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Ercis M, Sanchez-Ruiz JA, Webb LM, Solares-Bravo M, Betcher HK, Moore KM, Frye MA, Veldic M, Ozerdem A. Sex differences in effectiveness and adverse effects of mood stabilizers and antipsychotics: A systematic review. J Affect Disord 2024; 352:171-192. [PMID: 38367709 DOI: 10.1016/j.jad.2024.02.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/01/2024] [Accepted: 02/11/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Psychiatric disorders differ in their prevalence, symptom profiles, and disease courses in men and women. However, sex differences in psychiatric disorders have not received enough attention to guide treatment recommendations. This systematic review aims to summarize sex differences in the treatment responses and adverse effects of mood stabilizers and antipsychotics transdiagnostically. METHODS We conducted a systematic review following the PRISMA 2020 statement (CRD42020212478). A literature search was conducted using MEDLINE, Embase, Cochrane Central, PsycINFO, Web of Science Core Collection, and Scopus databases. Studies comparing mood stabilizer or antipsychotic treatment outcomes in men and women were included. JBI critical appraisal checklists were used to assess bias risk. RESULTS Out of 4866 records, 129 reports (14 on mood stabilizers, 115 on antipsychotics) with varying designs were included. Sample sizes ranged from 17 to 22,774 participants (median = 147). The most common psychiatric diagnoses were schizophrenia spectrum (n = 109, 84.5 %) and bipolar disorders (n = 38, 29.5 %). Only four studies explored sex differences in mood stabilizer treatment response. In 40 articles on antipsychotic treatment response, 18 indicated no sex difference, while 16 showed females had better outcomes. Women had more adverse effects with both mood stabilizers and antipsychotics. The risk of bias was low in 84 (65.1 %) of studies. LIMITATIONS Substantial heterogeneity among the studies precluded performing a meta-analysis. CONCLUSION Number of studies focusing on sex differences in treatment outcomes of mood stabilizers is limited. Women may respond better to antipsychotics than men, but also experience more side effects. The impact of pharmacokinetics on sex differences warrants more attention.
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Affiliation(s)
- Mete Ercis
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA; Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | | | - Lauren M Webb
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Hannah K Betcher
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Katherine M Moore
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Marin Veldic
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Aysegul Ozerdem
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
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2
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Zeng K, Wang S, Zhang L, Zhang Y, Ma J. Gender differences in prevalence and associated factors of metabolic syndrome in first-treatment and drug-naïve schizophrenia patients. Ann Gen Psychiatry 2023; 22:25. [PMID: 37381041 DOI: 10.1186/s12991-023-00455-0] [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: 04/05/2023] [Accepted: 06/07/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Metabolic syndromes (MetS) are clinical syndromes involving multiple pathological states with distinct gender-specific clinical patterns. As a serious disorder associated with psychiatric conditions, the prevalence of MetS is significantly higher in the population with schizophrenia (Sch). The aim of this paper is to report gender differences in the prevalence, associated factors and severity-related factors of MetS in first-treatment and drug-naïve (FTDN) patients with Sch. METHODS A total of 668 patients with FTDN Sch were included in this study. We collected socio-demographic and general clinical information on the target population, measured and evaluated common metabolic parameters and routine biochemical indicators, and assessed the severity of psychiatric symptoms using Positive and Negative Symptom Scale (PANSS). RESULTS In the target group, the prevalence of MetS was significantly higher in women (13.44%, 57/424) than in men (6.56%, 16/244). In the males, waist circumference (WC), fasting blood glucose (FBG), diastolic blood pressure (DBP), and triglycerides (TG) were risk factors for MetS, while systolic blood pressure (SBP), TG, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and platelet (PLT) were risk factors for the females. More importantly, for the females, we found that age, LDL-C, PANSS scores and blood creatinine (CRE) were risk factors for higher MetS scores, while onset age and hemoglobin (HGB) were protective factors. CONCLUSION There are significant gender differences in the prevalence of MetS and its factors among patients with FTDN Sch. The prevalence of MetS is higher and the factors that influence MetS are more numerous and extensive in females. The mechanisms of this difference need further research and clinical intervention strategies should be formulated with gender differences.
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Affiliation(s)
- Kuan Zeng
- Department of Psychiatry, Wuhan Mental Health Center, No. 89, Gongnongbing Road, Wuhan, Hubei, China
- Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Shuo Wang
- Department of Psychiatry, Wuhan Mental Health Center, No. 89, Gongnongbing Road, Wuhan, Hubei, China
- Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Lin Zhang
- Department of Psychiatry, Wuhan Mental Health Center, No. 89, Gongnongbing Road, Wuhan, Hubei, China
- Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Yanting Zhang
- Department of Psychiatry, Suzhou Guangji Hospital, No. 11, Guangqian Road, Suzhou, Jiangsu, China.
| | - Jun Ma
- Department of Psychiatry, Wuhan Mental Health Center, No. 89, Gongnongbing Road, Wuhan, Hubei, China.
