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Høgnason Mohr G, Barcella CA, Grand MK, Kriegbaum M, Siersma V, Hahn MK, Agarwal SM, Bakkedal C, Baandrup L, Knop FK, Andersen CL, Ebdrup BH. Management of dyslipidaemia in individuals with severe mental illness: a population-based study in the Greater Copenhagen Area. Ther Adv Psychopharmacol 2023; 13:20451253231211574. [PMID: 38022836 PMCID: PMC10656803 DOI: 10.1177/20451253231211574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 09/23/2023] [Indexed: 12/01/2023] Open
Abstract
Background Severe mental illness (SMI) is associated with increased cardiovascular risk. Dyslipidaemia is a potentially modifiable risk factor, which may be inadequately managed in patients with SMI. Objectives To assess management of dyslipidaemia in patients with SMI versus healthy controls (HCs) in 2005 and 2015. Design and methods Using Danish registers, we identified adult patients with SMI in the Greater Copenhagen Area (schizophrenia spectrum disorders or bipolar disorder) with ⩾1 general practitioner contact in the year before 2005 and 2015, respectively, and HCs without SMI matched on age and gender (1:5). Outcomes were lipid-profile measurements, presence of dyslipidaemia and redemption of lipid-lowering pharmacotherapy. Differences in outcomes between patients with SMI and controls were measured with multivariable logistic regression. Results We identified 7217 patients with SMI in 2005 and 9939 in 2015. After 10 years, patients went from having lower odds of lipid measurements to having higher odds of lipid measurements compared with HCs [odds ratio (OR)2005 0.70 (99% confidence interval (CI) 0.63-0.78) versus OR2015 1.34 (99% CI 1.24-1.44); p2005versus2015 < 0.01]. Patients had higher odds of dyslipidaemia during both years [OR2005 1.43 (99% CI 1.10-1.85) and OR2015 1.23 (99% CI 1.08-1.41)]. Patients went from having lower odds of receiving lipid-lowering pharmacotherapy to having higher odds of receiving lipid-lowering pharmacotherapy [OR2005 0.77 (99% CI 0.66-0.89) versus OR2015 1.37 (99% CI 1.24-1.51); p2005versus2015 < 0.01]. However, among persons at high cardiovascular risk, patients had lower odds of receiving lipid-lowering pharmacotherapy during both years, including subsets with previous acute coronary syndrome [OR2005 0.30 (99% CI 0.15-0.59) and OR2015 0.44 (99% CI 0.24-0.83)] and ischaemic stroke or transient ischaemic attack (TIA) [OR2005 0.43 (99% CI 0.26-0.69) and OR 2015 0.61 (99% CI 0.41-0.89)]. Conclusion These results imply an increased general awareness of managing dyslipidaemia among patients with SMI in the primary prophylaxis of cardiovascular disease. However, secondary prevention with lipid-lowering drugs in patients with SMI at high cardiovascular risk may be lacking.
