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Quadackers D, Liemburg E, Bos F, Doornbos B, Risselada A, Berger M, Visser E, Cath D. Cardiovascular risk assessment methods yield unequal risk predictions: a large cross-sectional study in psychiatric secondary care outpatients. BMC Psychiatry 2023; 23:536. [PMID: 37488548 PMCID: PMC10367364 DOI: 10.1186/s12888-023-05022-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 07/11/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Patients with a mental illness are more likely to develop, and die from, cardiovascular diseases (CVD), necessitating optimal CVD-risk (CVR)-assessment to enable early detection and treatment. Whereas psychiatrists use the metabolic syndrome (MetS)-concept to estimate CVR, GPs use absolute risk-models. Additionally, two PRIMROSE-models have been specifically designed for patients with severe mental illness. We aimed to assess the agreement in risk-outcomes between these CVR-methods. METHODS To compare risk-outcomes across the various CVR-methods, we used somatic information of psychiatric outpatients from the PHAMOUS-, and MOPHAR-database, aged 40-70 years, free of past or current CVD and diabetes. We investigated: (1) the degree-of-agreement between categorical assessments (i.e. MetS-status vs. binary risk-categories); (2) non-parametric correlations between the number of MetS-criteria and absolute risks; and (3) strength-of-agreement between absolute risks. RESULTS Seven thousand twenty-nine measurements of 3509 PHAMOUS-patients, and 748 measurements of 748 MOPHAR-patients, were included. There was systematic disagreement between the categorical CVR-assessments (all p < 0.036). Only MetS-status versus binary Framingham-assessment had a fair strength-of-agreement (κ = 0.23-0.28). The number of MetS-criteria and Framingham-scores, as well as MetS-criteria and PRIMROSE lipid-scores, showed a moderate-strong correlation (τ = 0.25-0.34). Finally, only the continuous PRIMROSE desk and lipid-outcomes showed moderate strength-of-agreement (ρ = 0.91). CONCLUSIONS The varying methods for CVR-assessment yield unequal risk predictions, and, consequently, carry the risk of significant disparities regarding treatment initiation in psychiatric patients. Considering the significantly increased health-risks in psychiatric patients, CVR-models should be recalibrated to the psychiatric population from adolescence onwards, and uniformly implemented by health care providers. TRIAL REGISTRATION The MOPHAR research has been prospectively registered with the Netherlands Trial Register on 19th of November 2014 (NL4779).
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Affiliation(s)
- Davy Quadackers
- Mental Health Services Drenthe, P.O. box 30007, 9400 RA, Assen, The Netherlands.
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Rob Giel Research Center, P.O. box 30.001, 9700 RB, Groningen, The Netherlands.
| | - Edith Liemburg
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Rob Giel Research Center, P.O. box 30.001, 9700 RB, Groningen, The Netherlands
| | - Fionneke Bos
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Rob Giel Research Center, P.O. box 30.001, 9700 RB, Groningen, The Netherlands
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Faculty of Behavioural and Social Sciences, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Bennard Doornbos
- Research Department, Lentis Psychiatric Institute, Hereweg 80, 9725 AG, Groningen, The Netherlands
| | - Arne Risselada
- Department of Clinical Pharmacy, Wilhelmina Hospital, Assen, The Netherlands
| | - Marjolein Berger
- Department of General Practice & Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Ellen Visser
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Rob Giel Research Center, P.O. box 30.001, 9700 RB, Groningen, The Netherlands
| | - Danielle Cath
- Mental Health Services Drenthe, P.O. box 30007, 9400 RA, Assen, The Netherlands
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Rob Giel Research Center, P.O. box 30.001, 9700 RB, Groningen, The Netherlands
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Zhao S, Zhu L, Yang J. Association between depression and macrovascular disease: a mini review. Front Psychiatry 2023; 14:1215173. [PMID: 37457763 PMCID: PMC10344456 DOI: 10.3389/fpsyt.2023.1215173] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023] Open
Abstract
Depression and macrovascular diseases are globally recognized as significant disorders that pose a substantial socioeconomic burden because of their associated disability and mortality. In addition, comorbidities between depression and macrovascular diseases have been widely reported in clinical settings. Patients afflicted with coronary artery disease, cerebrovascular disease or peripheral artery disease exhibit an elevated propensity for depressive symptoms. These symptoms, in turn, augment the risk of macrovascular diseases, thereby reflecting a bidirectional relationship. This review examines the physiological and pathological mechanisms behind comorbidity while also examining the intricate connection between depression and macrovascular diseases. The present mechanisms are significantly impacted by atypical activity in the hypothalamic-pituitary-adrenal axis. Elevated levels of cortisol and other hormones may disrupt normal endothelial cell function, resulting in vascular narrowing. At the same time, proinflammatory cytokines like interleukin-1 and C-reactive protein have been shown to disrupt the normal function of neurons and microglia by affecting blood-brain barrier permeability in the brain, exacerbating depressive symptoms. In addition, platelet hyperactivation or aggregation, endothelial dysfunction, and autonomic nervous system dysfunction are important comorbidity mechanisms. Collectively, these mechanisms provide a plausible physiological basis for the interplay between these two diseases. Interdisciplinary collaboration is crucial for future research aiming to reveal the pathogenesis of comorbidity and develop customised prevention and treatment strategies.