- Wuhan Hospital for Psychotherapy, Wuhan, China.
- Department of Psychiatry, Renmin Hospital, Wuhan University, Wuhan, China.
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3
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Yan H, Li Y, Li S, Zhou C, Wei S, Li J, Zhang XY. Sex differences in the prevalence and clinical correlates of diabetes in Chinese patients with chronic schizophrenia. Heliyon 2023; 9:e14183. [PMID: 36950609 PMCID: PMC10025886 DOI: 10.1016/j.heliyon.2023.e14183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/12/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023] Open
Abstract
Sex differences have been noted in schizophrenia (SCZ) and diabetes mellitus (DM); however, the effect of sex on SCZ patients with DM remains unknown. We aimed to investigate sex differences in the prevalence, demographic and clinical correlates of DM in Chinese patients with chronic SCZ. A total of 988 Han Chinese SCZ patients (male/female: 638/350) were recruited from two psychiatric hospitals in China. We used the Positive and Negative Syndrome Scale (PANSS) to evaluate the psychopathological symptoms of the patients. In addition, serum glucose and lipid levels were assayed. The prevalence of DM in female patients (57/350, 16.29%) was higher than that in male patients (79/638, 12.38%). Binary logistic regression analyses confirmed that the prevalence of DM in female patients was higher than that in male patients (P < 0.001, OR = 4.62, 95% CI = 2.11-10.11). Moreover, female patients had significantly higher positive symptoms than male patients (P = 0.003, OR = 1.08, 95% CI = 1.03-1.14). Further, higher body mass index (BMI) and higher triglyceride (TG) were significantly associated with DM in men (both P < 0.05). Decreased high density lipoprotein (HDL) was significantly associated with DM in both male and female patients (both P < 0.01). Comorbid DM is more common in female SCZ patients, and there are sex-specific correlates of DM in SCZ.
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Affiliation(s)
- Huiming Yan
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Yanzhe Li
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Shen Li
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Chi Zhou
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Shuochi Wei
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jie Li
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
- Corresponding authorTianjin Anding Hospital, Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China.
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
- Corresponding authorInstitute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.
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4
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Li S, Chen D, Xiu M, Li J, Zhang XY. Prevalence and clinical correlates of impaired glucose tolerance in first-episode versus chronic patients with schizophrenia. Early Interv Psychiatry 2022; 16:985-993. [PMID: 34743408 DOI: 10.1111/eip.13240] [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: 04/15/2021] [Revised: 07/26/2021] [Accepted: 10/19/2021] [Indexed: 11/30/2022]
Abstract
AIM Studies using oral glucose tolerance tests (OGTT) have shown that impaired glucose metabolism presents in the early stages of schizophrenia (SCZ). However, there is a lack of studies on changes in glucose metabolism with the stage of the disease. We first explored the features of glucose metabolic pattern at different phases of male SCZ. METHODS We recruited 83 male first episode drug-naïve patients with SCZ (FEDN-SCZ) and 64 male chronic patients with SCZ (CH-SCZ), as well as 14 male healthy controls. The Positive and Negative Syndrome Scale (PANSS) was used to assess the psychopathology of patients. OGTT, fasting plasma glucose and lipid profiles of all participants were examined. RESULTS While the impaired glucose tolerance (IGT) rate of male SCZ patients was higher than that of HC (P < .05), there was no difference in IGT prevalence between FEDN-SCZ and CH-SCZ. In male FEDN-SCZ, LDL (OR = 2.64, 95% CI = 1.11-6.29, P = .028) and PANSS total score (OR = 1.03, 95% CI = 1.00-1.06, P = .046) were positively correlated with IGT; in male CH-SCZ, BMI (OR = 1.7, 95% CI = 1.08-2.67, P = .023), PANSS total score (OR = 0.82, 95% CI = 0.70-0.96, P = .015) and positive symptoms (OR = 0.45, 95% CI = 0.20-0.99, P = .046) were significantly correlated with IGT. CONCLUSIONS Our findings reflect different glucose metabolism patterns in different stages of SCZ.