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Affiliation(s)
- Grimur Høgnason Mohr
- Center for Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Nordstjernevej 41, 2600 Glostrup, Denmark
| | - Carlo Alberto Barcella
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, University of Copenhagen, Hellerup, Denmark
- Department of Internal Medicine, Nykøbing Falster Hospital, Nykøbing Falster, Denmark
| | - Mia Klinten Grand
- Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Margit Kriegbaum
- Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Volkert Siersma
- Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Margaret K. Hahn
- Center for Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Sri Mahavir Agarwal
- Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Catrine Bakkedal
- Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lone Baandrup
- Center for Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Mental Health Centre Copenhagen, Bispebjerg-Gentofte, Copenhagen NV, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Filip Krag Knop
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Christen Lykkegaard Andersen
- Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Hematology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Bjørn Hylsebeck Ebdrup
- Center for Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Rødevand L, Rahman Z, Hindley GFL, Smeland OB, Frei O, Tekin TF, Kutrolli G, Bahrami S, Hoseth EZ, Shadrin A, Lin A, Djurovic S, Dale AM, Steen NE, Andreassen OA. Characterizing the Shared Genetic Underpinnings of Schizophrenia and Cardiovascular Disease Risk Factors. Am J Psychiatry 2023; 180:815-826. [PMID: 37752828 DOI: 10.1176/appi.ajp.20220660] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
OBJECTIVE Schizophrenia is associated with increased risk of cardiovascular disease (CVD), although there is variation in risk among individuals. There are indications of shared genetic etiology between schizophrenia and CVD, but the nature of the overlap remains unclear. The aim of this study was to fill this gap in knowledge. METHODS Overlapping genetic architectures between schizophrenia and CVD risk factors were assessed by analyzing recent genome-wide association study (GWAS) results. The bivariate causal mixture model (MiXeR) was applied to estimate the number of shared variants and the conjunctional false discovery rate (conjFDR) approach was used to pinpoint specific shared loci. RESULTS Extensive genetic overlap was found between schizophrenia and CVD risk factors, particularly smoking initiation (N=8.6K variants) and body mass index (BMI) (N=8.1K variants). Several specific shared loci were detected between schizophrenia and BMI (N=304), waist-to-hip ratio (N=193), smoking initiation (N=293), systolic (N=294) and diastolic (N=259) blood pressure, type 2 diabetes (N=147), lipids (N=471), and coronary artery disease (N=35). The schizophrenia risk loci shared with smoking initiation had mainly concordant effect directions, and the risk loci shared with BMI had mainly opposite effect directions. The overlapping loci with lipids, blood pressure, waist-to-hip ratio, type 2 diabetes, and coronary artery disease had mixed effect directions. Functional analyses implicated mapped genes that are expressed in brain tissue and immune cells. CONCLUSIONS These findings indicate a genetic propensity to smoking and a reduced genetic risk of obesity among individuals with schizophrenia. The bidirectional effects of the shared loci with the other CVD risk factors may imply differences in genetic liability to CVD across schizophrenia subgroups, possibly underlying the variation in CVD comorbidity.
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Affiliation(s)
- Linn Rødevand
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo (Rødevand, Rahman, Hindley, Smeland, Frei, Tekin, Kutrolli, Bahrami, Hoseth, Shadrin, Lin, Steen, Andreassen); Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Hindley); Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo (Frei); Division of Mental Health, Helse Møre Romsdal HF, Kristiansund, Norway (Hoseth); Department of Medical Genetics, Oslo University Hospital, Oslo, and NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway (Djurovic); Multimodal Imaging Laboratory and Departments of Radiology, Psychiatry, and Neurosciences, University of California San Diego, La Jolla (Dale)
| | - Zillur Rahman
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo (Rødevand, Rahman, Hindley, Smeland, Frei, Tekin, Kutrolli, Bahrami, Hoseth, Shadrin, Lin, Steen, Andreassen); Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Hindley); Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo (Frei); Division of Mental Health, Helse Møre Romsdal HF, Kristiansund, Norway (Hoseth); Department of Medical Genetics, Oslo University Hospital, Oslo, and NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway (Djurovic); Multimodal Imaging Laboratory and Departments of Radiology, Psychiatry, and Neurosciences, University of California San Diego, La Jolla (Dale)
| | - Guy F L Hindley