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Affiliation(s)
- Shuwu Zhao
- Department of Anesthesiology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Liping Zhu
- Department of Rehabilitation Medicine, The 3rd Xiangya Hospital, Central South University, Changsha, China
| | - Jinfeng Yang
- Department of Anesthesiology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
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Liu YK, Ling S, Lui LMW, Ceban F, Vinberg M, Kessing LV, Ho RC, Rhee TG, Gill H, Cao B, Mansur RB, Lee Y, Rosenblat J, Teopiz KM, McIntyre RS. Prevalence of type 2 diabetes mellitus, impaired fasting glucose, general obesity, and abdominal obesity in patients with bipolar disorder: A systematic review and meta-analysis. J Affect Disord 2022; 300:449-461. [PMID: 34965395 DOI: 10.1016/j.jad.2021.12.110] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/22/2021] [Accepted: 12/24/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The study herein aimed to assess the prevalence of type 2 diabetes mellitus (T2DM), impaired fasting glucose (IFG), as well as general and abdominal obesity in patients with bipolar disorder (BD). We also compared the prevalence of T2DM and general obesity in patients with BD with age- and gender-matched healthy controls. METHODS A systematic search of Embase, Medline, PubMed, and APA PsycArticles was conducted from inception to June 2021 without language restrictions. Methodological quality was assessed using the Newcastle-Ottawa Scale (NOS) modified for case-control studies. RESULTS A total of forty-nine studies were included in this analysis. The pooled prevalence of T2DM was 9.6% (95% CI, 7.3-12.2%). Patients with BD had a nearly 1.6 times greater risk of developing T2DM compared to their age- and gender-matched controls (RR=1.57, 95% CI 1.36-1.81, p<0.001). In the present analysis, IFG is defined as a fasting plasma glucose (FPG) ≥ 100 mg/dL (FPG≥100) with a prevalence of 22.4% (95% CI, 16.7-28.7%), or as an FPG equal to or greater than 110 mg/d (FPG≥110) with a prevalence of 14.8% (95% CI, 10.8-19.3%). The prevalence of general obesity (BMI≥30 kg/m2) was 29.0% (95% CI, 22.8-35.6%); the risk of obesity was almost twice the rate reported in patients with BD compared to controls (RR=1.67, 95% CI 1.32-2.12, p<0.001). We also observed that more than half of the BD participants had abdominal obesity (i.e., prevalence of 51.1%; 95% CI, 45.0-57.3%). LIMITATIONS A significant degree of heterogeneity was detected. Sources of heterogeneity included differences in study designs, inclusion criteria, measurement tools, and data analysis methods. CONCLUSION Bipolar disorder is associated with a higher prevalence of T2DM, IFG, general obesity, and abdominal obesity. Type 2 diabetes mellitus and obesity are significantly more prevalent in patients with BD than in their age- and gender-matched controls. STUDY REGISTRATION CRD42021258431.