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Affiliation(s)
- Shen Li
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Tianjin Medical University, Tianjin, China.,Department of Psychiatry, College of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Dachun Chen
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Meihong Xiu
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Jie Li
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Tianjin Medical University, Tianjin, China
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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5
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Diabetes in late-life schizophrenia: Prevalence, factors, and association with clinical symptoms. J Psychiatr Res 2021; 132:44-49. [PMID: 33038565 DOI: 10.1016/j.jpsychires.2020.09.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 08/25/2020] [Accepted: 09/26/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The prevalence of diabetes mellitus has been found to be higher in patients with schizophrenia. Older patients are the fastest-growing segment of the schizophrenia population. However, few studies have explored diabetes in older patients with schizophrenia. Therefore, this study aimed to determine the prevalence and characteristics of factors associated with diabetes in Chinese patients with late-life schizophrenia (LLS), which has not been reported in previous studies. METHODS A total of 289 inpatients aged 60 or above who met the DSM-IV criteria for schizophrenia were recruited. The severity of psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS). Diabetes was diagnosed by fasting blood glucose tests, or oral glucose tolerance tests. RESULTS The overall prevalence of diabetes in LLS patients was 25.3%. The prevalence of diabetes in female patients was significantly higher than that in male patients (35% vs. 21.53%). Other factors associated with diabetes included higher BMI, greater waistline (only for males), higher levels of triglyceride, and more severe positive symptoms. CONCLUSION These results indicate that the prevalence of diabetes in LLS patients is similar to that in the age-matched general population. Female gender, excess weight and abdominal obesity, dyslipidemia, and clinical symptoms can be potential risk factors of diabetes in the LLS patient group.
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6
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Lai FTT, Guthrie B, Mercer SW, Smith DJ, Yip BHK, Chung GKK, Lee KP, Chung RY, Chau PYK, Wong ELY, Yeoh EK, Wong SYS. Association between antipsychotic use and acute ischemic heart disease in women but not in men: a retrospective cohort study of over one million primary care patients. BMC Med 2020; 18:289. [PMID: 33131494 PMCID: PMC7604971 DOI: 10.1186/s12916-020-01765-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/25/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Research comparing sex differences in the effects of antipsychotic medications on acute ischemic heart disease (IHD) is limited and the findings ambiguous. This study aimed to investigate these associations within a primary care setting. METHODS Hong Kong public general outpatient electronic records of patients aged 45+ during 2007-2010 were extracted, with the last consultation date as the baseline for a 4-year follow-up period to observe acute IHD hospitalizations (2011-2014). Antipsychotic use was defined as any prescription over the previous 12 months from a list of 16 antipsychotics, while acute IHD was defined by ICD-9: 410.00-411.89. Both sex-specific and sex-combined (both sexes) mixed-effects Cox models (random intercept across 74 clinics) were implemented to examine the association and test the interaction between antipsychotics and sex. RESULTS Among 1,043,236 included patients, 17,780 (1.7%) were prescribed antipsychotics, and 8342 (0.8%) developed IHD. In sex-specific analyses, antipsychotic prescription was associated with a 32% increased hazard rate of acute IHD among women (95% CI 1.05-1.67) but not among men. A likelihood ratio test comparing sex-combined models with and without the interaction between antipsychotic use and sex suggested significant interaction (χ2 = 4.72, P = 0.030). The association between antipsychotic use and IHD among women attenuated and became non-significant when haloperidol was omitted from the operationalization of antipsychotic use (HR = 1.23, 95% CI 0.95-1.60). CONCLUSION Our results suggest that antipsychotic prescription is moderately associated with an increased risk of acute IHD among women in primary care and this relationship may be explained by specific antipsychotics. Further research should observe and capture the potential intermediary mechanisms and the dose-response relationship of this association to provide more rigorous evidence to establish causality and inform clinical practices.
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Affiliation(s)
- Francisco T T Lai
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, New Territories, China
| | - Bruce Guthrie
- Usher Institute, The University of Edinburgh, Scotland, UK
| | | | - Daniel J Smith
- Institute of Health & Wellbeing, The University of Glasgow, Scotland, UK
| | - Benjamin H K Yip
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, New Territories, China
| | - Gary K K Chung
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, New Territories, China
| | - Kam-Pui Lee
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, New Territories, China
| | - Roger Y Chung
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, New Territories, China
| | - Patsy Y K Chau
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, New Territories, China
| | - Eliza L Y Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, New Territories, China
| | - Eng-Kiong Yeoh
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, New Territories, China
| | - Samuel Y S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, New Territories, China.