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo (Rødevand, Rahman, Hindley, Smeland, Frei, Tekin, Kutrolli, Bahrami, Hoseth, Shadrin, Lin, Steen, Andreassen); Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Hindley); Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo (Frei); Division of Mental Health, Helse Møre Romsdal HF, Kristiansund, Norway (Hoseth); Department of Medical Genetics, Oslo University Hospital, Oslo, and NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway (Djurovic); Multimodal Imaging Laboratory and Departments of Radiology, Psychiatry, and Neurosciences, University of California San Diego, La Jolla (Dale)
| | - Olav B Smeland
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo (Rødevand, Rahman, Hindley, Smeland, Frei, Tekin, Kutrolli, Bahrami, Hoseth, Shadrin, Lin, Steen, Andreassen); Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Hindley); Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo (Frei); Division of Mental Health, Helse Møre Romsdal HF, Kristiansund, Norway (Hoseth); Department of Medical Genetics, Oslo University Hospital, Oslo, and NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway (Djurovic); Multimodal Imaging Laboratory and Departments of Radiology, Psychiatry, and Neurosciences, University of California San Diego, La Jolla (Dale)
| | - Oleksandr Frei
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo (Rødevand, Rahman, Hindley, Smeland, Frei, Tekin, Kutrolli, Bahrami, Hoseth, Shadrin, Lin, Steen, Andreassen); Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Hindley); Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo (Frei); Division of Mental Health, Helse Møre Romsdal HF, Kristiansund, Norway (Hoseth); Department of Medical Genetics, Oslo University Hospital, Oslo, and NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway (Djurovic); Multimodal Imaging Laboratory and Departments of Radiology, Psychiatry, and Neurosciences, University of California San Diego, La Jolla (Dale)
| | - Tahir Filiz Tekin
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo (Rødevand, Rahman, Hindley, Smeland, Frei, Tekin, Kutrolli, Bahrami, Hoseth, Shadrin, Lin, Steen, Andreassen); Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Hindley); Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo (Frei); Division of Mental Health, Helse Møre Romsdal HF, Kristiansund, Norway (Hoseth); Department of Medical Genetics, Oslo University Hospital, Oslo, and NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway (Djurovic); Multimodal Imaging Laboratory and Departments of Radiology, Psychiatry, and Neurosciences, University of California San Diego, La Jolla (Dale)
| | - Gleda Kutrolli
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo (Rødevand, Rahman, Hindley, Smeland, Frei, Tekin, Kutrolli, Bahrami, Hoseth, Shadrin, Lin, Steen, Andreassen); Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Hindley); Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo (Frei); Division of Mental Health, Helse Møre Romsdal HF, Kristiansund, Norway (Hoseth); Department of Medical Genetics, Oslo University Hospital, Oslo, and NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway (Djurovic); Multimodal Imaging Laboratory and Departments of Radiology, Psychiatry, and Neurosciences, University of California San Diego, La Jolla (Dale)
| | - Shahram Bahrami
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo (Rødevand, Rahman, Hindley, Smeland, Frei, Tekin, Kutrolli, Bahrami, Hoseth, Shadrin, Lin, Steen, Andreassen); Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Hindley); Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo (Frei); Division of Mental Health, Helse Møre Romsdal HF, Kristiansund, Norway (Hoseth); Department of Medical Genetics, Oslo University Hospital, Oslo, and NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway (Djurovic); Multimodal Imaging Laboratory and Departments of Radiology, Psychiatry, and Neurosciences, University of California San Diego, La Jolla (Dale)
| | - Eva Z Hoseth
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo (Rødevand, Rahman, Hindley, Smeland, Frei, Tekin, Kutrolli, Bahrami, Hoseth, Shadrin, Lin, Steen, Andreassen); Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Hindley); Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo (Frei); Division of Mental Health, Helse Møre Romsdal HF, Kristiansund, Norway (Hoseth); Department of Medical Genetics, Oslo University Hospital, Oslo, and NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway (Djurovic); Multimodal Imaging Laboratory and Departments of Radiology, Psychiatry, and Neurosciences, University of California San Diego, La Jolla (Dale)
| | - Alexey Shadrin
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo (Rødevand, Rahman, Hindley, Smeland, Frei, Tekin, Kutrolli, Bahrami, Hoseth, Shadrin, Lin, Steen, Andreassen); Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Hindley); Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo (Frei); Division of Mental Health, Helse Møre Romsdal HF, Kristiansund, Norway (Hoseth); Department of Medical Genetics, Oslo University Hospital, Oslo, and NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway (Djurovic); Multimodal Imaging Laboratory and Departments of Radiology, Psychiatry, and Neurosciences, University of California San Diego, La Jolla (Dale)
| | - Aihua Lin