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Affiliation(s)
- Yuhan Karida Liu
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
| | - Susan Ling
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
| | - Leanna M W Lui
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Felicia Ceban
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Maj Vinberg
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Psychiatric Research Unit, Psychiatric Centre North Zealand, Hillerød, Denmark
| | - Lars Vedel Kessing
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Copenhagen, Denmark
| | - Roger C Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
| | - Taeho Greg Rhee
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Hartej Gill
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, PR China
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Joshua Rosenblat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Kayla M Teopiz
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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Varadharajan N, Grover S. Prevalence of risk for obstructive sleep apnea in patients with bipolar disorder. Ind Psychiatry J 2021; 30:285-290. [PMID: 35017813 PMCID: PMC8709523 DOI: 10.4103/ipj.ipj_91_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 12/06/2020] [Accepted: 06/08/2021] [Indexed: 12/03/2022] Open
Abstract
AIM To evaluate the prevalence of risk for obstructive sleep apnea (OSA) among patients with bipolar disorder (BD). METHODOLOGY Eighty-seven patients with BD and 50 matched controls were assessed by using the Berlin questionnaire. RESULTS One-fifth of the patients with BD was found to be at high risk for OSA, compared to the 6% prevalence in the control group. Patients in high risk for OSA were more often females, had significantly higher body mass index, high waist circumference, and comorbid physical illnesses. In terms of pharmacotherapy, there was association of use of antipsychotics with higher risk of OSA at the trend level (p=0.052). CONCLUSION The prevalence of high risk for OSA is significantly higher among patients with BD and higher prevalence is related to obesity and comorbid physical illnesses.
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Affiliation(s)
- Natarajan Varadharajan
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Framingham coronary score in individuals with symptoms or diagnoses of mental disorders: A review and meta-analysis. Psychiatry Res 2018; 263:41-47. [PMID: 29494881 DOI: 10.1016/j.psychres.2018.02.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 02/02/2018] [Accepted: 02/14/2018] [Indexed: 01/07/2023]
Abstract
Patients with mental disorders have a higher coronary morbidity and mortality as compared to the general population. However, it remains unclear whether their coronary risk scores are higher than those of the general population. We reviewed studies and meta-analyze case-control studies about coronary risk scores in individuals with symptoms or diagnoses of mental disorders. Search was performed in Pubmed and clinical trial registration databases. Four case-control studies were identified, comprising 963 individuals with symptoms or diagnoses of mental disorders and 1681 controls. They focused on the most validated coronary risk score, the Framingham Risk Score 1998 (FRS 1998). The mean FRS 1998 was significantly higher in individuals with symptoms or diagnoses of mental disorders than in the general population 7.9( ± 6.9) vs. 5.0( ± 4.8). FRS 1998 differs between individuals with symptoms or diagnoses of mental disorders and controls (Mean difference:1.84 [95% CI:0.57-3.11], p = 0.005]; high heterogeneity was observed (I2= 78%; p < 0.003). The difference was driven by three FRS 1998 criteria: smoking, diabetes and HDL cholesterolemia. The mean FRS 1998 was significantly higher in men, and to a trend in women. In conclusion, individuals with symptoms or diagnoses of mental disorders have a higher coronary risk score than controls. The FRS 1998 should be used as a simple and objective way of monitoring coronary risk in order to improve prevention of coronary events in psychiatric settings.
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Grover S, Nehra R, Thakur A. Bipolar affective disorder and its impact on various aspects of marital relationship. Ind Psychiatry J 2017; 26:114-120. [PMID: 30089956 PMCID: PMC6058431 DOI: 10.4103/ipj.ipj_15_16] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Bipolar disorder (BD) is a severe mental disorder, which not only has negative consequences on the life of the patient, but also affects the immediate family members. As it often starts early in life, patients who get married often suffer from many negative consequences in their marital life due to the illness. This review focuses on studies which have evaluated marital rates, rate of marital failure, divorce, infertility, and procreation among patients with BD. In addition, this review evaluates the existing literature pertaining to marital adjustment, marital satisfaction, sexual dysfunction, and sexual satisfaction among patients with BD and their partners/spouses. Data suggest that very high proportion of patients with BD get married and marital rates are higher for patients with BD, when compared with those suffering from schizophrenia. In terms of divorce rates, studies suggest that patients with BD have higher rates of divorce. In terms of fertility rates, studies suggest that compared to those without the illness, the fertility rates among patients with BD are lower. In terms of marital adjustment, results are mixed with some studies suggesting poorer marital adjustment among patients and their spouses too. In terms of sexual dysfunction, studies suggest the presence of sexual dysfunction among one-third to half of the patients receiving lithium. To conclude, this review suggests that patients with BD experience multiple negative marital and sexual consequences.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ritu Nehra
