The prevalence of diabetes mellitus is increased in relatives of patients with a non-affective psychotic disorder

Welie, Hanneke; Derks, Eske M.; Verweij, Kim; Valk, Harold W. de; Kahn, René S.; Cahn, Wiepke

doi:10.1016/j.schres.2012.11.011

Cited by 28 publications

(26 citation statements)

References 20 publications

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“…The unaffected family group, independent of any psychiatric problems and drug effects, reported 1.6 times the risk compared to healthy controls. This is in agreement with findings from another large sample analysis looking at associations between diabetes and relatives of patients but was restrictive to non-affective psychosis (van Welie et al, 2013). In comparison, our finding is novel due to the inclusion of multiple diagnostic categories (both affective and non-affective psychosis) and is suggestive of CMD prevalence as trans-diagnostic and not restricted to non-affective psychosis.…”

Section: Discussionsupporting

confidence: 91%

“…Our study is reasonably representative of the general population of patients with psychotic disorders, their first degree relatives and healthy controls. By contrast, the van Welie et al study (van Welie et al, 2013) had a much higher mean age (62.5) and included only a Caucasian population, and Mukherjee et al (Mukherjee et al, 1989) used data from a population registry, and lacked a comparable control group.…”

Section: Discussionmentioning

confidence: 99%

“…Two studies detected increased prevalence of diabetes mellitus type-II in first-degree relatives (Fernandez-Egea et al, 2008b; Mukherjee et al, 1989). Another study found associations in a larger sample, but also included second and third degree relatives in the investigation (van Welie et al, 2013). While these studies contribute to our knowledge about the relationship between psychosis and CMD, they were mostly small in sample size and restricted to non-affective psychoses.…”

Section: Introductionmentioning

confidence: 99%

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Increased cardiometabolic dysfunction in first-degree relatives of patients with psychotic disorders

Mothi

Tandon

Padmanabhan

et al. 2015

Schizophrenia Research

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Introduction Elevated prevalence of comorbid cardio-vascular and metabolic dysfunction (CMD) is consistently reported in patients with severe psychotic disorders such as schizophrenia (SZ), schizoaffective (SZA) and bipolar disorder (BP-P). Since both psychosis and CMD are substantively heritable in nature, we attempted to investigate the occurrence of CMD disorders in first degree relatives of probands with psychosis. Methods Our sample included 861 probands with a diagnoses of SZ (n=354), SZA (n=212) and BP-P (n=295), 776 first-degree relatives of probands and 416 healthy controls. Logistic regression was used to compare prevalence of any CMD disorders (diabetes, hypertension, hyperlipidaemia or coronary artery disease) across groups. Post-hoc tests of independence checked for CMD prevalence across psychosis diagnosis (SZ, SZA and BP-P), both in relatives of probands and within probands themselves. Results After controlling for potential confounders, first degree relatives with (p<0.001) and without (p=0.03) Axis I non-psychotic or Axis- II cluster disorders were at a significant risk for CMD compared to controls. No significant difference (p=0.42) was observed in prevalence of CMD between relatives of SZ, SZA and BP-P, or between psychosis diagnoses for probands (p=0.25). Discussion Prevalence of CMD was increased in the first degree relatives of psychosis subjects. This finding suggests the possibility of overlapping genetic contributions to CMD and psychosis. Increased somatic disease burden in relatives of psychotic disorder probands points to need for early detection and preventive efforts in this population.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Increased cardiometabolic dysfunction in first-degree relatives of patients with psychotic disorders

Mothi

Tandon

Padmanabhan

et al. 2015

Schizophrenia Research

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“…Family studies have found an increased risk of type 2 diabetes or abnormal glucose in the first degree relatives of people with NAP (Fernandez-Egea et al, 2008a, 2008b; Mukherjee et al, 1989; Van Welie et al, 2013), suggesting patients with psychosis may have an increased risk of diabetes that exists prior to exposure to antipsychotics, many of which increase the risk of diabetes (American Diabetes Association et al, 2004). Some studies of antipsychotic-naive patients with NAP have also found increased fasting glucose (Ryan et al, 2003) or abnormal glucose tolerance on a glucose tolerance test (Fernandez-Egea et al, 2009), but the results have been inconsistent.…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis of glucose tolerance, insulin, and insulin resistance in antipsychotic-naïve patients with nonaffective psychosis