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7
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Huo L, Zhang G, Du XD, Jia Q, Qian ZK, Chen D, Xiu M, Wu F, Soares JC, Huang X, Cassidy RM, Ning Y, Zhang XY. The prevalence, risk factors and clinical correlates of diabetes mellitus in Chinese patients with schizophrenia. Schizophr Res 2020; 218:262-266. [PMID: 31987695 DOI: 10.1016/j.schres.2019.12.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 12/21/2019] [Indexed: 01/19/2023]
Abstract
Diabetes is one of the most common comorbid diseases in patients with schizophrenia. The present study examined the prevalence of diabetes and its clinical correlates in a large sample of Chinese patients with schizophrenia, which has not been examined systemically. In this cross-sectional study, a total of 1189 patients (males/females = 938/251; average age: 48.51 ± 10.09 years) were recruited. Fasting blood samples were collected to diagnose diabetes. Psychiatric symptoms were measured with the Positive and Negative Syndrome Scale (PANSS). The prevalence of diabetes was 12.53% with a significant gender difference (males: 10.87% versus females: 18.73%). Compared to patients without diabetes, those with diabetes were older, had a later age of onset, had a higher BMI, had higher positive symptom scores and had higher level of metabolic indices, including triglyceride, cholesterol and HDL cholesterol. After stepwise binary logistic regression analysis, age, BMI, and triglyceride level remained significantly associated with diabetes. This study suggests that diabetes occur with high prevalence in Chinese schizophrenia patients. In addition, age, BMI, and triglyceride level possibly are useful markers predicting an increased risk for diabetes.
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Affiliation(s)
- Lijuan Huo
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Guangya Zhang
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Xiang-Dong Du
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Qiaqiufang Jia
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Zheng-Kang Qian
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Dachun Chen
- Beijing HuilongGuan Hosptial, Beijing, China
| | - Meihong Xiu
- Beijing HuilongGuan Hosptial, Beijing, China
| | - Fengchun Wu
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Xingbing Huang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Ryan M Cassidy
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Yuping Ning
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China; Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China; Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.
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8
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Ruppert J, Hartung D, Westhoff-Bleck M, Herrmann J, Stubbs B, Cordes J, Krüger THC, Lichtinghagen R, Kahl KG. Increased pericardial adipose tissue and cardiometabolic risk in patients with schizophrenia versus healthy controls. Eur Arch Psychiatry Clin Neurosci 2018; 268:719-725. [PMID: 29170826 DOI: 10.1007/s00406-017-0858-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 11/14/2017] [Indexed: 02/07/2023]
Abstract
Patients with schizophrenia are at increased risk of diabetes, cardiovascular disease (CVD) and associated mortality versus the general population. Increased intra-abdominal and pericardial adipose tissue are associated with elevated CVD and mortality in the general population, but little is known about these in patients with schizophrenia. This study examined pericardial and intra-abdominal adipose tissue in schizophrenia and compared this to healthy controls. Thirty-one patients with schizophrenia (mean age 41.2 years, 76% males) and 30 healthy volunteers (CTRL) were examined in this study. The primary outcomes were the volumes of pericardial adipose tissue and intra-abdominal adipose tissue, measured using magnetic resonance imaging. Secondary outcomes included diabetes and cardiac event risk assessed by established instruments. Volumes of pericardial adipose tissue were increased in male and female patients with schizophrenia compared to healthy controls after the adjustment of age, sex and body mass index (P < 0.005). The 10-year risk of a cardiac event was significantly higher in patients with schizophrenia. Furthermore, the risk for developing type-2 diabetes mellitus was slightly increased in schizophrenia. Volumes of intra-abdominal adipose tissue were slightly increased in male and female patients with schizophrenia, albeit not statistically significant. This study demonstrates that patients with schizophrenia have increased pericardial adipose tissue versus controls. This increased fat deposit around the heart is highly relevant for understanding the comorbidity between heart disease and schizophrenia. Interventions aiming to reduce pericardial and intra-abdominal adipose tissue, such as exercise, may be essential to reduce the burden of heart disease in schizophrenia.
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Affiliation(s)
- J Ruppert
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Carl-Neuberg. Str. 1, 30625, Hannover, Germany
| | - D Hartung
- Institute for Diagnostic and Interventional Radiology, MHH, Hannover, Germany
| | - M Westhoff-Bleck
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - J Herrmann
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Carl-Neuberg. Str. 1, 30625, Hannover, Germany
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK.,Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK
| | - J Cordes
- Department of Psychiatry and Psychotherapy, Heinrich-Heine University, Düsseldorf, Germany
| | - T H C Krüger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Carl-Neuberg. Str. 1, 30625, Hannover, Germany
| | - R Lichtinghagen
- Institute for Clinical Chemistry, Hannover Medical School, Hannover, Germany
| | - K G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Carl-Neuberg. Str. 1, 30625, Hannover, Germany.