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo (Rødevand, Rahman, Hindley, Smeland, Frei, Tekin, Kutrolli, Bahrami, Hoseth, Shadrin, Lin, Steen, Andreassen); Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Hindley); Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo (Frei); Division of Mental Health, Helse Møre Romsdal HF, Kristiansund, Norway (Hoseth); Department of Medical Genetics, Oslo University Hospital, Oslo, and NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway (Djurovic); Multimodal Imaging Laboratory and Departments of Radiology, Psychiatry, and Neurosciences, University of California San Diego, La Jolla (Dale)
| | - Srdjan Djurovic
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo (Rødevand, Rahman, Hindley, Smeland, Frei, Tekin, Kutrolli, Bahrami, Hoseth, Shadrin, Lin, Steen, Andreassen); Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Hindley); Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo (Frei); Division of Mental Health, Helse Møre Romsdal HF, Kristiansund, Norway (Hoseth); Department of Medical Genetics, Oslo University Hospital, Oslo, and NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway (Djurovic); Multimodal Imaging Laboratory and Departments of Radiology, Psychiatry, and Neurosciences, University of California San Diego, La Jolla (Dale)
| | - Anders M Dale
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo (Rødevand, Rahman, Hindley, Smeland, Frei, Tekin, Kutrolli, Bahrami, Hoseth, Shadrin, Lin, Steen, Andreassen); Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Hindley); Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo (Frei); Division of Mental Health, Helse Møre Romsdal HF, Kristiansund, Norway (Hoseth); Department of Medical Genetics, Oslo University Hospital, Oslo, and NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway (Djurovic); Multimodal Imaging Laboratory and Departments of Radiology, Psychiatry, and Neurosciences, University of California San Diego, La Jolla (Dale)
| | - Nils Eiel Steen
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo (Rødevand, Rahman, Hindley, Smeland, Frei, Tekin, Kutrolli, Bahrami, Hoseth, Shadrin, Lin, Steen, Andreassen); Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Hindley); Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo (Frei); Division of Mental Health, Helse Møre Romsdal HF, Kristiansund, Norway (Hoseth); Department of Medical Genetics, Oslo University Hospital, Oslo, and NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway (Djurovic); Multimodal Imaging Laboratory and Departments of Radiology, Psychiatry, and Neurosciences, University of California San Diego, La Jolla (Dale)
| | - Ole A Andreassen
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo (Rødevand, Rahman, Hindley, Smeland, Frei, Tekin, Kutrolli, Bahrami, Hoseth, Shadrin, Lin, Steen, Andreassen); Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Hindley); Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo (Frei); Division of Mental Health, Helse Møre Romsdal HF, Kristiansund, Norway (Hoseth); Department of Medical Genetics, Oslo University Hospital, Oslo, and NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway (Djurovic); Multimodal Imaging Laboratory and Departments of Radiology, Psychiatry, and Neurosciences, University of California San Diego, La Jolla (Dale)
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Lunding SH, Ueland T, Aas M, Høegh MC, Werner MCF, Rødevand L, Johansen IT, Hjell G, Ormerod MBEG, Ringen PA, Ottesen A, Lagerberg TV, Melle I, Andreassen OA, Simonsen C, Steen NE. Tobacco smoking related to childhood trauma mediated by cognitive control and impulsiveness in severe mental disorders. Schizophr Res 2023; 261:236-244. [PMID: 37806047 DOI: 10.1016/j.schres.2023.09.041] [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: 05/12/2022] [Revised: 05/26/2023] [Accepted: 09/24/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND People with severe mental disorders (SMDs) show an increased prevalence of tobacco smoking compared to the general population. Tobacco smoking and other adult adverse health behaviors have been associated with traumatic experiences in childhood. In the present study we investigated the relationship between childhood trauma and tobacco smoking in people with SMDs, including the possible mediating role of cognitive- and personality characteristics, i.e. cognitive control, impulsiveness, affective lability and self-esteem. METHODS Enrolled in the study were 871 participants with schizophrenia (SCZ, N = 484) and bipolar (BD, N = 387) spectrum disorders. We assessed tobacco smoking behavior (yes/no and amount), and history of childhood trauma with the Childhood Trauma Questionnaire. Data on cognitive control, impulsiveness, affective lability, and self-esteem were available in subsamples. We performed linear and logistic regressions, and conducted mediation analyses in PROCESS. All analyses were as standard adjusted for age, sex, and diagnostic group. RESULTS Experience of one or more subtypes of childhood trauma was significantly associated with smoking tobacco in SMDs (p = 0.002). There were no significant associations between childhood trauma and amount of tobacco smoking. Cognitive control and impulsiveness were significant mediators between childhood trauma and tobacco smoking. CONCLUSIONS These findings indicate the experience of childhood trauma as a predisposing factor for tobacco smoking in SMDs. Cognitive control and impulsiveness were suggested as mediating mechanisms, indicating the importance of considering inhibition related self-regulatory aspects in efforts to improve health behavior in individuals with SMDs and childhood trauma.