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anita Thakur
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Kumar A, Narayanaswamy JC, Venkatasubramanian G, Raguram R, Grover S, Aswath M. Prevalence of metabolic syndrome and its clinical correlates among patients with bipolar disorder. Asian J Psychiatr 2017; 26:109-114. [PMID: 28483070 DOI: 10.1016/j.ajp.2017.01.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 01/10/2017] [Accepted: 01/16/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To assess the prevalence of metabolic syndrome (MetS) in patients with bipolar disorder (BD) and examine the clinical correlates of MetS. METHODS Sixty-seven patients with BD were evaluated for presence for MetS. The consensus definition was used to define MetS. The clinical variables were recorded on the basis of information provided by the patients, accompanying caregivers and review of treatment records. The symptoms severity of present depressive and manic episode was assessed by using Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS) respectively. RESULTS The prevalence of MetS was 53.7%. Patients with MetS were older than the patients with BD alone (P=0.001). Increased waist circumference was the most common abnormal parameter (74.6%) followed by low high density lipoprotein (HDL) (71.6%) and raised triglycerides (64.2%). High blood pressures were recorded in 35.8% with high fasting blood glucose levels were seen in 33.3%. MetS was associated with greater number of life time episodes (p=0.010), longer duration of illness (p=0.010), greater numbers of lifetime depressive episodes (p<0.001). Substance use (alcohol and nicotine) associated with significantly higher prevalence of high blood pressure among MetS patients (p<0.001) while abnormal triglyceride level shown associated with substance use (p=0.010). Age of the patients, number of lifetime depressive episodes and use of Olanzapine were found to predictive of the development of MetS. CONCLUSIONS Patients with BD have high prevalence of MetS and its presence correlates with clinical variables.
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Affiliation(s)
- Ajay Kumar
- Department of Psychiatry, PGIMER, Chandigarh, India.
| | | | | | - R Raguram
- Kempegowda Institute of Medical Sciences (KIMS), Bangalore, India.
| | | | - Manju Aswath
- Kempegowda Institute of Medical Sciences (KIMS), Bangalore, India.
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Foguet-Boreu Q, Fernandez San Martin MI, Flores Mateo G, Zabaleta Del Olmo E, Ayerbe García-Morzon L, Perez-Piñar López M, Martin-López LM, Montes Hidalgo J, Violán C. Cardiovascular risk assessment in patients with a severe mental illness: a systematic review and meta-analysis. BMC Psychiatry 2016; 16:141. [PMID: 27176477 PMCID: PMC4866037 DOI: 10.1186/s12888-016-0833-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 04/25/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Cardiovascular risk (CVR) has been observed to be higher in patients with severe mental illness (SMI) than in the general population. However, some studies suggest that CVR is not equally increased in different subgroups of SMI. The purposes of this review are to summarise CVR scores of SMI patients and to determine the differences in CVR between patients with different SMIs and between SMI patients and the control-population. METHODS MEDLINE (via PubMed) was searched for literature published through August 28, 2014, followed by a snowball search in the Web of Science. Observational and experimental studies that reported CVR assessments in SMI patients using validated tools were included. The risk of bias was reported using STROBE and CONSORT criteria. Pooled continuous data were expressed as standardized mean differences (SMD) with 95% confidence intervals (CI). Two reviewers independently selected studies, extracted data and assessed methodological quality. RESULTS A total of 3,608 articles were identified, of which 67 full text papers were assessed for eligibility and 35 were finally included in our review, in which 12,179 psychiatric patients and 225,951 comparative patients had been assessed. The most frequent diagnoses were schizophrenia and related diagnoses (45.7%), depressive disorders (14.7%), SMI (11.4%) and bipolar disorders (8.6%). The most frequent CVR assessment tool used was the Framingham risk score. Subgroups analysis showed a higher CVR in schizophrenia than in depressive disorder or in studies that included patients with multiple psychiatric diagnoses (SMD: 0.63, 0.03, and 0.02, respectively). Six studies were included in the meta-analysis. Total overall CVR did not differ between SMI patients and controls (SMD: 0.35 [95% CI:-0.02 to 0.71], p = 0.06); high heterogeneity was observed (I (2) = 93%; p < 0.001). CONCLUSIONS The summary of results from studies that assessed CVR using validated tools in SMI patients did not find sufficient data (except for limited evidence associated with schizophrenia) to permit any clear conclusions about increased CVR in this group of patients compared to the general population. The systematic review is registered in PROSPERO CRD42013003898 .