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Feng L, Nian S, Zhao Y, Bai X, Luo F, Luo X, Xu W, Ye D, Tong Z. Higher HbA1c and/or glucose levels alter the association patterns between glycated hemoglobin and fasting glucose levels. Diabetes Res Clin Pract 2018; 142:353-362. [PMID: 29936252 DOI: 10.1016/j.diabres.2018.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 05/27/2018] [Accepted: 06/13/2018] [Indexed: 12/11/2022]
Abstract
AIMS To verify the correlations between HbA1c and fasting glucose levels. METHODS A cross-sectional study with 14,249 Chinese subjects. Objective was evaluated in pooled, age-stratified, HbA1c and fasting glucose-stratified populations. RESULTS In pooled populations, the Pearson correlation coefficients (PCCs) of males and females were 0.684 (P < 0.001) and 0.800 (P < 0.001), respectively. HbA1c and fasting glucose maintained significant correlations within the group with HbA1c < 6.5% and glucose <7.0 mmol/L and the group with HbA1c ≥ 6.5% and glucose ≥7.0 mmol/L in both males (PCC: 0.342, P < 0.001; and PCC: 0.765, P < 0.001, respectively) and females (PCC: 0.318, P < 0.001 and PCC: 0.788, P < 0.001, respectively). The slopes increased from the group with HbA1c < 6.5% and glucose <7.0 mmol/L to the group with HbA1c ≥ 6.5% and glucose ≥7.0 mmol/L in both males (0.26-0.44) and females (0.31-0.46). Linear regression analysis showed that fasting glucose and age were two common factors positively associated with HbA1C, and red blood cell count and red cell distribution width were two common factors negatively associated with HbA1c in both males and females with HbA1c < 6.5% and glucose <7.0 mmol/L. The correlations changed dramatically in the groups with HbA1c ≥ 6.5% and glucose <7.0 mmol/L and HbA1c < 6.5% and glucose ≥7.0 mmol/L. CONCLUSIONS High HbA1c and fasting glucose levels greatly altered the associations between HbA1c, glucose and age.
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Affiliation(s)
- Lei Feng
- Department of Laboratory, People's Hospital of Yuxi City, 21 Nieer Road, Yuxi City, Yunnan Province 653100, PR China.
| | - Shiyan Nian
- Intensive Care Unit, People's Hospital of Yuxi City, 21 Nieer Road, Yuxi City, Yunnan Province 653100, PR China.
| | - Yang Zhao
- The Sixth Affiliated Hospital of Kunming Medical University, 21 Nieer Road, Yuxi City, Yunnan Province 653100, PR China
| | - Xuejing Bai
- The Sixth Affiliated Hospital of Kunming Medical University, 21 Nieer Road, Yuxi City, Yunnan Province 653100, PR China
| | - Feng Luo
- The Sixth Affiliated Hospital of Kunming Medical University, 21 Nieer Road, Yuxi City, Yunnan Province 653100, PR China
| | - Xuan Luo
- The Sixth Affiliated Hospital of Kunming Medical University, 21 Nieer Road, Yuxi City, Yunnan Province 653100, PR China
| | - Wenbo Xu
- Department of Laboratory, People's Hospital of Yuxi City, 21 Nieer Road, Yuxi City, Yunnan Province 653100, PR China
| | - Dan Ye
- Department of Laboratory, People's Hospital of Yuxi City, 21 Nieer Road, Yuxi City, Yunnan Province 653100, PR China
| | - Zongwu Tong
- Department of Nephrology, People's Hospital of Yuxi City, 21 Nieer Road, Yuxi City, Yunnan Province 653100, PR China.
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10
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Campesi I, Franconi F, Seghieri G, Meloni M. Sex-gender-related therapeutic approaches for cardiovascular complications associated with diabetes. Pharmacol Res 2017; 119:195-207. [PMID: 28189784 DOI: 10.1016/j.phrs.2017.01.023] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 12/14/2016] [Accepted: 01/23/2017] [Indexed: 12/14/2022]
Abstract
Diabetes is a chronic disease associated with micro- and macrovascular complications and is a well-established risk factor for cardiovascular disease. Cardiovascular complications associated with diabetes are among the most important causes of death in diabetic patients. Interestingly, several sex-gender differences have been reported to significantly impact in the pathophysiology of diabetes. In particular, sex-gender differences have been reported to affect diabetes epidemiology, risk factors, as well as cardiovascular complications associated with diabetes. This suggests that different therapeutic approaches are needed for managing diabetes-associated cardiovascular complications in men and women. In this review, we will discuss about the sex-gender differences that are known to impact on diabetes, mainly focusing on the cardiovascular complications associated with the disease. We will then discuss the therapeutic approaches for managing diabetes-associated cardiovascular complications and how differences in sex-gender can influence the existing therapeutic approaches.
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Affiliation(s)
- Ilaria Campesi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
| | - Flavia Franconi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy; Dipartimento Politiche della Persona, Regione Basilicata, Italy.
| | | | - Marco Meloni
- BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, UK.