Greenhalgh

González‐Blanco

García-Rizo

et al. 2017

Schizophrenia Research

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Background Some studies have suggested antipsychotic-naive patients with nonaffective psychosis (NAP) have glucose intolerance. Aims To conduct a systematic review and meta-analysis of fasting glucose (FG), two hour values in the oral glucose tolerance test (2HG), fasting insulin concentration (INS), and insulin resistance (IR). Method We identified possibly relevant studies, then selected studies, following usual guidelines, with two authors reviewing the manuscripts. We required studies to include subjects with nonaffective psychosis and control subjects. Results There were 911 patients and 870 control subjects in the analysis of FG; their average ages were respectively 28.7 and 29.5 years. Significant differences were found for all four variables, with effect size estimates ranging from 0.21 to 0.58. Conclusions As a group, at the time of first clinical contact for psychosis, people with NAP have a slight increase in FG, which most of them maintain in the normal range despite a small increase in IR by secreting additional INS. When faced with a physiological challenge such as a glucose tolerance test or antipsychotics, they are no longer able to maintain a normal glucose concentration.

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“…For example, diabetes represents a significant medical illness among individuals with schizophrenia [15], the prevalence of diabetes being usually increased 2 to 3 fold with them [16]. In effect, the association between schizophrenia and diabetes has been known at least since 1879 [17]. It can be explained by potential cellular and genetic links [18,19] or physical inactivity, poor diet, and cigarette smoking [20,21].…”

Section: Introductionmentioning

confidence: 99%

Recovery-oriented Medical Training: An Informational Rapid Literature Review for the University of Recovery as a New Concept of Co-learning between Patients and (Future) Healthcare Providers

Pelletier¹,

Tourette-Turgis²

2016

J Community Med Health Educ

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Recovery has undoubtedly gained traction throughout the world, and much effort is going into the transformation of mental health policies and systems to achieve recovery-oriented outcomes. There is also a growing argument that emphasizes the interconnectedness of mental and somatic health dimensions, with one dimension affecting the state of the other, and the recovery vision has thus also begun to influence chronic physical illness management. As mental and physical health integration may include colocation, by which the mental health specialist sees patients with various physical health conditions in the same primary care setting, it has been suggested that this colocation could also be conceptual and, in fact, favored by the sharing of a common and global recovery vision for a genuine holistic and person-centered approach. A rapid review of literature was performed to inform the development of a series of workshops to train psychiatry residents and medical students to recovery. Although a plethora of writings exists on ways to transform existing practices to make them more recovery-oriented, not much is known about training techniques meant to inculcate recovery values and principles within the initial training of doctors and other professionals. Through this review, we could not find any faculty of medicine-based class with official institutional credentials specifically and explicitly meant to train future professionals to recovery. The University of Recovery emerged as a new approach to training, not only on recovery, but more importantly for training in recovery. In effect, at the 'with-no-walls' University of Recovery, professors learn from students and conversely through a 'flipped classes' approach by which patients and (future) providers experiment with recovery together, for example, with inversed role plays and other small group techniques of co-learning, as discussed in this paper.

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The prevalence of diabetes mellitus is increased in relatives of patients with a non-affective psychotic disorder

Cited by 28 publications

References 20 publications

Increased cardiometabolic dysfunction in first-degree relatives of patients with psychotic disorders

Increased cardiometabolic dysfunction in first-degree relatives of patients with psychotic disorders

Meta-analysis of glucose tolerance, insulin, and insulin resistance in antipsychotic-naïve patients with nonaffective psychosis

Recovery-oriented Medical Training: An Informational Rapid Literature Review for the University of Recovery as a New Concept of Co-learning between Patients and (Future) Healthcare Providers

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