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Affiliation(s)
- Quintí Foguet-Boreu
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Universitat Autònoma de Barcelona, Gran Via Corts Catalanes, 587 àtic, 08007, Barcelona, Spain.
- Department of Medical Sciences, School of Medicine, University of Girona, Emili Grahit, 77, 17071, Girona, Spain.
| | - Maria Isabel Fernandez San Martin
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Universitat Autònoma de Barcelona, Gran Via Corts Catalanes, 587 àtic, 08007, Barcelona, Spain
- Técnica de Salud ICS, Unitat Docent AFiC, Sardenya, 375, Entl., 08025, Barcelona, Spain
| | - Gemma Flores Mateo
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Universitat Autònoma de Barcelona, Gran Via Corts Catalanes, 587 àtic, 08007, Barcelona, Spain
| | - Edurne Zabaleta Del Olmo
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Universitat Autònoma de Barcelona, Gran Via Corts Catalanes, 587 àtic, 08007, Barcelona, Spain
- Faculty of Nursing, University of Girona, Emili Grahit, 77, 17071, Girona, Spain
| | - Luís Ayerbe García-Morzon
- The Westborough Road Health Centre, 258 Westborough Road, Westcliff-on-Sea, SS0 9PT, United Kingdom
- Centre of Primary Care and Public Health, Queen Mary University of London, Yvone Carter Building 58 Tuner Street, E1 2AB, London, United Kingdom
| | - Maria Perez-Piñar López
- The Westborough Road Health Centre, 258 Westborough Road, Westcliff-on-Sea, SS0 9PT, United Kingdom
| | - Luis Miguel Martin-López
- Departamento de Psiquiatría y Medicina Legal, Instituto de Neuropsiquiatría y Adicciones (INAD), Hospital del Mar Parc de Salut Mar., Universidad Autónoma de Barcelona, Passeig Marítim 25-29, 08003, Barcelona, Spain
| | - Javier Montes Hidalgo
- Gimbernat School of Nursing, Universitat Autònoma de Barcelona, Avinguda de la Generalitat, 202-206, Sant Cugat del Vallès, 08174, Barcelona, Spain
| | - Concepción Violán
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Universitat Autònoma de Barcelona, Gran Via Corts Catalanes, 587 àtic, 08007, Barcelona, Spain
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Grover S, Nebhinani N, Chakrabarti S, Avasthi A, Basu D, Kulhara P, Mattoo SK, Malhotra S. Cardiac risk factors and metabolic syndrome in patients with schizophrenia admitted to a general hospital psychiatric unit. Indian J Psychiatry 2014; 56:371-6. [PMID: 25568478 PMCID: PMC4279295 DOI: 10.4103/0019-5545.146520] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE The study aimed to evaluate the prevalence of cardiovascular risk (CVR) factors and metabolic syndrome (MS) in patients with schizophrenia. MATERIALS AND METHODS By consecutive sampling, 143 patients (of age ≥ 20 years), out of total 159 patients with schizophrenia admitted to the inpatient unit were evaluated for the coronary heart disease (CHD) risk as per Framingham (10-year all CHD events) function/risk equation and systematic coronary risk evaluation (SCORE) - 10-year cardiovascular mortality risk (CMR). Prevalence of MS was estimated by using the consensus definition. RESULTS Fifty-two (36.4%) patients fulfilled the criteria for MS. 10-year CHD risk was 1.65%, and 10-year CMR was 1.39%. Compared to females, males had higher Framingham score (1.96 ± 2.74 vs. 1.09 ± 0.41, U value 1987.5*, P < 0.05). CONCLUSION Patients of schizophrenia have a high prevalence of MS and CVR factors. Hence, there is a need to screen the patient of schizophrenia for the same and manage the same as early as possible during the course of illness.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | | | - Subho Chakrabarti
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Ajit Avasthi
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Debasish Basu
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Parmanand Kulhara
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Surendra Kumar Mattoo
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Savita Malhotra
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
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