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Chen S, Broqueres-You D, Yang G, Wang Z, Li Y, Yang F, Tan Y. Male sex may be associated with higher metabolic risk in first-episode schizophrenia patients: A preliminary study. Asian J Psychiatr 2016; 21:25-30. [PMID: 27208452 DOI: 10.1016/j.ajp.2015.12.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 12/05/2015] [Indexed: 01/09/2023]
Abstract
BACKGROUND High incidence of metabolic syndrome has been evidenced in schizophrenia patients. However, gender-specific relationship with risk of metabolic disorders in first-episode schizophrenia has received poor systematic study. AIM We aimed at exploring the impact of sex difference on the parameters of glucolipid metabolism in first-episode psychosis schizophrenia (FEP) patients. METHODS We performed a post hoc analysis of data from our previously performed clinical trial. A total of 60 FEP patients and 28 healthy sex- and age-matched volunteers were included. Blood glucose and lipid metabolic profiles, as well as schizophrenia-related clinical symptoms were assessed. The body mass index, level of blood insulin and the homeostasis model assessment-insulin resistance index (HOMA-IR) were measured. RESULTS The FEP patients demonstrated significant increases in blood insulin concentration, insulin resistance and blood triglyceride when compared with healthy controls. In FEP patients, there were no differences in psychopathology measurements between the genders. BMI and HOMA-IR were significantly greater in male vs female FEP patients. In addition, a more severe dyslipidemia was also observed in male FEP patients, including an increased triglyceride level, an augmented LDL content and a decreased HDL concentration. Multivariate linear regression analysis demonstrated that the gender was significantly correlated to HOMA-IR. CONCLUSION These preliminary results suggest that male FEP patients may be more predisposed to insulin resistance and dyslipidemia than female FEP patients. These results could contribute to the understanding of prevention and treatment of metabolic syndrome in FEP patients.
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Affiliation(s)
- Song Chen
- Center for Biological Psychiatry, Beijing HuiLongGuan Hospital, Changping District, Beijing, PR China
| | - Dong Broqueres-You
- Center for Biological Psychiatry, Beijing HuiLongGuan Hospital, Changping District, Beijing, PR China
| | - Guigang Yang
- Center for Biological Psychiatry, Beijing HuiLongGuan Hospital, Changping District, Beijing, PR China
| | - Zhiren Wang
- Center for Biological Psychiatry, Beijing HuiLongGuan Hospital, Changping District, Beijing, PR China
| | - Yanli Li
- Center for Biological Psychiatry, Beijing HuiLongGuan Hospital, Changping District, Beijing, PR China
| | - Fude Yang
- Center for Biological Psychiatry, Beijing HuiLongGuan Hospital, Changping District, Beijing, PR China.
| | - Yunlong Tan
- Center for Biological Psychiatry, Beijing HuiLongGuan Hospital, Changping District, Beijing, PR China.
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12
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Zhang BH, Han M, Zhang XY, Hui L, Jiang SR, Yang FD, Tan YL, Wang ZR, Li J, Huang XF. Gender differences in cognitive deficits in schizophrenia with and without diabetes. Compr Psychiatry 2015; 63:1-9. [PMID: 26555485 DOI: 10.1016/j.comppsych.2015.07.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 06/18/2015] [Accepted: 07/09/2015] [Indexed: 01/16/2023] Open
Abstract
This study investigated gender differences in cognition in schizophrenia with and without diabetes. Cognition was assessed in 263 individuals with schizophrenia with age range (40-68): 67 males and 34 females with schizophrenia with diabetes; and 125 males and 37 females with schizophrenia without diabetes according to the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Fasting glucose, hemoglobin A1c (HbA1c) and lipid levels were measured. Results showed that male individuals performed worse on most cognitive tasks, especially attention, in schizophrenia with than without diabetes. This result was not observed in female individuals. Also, individuals of both genders showed higher fasting glucose and HbA1c in schizophrenia with than without diabetes. In schizophrenia with diabetes, males had significantly worse cognition than females in all cognitive domains. Higher HbA1c, lower high-density lipoprotein, and an earlier age of onset of schizophrenia were found in males compared with female individuals. HbA1c was negatively associated with attention and the RBANS total score for males but not for females. In schizophrenia without diabetes, males showed worse performance in immediate and delayed memory than females. This study support cognition was worse for males with schizophrenia irrespective of whether they have diabetes. However, diabetes exemplified the gender differences, especially in attention.