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Affiliation(s)
- Synve Hoffart Lunding
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Torill Ueland
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway
| | - Monica Aas
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Margrethe Collier Høegh
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Maren Caroline Frogner Werner
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Linn Rødevand
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Torp Johansen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gabriela Hjell
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatry, Ostfold Hospital, Graalum, Norway
| | | | - Petter Andreas Ringen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Akiah Ottesen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Trine Vik Lagerberg
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Melle
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Carmen Simonsen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Early Intervention in Psychosis Advisory Unit for South East Norway, Oslo University Hospital, Oslo, Norway
| | - Nils Eiel Steen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Højstrup S, Thomsen JH, Prescott E. Disparities in cardiovascular disease and treatment in the Nordic countries. THE LANCET REGIONAL HEALTH. EUROPE 2023; 33:100699. [PMID: 37953994 PMCID: PMC10636266 DOI: 10.1016/j.lanepe.2023.100699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/27/2023] [Accepted: 07/10/2023] [Indexed: 11/14/2023]
Abstract
The Nordic countries, including Denmark, Finland, Iceland, Norway, and Sweden have seen a steep decline in cardiovascular mortality in recent decades. They are among the most egalitarian countries by several measures, and all have universal, publicly funded welfare systems providing healthcare for all citizens. However, despite these seemingly ideal conditions, disparities in access to cardiovascular care and outcomes persist. To address this challenge, The Lancet Region Health-Europe convened experts from a broad range of countries to summarize the current state of knowledge on cardiovascular disease disparities across Europe. This Series Paper presents the main challenges in Nordic countries based on evidence from high-quality nationwide registries. Focusing on major cardiovascular health determinants, areas in need of improvement were identified. There is a need for addressing structural causes underlying these disparities, such as poverty and discrimination, but also to improve access to healthcare in deprived neighborhoods and to address underlying social determinants of health that may mitigate disparities in cardiovascular outcomes. Overall, while the Nordic countries have made great strides in promoting egalitarianism and providing universal healthcare, there is still much work to be done to ensure equitable access to care and improved cardiovascular outcomes for all members of society.
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Affiliation(s)
- Signe Højstrup
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Jakob Hartvig Thomsen
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Eva Prescott
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
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Noortman L, de Winter L, van Voorst A, Cahn W, Deenik J. Screening and prevalence of cardiometabolic risk factors in patients with severe mental illness: A multicenter cross-sectional cohort study in the Netherlands. Compr Psychiatry 2023; 126:152406. [PMID: 37506537 DOI: 10.1016/j.comppsych.2023.152406] [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: 04/25/2023] [Revised: 07/13/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Due to increased cardiometabolic risks and premature mortality in people with severe mental illness (SMI), monitoring cardiometabolic health is considered essential. We aimed to analyse screening rates and prevalences of cardiometabolic risks in routine mental healthcare and its associations with patient and disease characteristics. METHODS We collected screening data in SMI from three mental healthcare institutions in the Netherlands, using most complete data on the five main metabolic syndrome (MetS) criteria (waist circumference, blood pressure, HDL-cholesterol, triglycerides, fasting blood glucose) within a 30-day timeframe in 2019/2020. We determined screened patients' cardiometabolic risks and analysed associations with patient and disease characteristics using multiple logistic regression. RESULTS In 5037 patients, screening rates ranged from 28.8% (waist circumference) to 76.4% (fasting blood glucose) within 2019-2020, and 7.6% had a complete measurement of all five MetS criteria. Older patients, men and patients with psychotic disorders had higher odds of being screened. Without regarding medication use, risk prevalences ranged from 29.6% (fasting blood glucose) to 56.8% (blood pressure), and 48.6% had MetS. Gender and age were particularly associated with odds for individual risk factors. Cardiometabolic risk was present regardless of illness severity and did generally not differ substantially between diagnoses, in-/outpatients and institutions. CONCLUSIONS Despite increased urgency and guideline development for cardiometabolic health in SMI last decades, screening rates are still low, and the MetS prevalence across screened patients is almost twice that of the general population. More intensive implementation strategies are needed to translate policies into action to improve cardiometabolic health in SMI.
