australia, 26 and India. 25 Figure 1.PRISMA flow diagram.…”
Section: Resultsmentioning
confidence: 99%
“…846 were excluded at the title and abstract level and 62 studies that met the inclusion criteria were retrieved and assessed at full text level. Twenty articles 1,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] (Figure 1) published between 2011 and 2021 met the criteria for our final review. The majority of these studies (n = 12) were cross-sectional, 14,[17][18][21][22][23][24][25][26][27][28][29] while seven were case-control studies, 1,11,13,15,16,19,20 and one study was prospective, monitoring the weight gain in the participants for a year.…”
Objective A history of adverse childhood experiences (ACE) is common among people with severe mental illness (SMI), and they are also associated with physical health problems, including metabolic syndrome (MetS) in general adult populations. We aimed to evaluate and synthesise the evidence relating to the association between ACE and MetS and/or its components in patients with SMI. Methods We systematically searched multiple databases (MEDLINE, PubMed, PsycINFO, EMBASE, Emcare, Cochrane Library, Health Technology Assessments, Joanna Briggs Institute, and Maternity and Infant Care database) and reviewed studies that described an association between ACE and MetS or its components in SMI adult patients. Results Twenty studies were reviewed. Most studies described a significant association between ACE and at least one to three components of MetS, with obesity being the most studied and, therefore, showing a more consistent association compared to the other MetS components. ACE and the components of MetS did not remain significant, in most of the studies, after adjusting for confounders. None of the studies showed an association with MetS as a whole entity. Conclusion Adults with SMI with a history of ACE are more likely to demonstrate health problems such as MetS and cardiovascular disease-related risk factors.
“…Assessment of traumatic events. Clinicians were trained to conduct an extensive assessment of patients, including evaluation of exposure to traumatic life events [ 39 ]. Case managers met patients frequently over the 36-month treatment period, providing the framework to establish a trusting relationship and gather extensive knowledge of patients’ history.…”
Traumatic events during childhood/early adolescence can cause long-lasting physiological and behavioral changes with increasing risk for psychiatric conditions including psychosis. Genetic factors and trauma (and their type, degree of repetition, time of occurrence) are believed to influence how traumatic experiences affect an individual. Here, we compared long-lasting behavioral effects of repeated social defeat stress (SD) applied during either peripuberty or late adolescence in adult male WT and Gclm-KO mice, a model of redox dysregulation relevant to schizophrenia. As SD disrupts redox homeostasis and causes oxidative stress, we hypothesized that KO mice would be particularly vulnerable to such stress. We first found that peripubertal and late adolescent SD led to different behavioral outcomes. Peripubertal SD induced anxiety-like behavior in anxiogenic environments, potentiated startle reflex, and increased sensitivity to the NMDA-receptor antagonist, MK-801. In contrast, late adolescent SD led to increased exploration in novel environments. Second, the long-lasting impact of peripubertal but not late adolescent SD differed in KO and WT mice. Peripubertal SD increased anxiety-like behavior in anxiogenic environments and MK-801-sensitivity mostly in KO mice, while it increased startle reflex in WT mice. These suggest that a redox dysregulation during peripuberty interacts with SD to remodel the trajectory of brain maturation, but does not play a significant role during later SD. As peripubertal SD induced persisting anxiety- and fear-related behaviors in male mice, we then investigated anxiety in a cohort of 89 early psychosis male patients for whom we had information about past abuse and clinical assessment during the first year of psychosis. We found that a first exposure to physical/sexual abuse (analogous to SD) before age 12, but not after, was associated with higher anxiety at 6–12 months after psychosis onset. This supports that childhood/peripuberty is a vulnerable period during which physical/sexual abuse in males has wide and long-lasting consequences.
“…It could also mean that antipsychotic use is not the only factor that can explain MetS; and that other factors, for which we have not accounted in this work, and that can account for it are already present early in the disease. In addition to antipsychotics, diet and a sedentary lifestyle, the tendency towards obesity in a group of patients with schizophrenia may also be influenced by genetic factors (Hasnain, 2015) and by the impact of social adversity (Aas et al, 2017;Alameda et al, 2020). In this regard, one aspect to consider in future research could be the possible pathway linking social stress with obesity-related outcomes in people with psychosis, exploring the role of inflammation, stress hormones and the genetic and epigenetic underpinnings (Coleman, Krapohl, Eley, & Breen, 2018).…”
Section: Naïve Patients Have Double the Amount Of Risk Of Mets Than General Populationmentioning
Background
It is unclear what the prevalence of metabolic syndrome (MetS) in drug-naïve first-episode of psychosis (FEP) is, as previous meta-analyses were conducted in minimally exposed or drug-naïve FEP patients with psychotic disorder at any stage of the disease; thus, a meta-analysis examining MetS in naïve FEP compared with the general population is needed.
Methods
Studies on individuals with FEP defined as drug-naïve (0 days exposure to antipsychotics) were included to conduct a systematic review. A meta-analysis of proportions for the prevalence of MetS in antipsychotic-naïve patients was performed. Prevalence estimates and 95% CI were calculated using a random-effect model. Subgroup analyses and meta-regressions to identify sources and the amount of heterogeneity were also conducted.
Results
The search yielded 4143 articles. After the removal of duplicates, 2473 abstracts and titles were screened. At the full-text stage, 112 were screened, 18 articles were included in a systematic review and 13 articles in the main statistical analysis. The prevalence of MetS in naïve (0 days) FEP is 13.2% (95% CI 8.7–19.0). Ethnicity accounted for 3% of the heterogeneity between studies, and diagnostic criteria used for MetS accounted for 7%. When compared with controls matched by sex and age, the odds ratio is 2.52 (95% CI 1.29–5.07; p = 0.007).
Conclusions
Our findings of increased rates of MetS in naïve FEP patients suggest that we are underestimating cardiovascular risk in this population, especially in those of non-Caucasian origin. Our findings support that altered metabolic parameters in FEPs are not exclusively due to antipsychotic treatments.
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