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Affiliation(s)
- Bao Hua Zhang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, PR China; School of Medicine, Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, NSW, Australia
| | - Mei Han
- School of Medicine, Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, NSW, Australia; Schizophrenia Research Institute, Sydney, NSW, Australia
| | - Xiang Yang Zhang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, PR China; Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Li Hui
- Institute of Wenzhou Kangning Mental Health, Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, PR China
| | - Shu Rong Jiang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, PR China
| | - Fu De Yang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, PR China
| | - Yun Long Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, PR China
| | - Zhi Ren Wang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, PR China
| | - Juan Li
- Beijing HuiLongGuan Hospital, Peking University, Beijing, PR China
| | - Xu Feng Huang
- School of Medicine, Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, NSW, Australia; Schizophrenia Research Institute, Sydney, NSW, Australia.
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13
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Xu K, Krystal JH, Ning Y, Chen DC, He H, Wang D, Ke X, Zhang X, Ding Y, Liu Y, Gueorguieva R, Wang Z, Limoncelli D, Pietrzak RH, Petrakis IL, Zhang X, Fan N. Preliminary analysis of positive and negative syndrome scale in ketamine-associated psychosis in comparison with schizophrenia. J Psychiatr Res 2015; 61:64-72. [PMID: 25560772 PMCID: PMC4445679 DOI: 10.1016/j.jpsychires.2014.12.012] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 12/02/2014] [Accepted: 12/11/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Studies of the effects of the N-methyl-d-aspartate (NMDA) glutamate receptor antagonist, ketamine, have suggested similarities to the symptoms of schizophrenia. Our primary goal was to evaluate the dimensions of the Positive and Negative Syndrome Scale (PANSS) in ketamine users (acute and chronic) compared to schizophrenia patients (early and chronic stages). METHOD We conducted exploratory factor analysis for the PANSS from four groups: 135 healthy subject administrated ketamine or saline, 187 inpatients of ketamine abuse; 154 inpatients of early course schizophrenia and 522 inpatients of chronic schizophrenia. Principal component factor analyses were conducted to identify the factor structure of the PANSS. RESULTS Factor analysis yielded five factors for each group: positive, negative, cognitive, depressed, excitement or dissociation symptoms. The symptom dimensions in two schizophrenia groups were consistent with the established five-factor model (Wallwork et al., 2012). The factor structures across four groups were similar, with 19 of 30 symptoms loading on the same factor in at least 3 of 4 groups. The factors in the chronic ketamine group were more similar to the factors in the two schizophrenia groups rather than to the factors in the acute ketamine group. Symptom severities were significantly different across the groups (Kruskal-Wallis χ(2)(4) = 540.6, p < 0.0001). Symptoms in the two ketamine groups were milder than in the two schizophrenia groups (Cohen's d = 0.7). CONCLUSION Our results provide the evidence of similarity in symptom dimensions between ketamine psychosis and schizophrenia psychosis. The interpretations should be cautious because of potential confounding factors.
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Affiliation(s)
- Ke Xu
- Department of Psychiatry, Yale School of Medicine, 300 George St, New Haven, CT, USA,United States Department of Veterans Affairs, VA Connecticut Healthcare System, West Haven, CT, USA
| | - John H. Krystal
- Department of Psychiatry, Yale School of Medicine, 300 George St, New Haven, CT, USA,United States Department of Veterans Affairs, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Yuping Ning
- Guangzhou Brain Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong Province 510370, China
| | - Da Chun Chen
- Biological Psychiatry Center, Beijing Hui-Long-Guan Hospital, Peking University, Beijing 100096, China
| | - Hongbo He
- Guangzhou Brain Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong Province 510370, China
| | - Daping Wang
- Guangzhou Brain Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong Province 510370, China
| | - Xiaoyin Ke
- Guangzhou Brain Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong Province 510370, China
| | - Xifan Zhang
- Guangzhou Baiyun Mental Health Hospital, China
| | - Yi Ding
- Guangzhou Brain Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong Province 510370, China
| | - Yuping Liu
- Guangzhou Brain Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong Province 510370, China
| | - Ralitza Gueorguieva
- Department of Psychiatry, Yale School of Medicine, 300 George St, New Haven, CT, USA,Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Zuoheng Wang
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Diana Limoncelli
- United States Department of Veterans Affairs, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Robert H. Pietrzak
- Department of Psychiatry, Yale School of Medicine, 300 George St, New Haven, CT, USA,United States Department of Veterans Affairs, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Ismene L. Petrakis
- Department of Psychiatry, Yale School of Medicine, 300 George St, New Haven, CT, USA,United States Department of Veterans Affairs, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Xiangyang Zhang
- Biological Psychiatry Center, Beijing Hui-Long-Guan Hospital, Peking University, Beijing 100096, China
| | - Ni Fan
- Guangzhou Brain Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong Province 510370, China.