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Affiliation(s)
- Laurien Noortman
- GGz Centraal, Amersfoort, the Netherlands; Faculty of Medicine, Utrecht University, Utrecht, the Netherlands
| | - Lars de Winter
- Phrenos Center of Expertise for Severe Mental Illnesses, Utrecht, the Netherlands
| | | | - Wiepke Cahn
- University Medical Centre Utrecht, Utrecht, the Netherlands; Altrecht, Utrecht, the Netherlands
| | - Jeroen Deenik
- GGz Centraal, Amersfoort, the Netherlands; School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.
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Robinson DJ, Hanson K, Jain AB, Kichler JC, Mehta G, Melamed OC, Vallis M, Bajaj HS, Barnes T, Gilbert J, Honshorst K, Houlden R, Kim J, Lewis J, MacDonald B, MacKay D, Mansell K, Rabi D, Sherifali D, Senior P. Diabetes and Mental Health. Can J Diabetes 2023; 47:308-344. [PMID: 37321702 DOI: 10.1016/j.jcjd.2023.04.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
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7
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Reponen EJ, Ueland T, Rokicki J, Bettella F, Aas M, Werner MCF, Dieset I, Steen NE, Andreassen OA, Tesli M. Polygenic risk for schizophrenia and bipolar disorder in relation to cardiovascular biomarkers. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01591-0. [PMID: 37145175 DOI: 10.1007/s00406-023-01591-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 02/20/2023] [Indexed: 05/06/2023]
Abstract
Individuals with schizophrenia and bipolar disorder are at an increased risk of cardiovascular disease (CVD), and a range of biomarkers related to CVD risk have been found to be abnormal in these patients. Common genetic factors are a putative underlying mechanism, alongside lifestyle factors and antipsychotic medication. However, the extent to which the altered CVD biomarkers are related to genetic factors involved in schizophrenia and bipolar disorder is unknown. In a sample including 699 patients with schizophrenia, 391 with bipolar disorder, and 822 healthy controls, we evaluated 8 CVD risk biomarkers, including BMI, and fasting plasma levels of CVD biomarkers from a subsample. Polygenic risk scores (PGRS) were obtained from genome-wide associations studies (GWAS) of schizophrenia and bipolar disorder from the Psychiatric Genomics Consortium. The CVD biomarkers were used as outcome variables in linear regression models including schizophrenia and bipolar disorder PGRS as predictors, age, sex, diagnostic category, batch and 10 principal components as covariates, controlling for multiple testing by Bonferroni correction for the number of independent tests. Bipolar disorder PGRS was significantly (p = 0.03) negatively associated with BMI after multiple testing correction, and schizophrenia PGRS was nominally negatively associated with BMI. There were no other significant associations between bipolar or schizophrenia PGRS, and other investigated CVD biomarkers. Despite a range of abnormal CVD risk biomarkers in psychotic disorders, we only found a significant negative association between bipolar disorder PGRS and BMI. This has previously been shown for schizophrenia PGRS and BMI, and warrants further exploration.
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Affiliation(s)
- Elina J Reponen
- NORMENT, Norwegian Centre for Mental Disorders Research, Oslo University Hospital and University of Oslo, Nydalen, P.O. Box 4956, N- 0424, Oslo, Norway.
