Schizophrenia and increased risks of cardiovascular disease

Hennekens, Charles H.; Hennekens, Alissa R.; Hollar, Danielle; Casey, Dympna

doi:10.1016/j.ahj.2005.02.007

Cited by 949 publications

(685 citation statements)

References 48 publications

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“…This discrepancy is at least in part generally explained as being caused by increases in comorbid medical conditions in the mentally ill, particularly chronic illnesses such as diabetes (6–9) and cardiovascular disease (2, 10–14). To alleviate these problems there have been reports of clinical interventions to improve health care in the seriously mentally ill with some success (15, 16).…”

Section: Objectivementioning

confidence: 99%

Comorbidity Profile and Healthcare Utilization in Elderly Patients with Serious Mental Illnesses

Hendrie¹,

Lindgren²,

Hay³

et al. 2013

The American Journal of Geriatric Psychiatry

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Objectives Patients with serious mental illness are living longer. Yet there remain few studies that focus on health care utilization and its relationship to comorbidities in these elderly mentally ill patients. Design Comparative study. Information on demographics, comorbidities and health care utilization were taken from an electronic medical record system. Setting Wishard Health Services senior care and community mental health clinics. Participants Patients age 65 years and over-255 patients with serious mental illness (schizophrenia, major recurrent depression and bipolar illness) attending a mental health clinic and a representative sample of 533 non-demented patients without serious mental illness attending primary care clinics. Results Patients having serious mental illness had significantly higher rates of medical emergency room visits (p=0.0027) and significantly longer lengths of medical hospitalizations (p<0.0001) than did the primary care control group. The frequency of medical comorbidities such as diabetes, coronary artery disease, congestive heart failure, chronic obstructive pulmonary disease, thyroid disease, and cancer were not significantly different between the groups. Hypertension was lower in the mentally ill group (p<0.0001). Reported falls (p<0.0001), diagnoses of substance abuse (p=0.02), and alcoholism (p=0.0016) were higher in the seriously mentally ill. The differences in health care utilization between the groups remained significant after adjusting for comorbidity levels, lifestyle factors, and attending primary care. Conclusions Our findings of higher rates of emergency care, longer hospitalizations, and increased frequency of falls, substance abuse, and alcoholism suggest the elderly seriously mentally ill remain a vulnerable population requiring an integrated model of health care.

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Section: Objectivementioning

confidence: 99%

Comorbidity Profile and Healthcare Utilization in Elderly Patients with Serious Mental Illnesses

Hendrie¹,

Lindgren²,

Hay³

et al. 2013

The American Journal of Geriatric Psychiatry

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“…Among these metabolic syndrome, already a concern in persons with schizophrenia based on life style risk factors, is a major concern with drugs that cause increased body mass index, hyperlipidemia, reduced insulin sensitivity, and are associated with an increased incidence of diabetes. Reduction in life span is great, and expected to worsen with increased exposure to pharmacological adverse effects (Hennekens et al, 2005;Auquier et al, 2006;Seeman, 2007;Colton and Manderscheid, 2006;Newcomer and Hennekens, 2007). In most respects, drug development for schizophrenia has not progressed appreciably since the introduction of chlorpromazine, a point which recently found emphasis in a large first episode clinical trial in Beijing comparing the original antipsychotic drug, chlorpromazine, with the only second generation drug with documented superiority, clozapine.…”

Section: Introductionmentioning

confidence: 99%

The Evolution of Drug Development in Schizophrenia: Past Issues and Future Opportunities

Carpenter

Koenig

2007

Neuropsychopharmacol

183

128

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“…Patients with schizophrenia have other physical health problems that might be related to the BH response. For example, patients with schizophrenia are at increased risk of cardiovascular disease diabetes, hyerplipidemia, and hypertension (Hennekens et al, 2005;Marder et al, 2004). Perhaps one of these health problems (or their pharmacologic treatment) might explain the increase in the BH response in patients.…”

Section: Discussion Of Breath Hold Resultsmentioning

confidence: 99%

Chronic smoking and the BOLD response to a visual activation task and a breath hold task in patients with schizophrenia and healthy controls

et al. 2008

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Many psychiatric patient groups smoke heavily, but little is known regarding the effects of this habit on functional brain imaging results. The present report assesses the effect of chronic smoking on the blood-oxygen-level-dependent (BOLD) response to a simple visual activation (VA) task and a breath hold (BH) task in patients with schizophrenia. Eight healthy controls and twelve patients with schizophrenia were studied. Half of each group had never smoked and the other half of each group had smoked for more than 10 pack years. Responses to the VA task were assessed in the visual cortex and responses to the BH task were assessed in gray matter generally. There were four fMRI dependent measures: (1) median percent signal change; (2) activation volume (in voxels); (3) time-to-peak of the impulse response function (IRF); and (4) time-to-trough of the IRF. All measures were tested as dependent variables in an ANCOVA with diagnosis and smoking status as crossed factors and age as a covariate. Heavy smokers had 22% larger percent signal change for the VA task and 50% larger percent signal change for the BH task. Patients had a 40% larger percent signal change for the breathhold task. Other statistically significant effects of smoking history on activation volume and the timing of the brain responses were noted. If replicated, the results may have important implications for fMRI studies comparing groups with markedly different smoking habits, such as studies comparing patients with schizophrenia, 60-90% of whom smoke, and healthy controls, who smoke with a much lower frequency.

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Schizophrenia and increased risks of cardiovascular disease

Cited by 949 publications

References 48 publications

Comorbidity Profile and Healthcare Utilization in Elderly Patients with Serious Mental Illnesses

Comorbidity Profile and Healthcare Utilization in Elderly Patients with Serious Mental Illnesses

The Evolution of Drug Development in Schizophrenia: Past Issues and Future Opportunities

Chronic smoking and the BOLD response to a visual activation task and a breath hold task in patients with schizophrenia and healthy controls

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