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Relationship between insulin resistance, dyslipidaemia and positive symptom in Chinese antipsychotic-naive first-episode patients with schizophrenia. Psychiatry Res 2013; 210:825-9. [PMID: 24113122 DOI: 10.1016/j.psychres.2013.08.056] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 05/14/2013] [Accepted: 08/27/2013] [Indexed: 11/23/2022]
Abstract
Controversial results concerning insulin resistance and lipid metabolism have been reported in antipsychotic-naive first-episode psychosis (AN-FEP) patients with schizophrenia of different countries. We aimed at determining whether schizophrenia-related psychopathology was associated with insulin resistance and/or dyslipidaemia in Chinese patients with AN-FEP schizophrenia. A cross-sectional study was performed in Chinese patients newly diagnosed with schizophrenia (n = 49, antipsychotic-naïve or antipsychotic medications< 2 weeks) and healthy volunteers (n = 30). The serum levels of insulin and triglyceride levels as well as homeostasis model of assessment-insulin resistance (HOMA-IR) index were significantly increased in AN-FEP patients, when compared with healthy volunteers. The gender difference had a significant impact on the insulin resistance and dyslipidaemia in these AN-FEP subjects. Multiple linear regression analysis demonstrated that the severity of positive symptoms of schizophrenia was negatively related to insulin resistance. No difference of serum glucose level, total cholesterol content, body mass index (BMI) and smoking status was detected between patients with schizophrenia and healthy controls. In conclusion, Chinese AN-FEP patients were more prone to insulin resistance and dyslipidaemia as compared to the healthy population, which is negatively correlated to positive symptoms. The results may contribute to the understanding of the relationship between the glucose/lipidaemia metabolic dysfunction and the psychopathology in patients with schizophrenia.
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15
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Yang J, Liu X, Liu X, Wang L, Lv H, Yu J, Xun Z, Yang G. Abnormality of glycometabolism related factors in non-psychotic offspring of schizophrenic patients. Psychiatry Res 2012; 198:183-6. [PMID: 22405633 DOI: 10.1016/j.psychres.2011.12.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 09/14/2011] [Accepted: 12/11/2011] [Indexed: 11/15/2022]
Abstract
Schizophrenic patients appear to have higher rates of abnormality of glycometabolism. It has been suggested that these could be secondary to the use of antipsychotics. However, findings indicate that abnormal glucose metabolism may be potentially involved in the pathogenesis of schizophrenia. The present study examined the fasting plasma levels of glycometabolism related factors in healthy offspring of schizophrenic patients. Our objective was to test the hypothesis that abnormal glucose metabolism might be potentially involved in the pathogenesis of schizophrenia. Thirty-two healthy offspring of schizophrenic inpatients who met DSM-IV criteria for schizophrenia and 37 comparison subjects were recruited. Fasting plasma levels of glucose, insulin, insulin-like growth factor 1 (IGF-1), growth hormone (GH), leptin and cortisol were tested for all subjects. Compared with controls, offspring of schizophrenic patients had significantly higher mean plasma insulin and insulin resistance, and lower mean plasma IGF-1 level. Meanwhile, the mean fasting plasma levels of glucose, GH, leptin and cortisol did not differ significantly between offspring of schizophrenic patients and healthy comparison subjects. Offspring of schizophrenic patients showed significant differences from comparison subjects in glycometabolism related factors. Abnormal glucose metabolism might be potentially involved in the pathogenesis of schizophrenia.
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Affiliation(s)
- Jianli Yang
- Tianjin Mental Health Institute, Tianjin Mental Health Center, Tianjin 300222, PR China.
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Ress C, Tschoner A, Kaser S, Ebenbichler CF. [Psychotropic drugs and diabetes]. Wien Med Wochenschr 2011; 161:531-42. [PMID: 21792529 DOI: 10.1007/s10354-011-0004-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Accepted: 06/15/2011] [Indexed: 11/28/2022]
Abstract
Psychotropic drugs, such as antipsychotics and antidepressants, are widely used substances which can display marked metabolic side effects. Psychiatric patients display increased morbidity and mortality which, besides disease specific factors, may be attributed to metabolic side effects of psychotropic drugs. Commonly observed side effects of antipsychotics are weight gain as well as disturbances in glucose and lipid metabolism. Additionally, antipsychotics have been shown to increase diabetes risk. Also, the use of some of the antidepressant substances is associated with an increased diabetes risk. However, large inter-substance variations have been observed. Conversely, diabetics have an increased risk of depression. Metabolic side effects of psychotropic drugs pose a serious impairment for psychiatric patients and their management can play a pivotal role in therapeutic compliance and success. This review aims to give an overview of metabolic side effects of commonly used psychotic drugs and to give an insight into possible underlying mechanisms.
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Affiliation(s)
- Claudia Ress
- Department für Innere Medizin I, Medizinische Universität Innsbruck, Austria
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