| | - Thor Ueland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- K.G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, Tromsø, Norway
| | - Jaroslav Rokicki
- NORMENT, Norwegian Centre for Mental Disorders Research, Oslo University Hospital and University of Oslo, Nydalen, P.O. Box 4956, N- 0424, Oslo, Norway
- Centre for Research and Education in Forensic Psychiatry, Department of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Francesco Bettella
- NORMENT, Norwegian Centre for Mental Disorders Research, Oslo University Hospital and University of Oslo, Nydalen, P.O. Box 4956, N- 0424, Oslo, Norway
| | - Monica Aas
- NORMENT, Norwegian Centre for Mental Disorders Research, Oslo University Hospital and University of Oslo, Nydalen, P.O. Box 4956, N- 0424, Oslo, Norway
- Department of Mental Health Research and Development, Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
| | - Maren C F Werner
- NORMENT, Norwegian Centre for Mental Disorders Research, Oslo University Hospital and University of Oslo, Nydalen, P.O. Box 4956, N- 0424, Oslo, Norway
| | - Ingrid Dieset
- NORMENT, Norwegian Centre for Mental Disorders Research, Oslo University Hospital and University of Oslo, Nydalen, P.O. Box 4956, N- 0424, Oslo, Norway
- Division of Mental Health and Addiction, Acute Psychiatric Department, Oslo University Hospital, Oslo, Norway
| | - Nils E Steen
- NORMENT, Norwegian Centre for Mental Disorders Research, Oslo University Hospital and University of Oslo, Nydalen, P.O. Box 4956, N- 0424, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Norwegian Centre for Mental Disorders Research, Oslo University Hospital and University of Oslo, Nydalen, P.O. Box 4956, N- 0424, Oslo, Norway
| | - Martin Tesli
- NORMENT, Norwegian Centre for Mental Disorders Research, Oslo University Hospital and University of Oslo, Nydalen, P.O. Box 4956, N- 0424, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
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8
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Glastad SH, Aminoff SR, Hagen R, Høegh MC, Büchmann CB, Barrett EA, Melle I, Etain B, Lagerberg TV. Nicotine use and non-pathological alcohol use and their relationship to affective symptoms and sleep disturbances in bipolar disorder. J Affect Disord 2023; 327:236-243. [PMID: 36746243 DOI: 10.1016/j.jad.2023.02.003] [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: 11/22/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND The use of alcohol and nicotine can negatively impact the course of bipolar disorder (BD), but there is limited knowledge about how symptoms and sleep disturbances are related to concurrent nicotine use and non-pathological use of alcohol. METHODS We investigated how nicotine use and non-pathological use of alcohol relates to affective symptoms and sleep disturbances in 453 participants with BD without substance use disorders. Manic symptoms were assessed with the Young Mania Rating Scale, and depressive symptoms with The Inventory of Depressive Symptomatology, Clinician-Rated (IDS-C). Sleep-related questions from IDS-C were used to create proxy variables for sleep disturbances, including Insomnia and Hypersomnia. Multinomial regression analysis was conducted to investigate the associations between nicotine use and sleep disturbances, controlling for possible confounders such as current use of illicit drugs and psychopharmacological treatment. RESULTS Depressive and manic symptoms were not associated with the concurrent level of alcohol or nicotine use. Individuals with medium and high levels of daily nicotine use had higher risk of insomnia than those without. Non-pathological alcohol use was not associated with sleep disturbances. LIMITATIONS Sleep disturbances were based on items from the IDS-C questionnaire. CONCLUSION We found an elevated risk for insomnia in individuals with BD and medium or high levels of daily nicotine use. We found no association between the level of affective symptoms and the level of use of alcohol or nicotine. The direction of the relationship between nicotine use and insomnia needs clarification, as it is highly relevant for treatment planning.
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Affiliation(s)
- Stine Holmstul Glastad
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway.
| | - Sofie Ragnhild Aminoff
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway; Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Roger Hagen
- Department of Psychology, University of Oslo, Oslo, Norway; Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway; Research institute, Modum Bad, Vikersund, Norway
| | - Margrethe Collier Høegh
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Camilla Bakkalia Büchmann
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Elizabeth Ann Barrett
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway; Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ingrid Melle
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Bruno Etain
- INSERM U1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France; Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France; Université Paris Cité, Paris, France; Fondation FondaMental, Créteil, France
| | - Trine Vik Lagerberg
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
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9
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Jørgensen LR, Hegtmann CL, Straszek SPV, Høyer C, Polcwiartek C, Petersen LJ, Dalgaard MK, Jensen SE, Nielsen RE. Peripheral artery disease in patients with schizophrenia as compared to controls. BMC Cardiovasc Disord 2023; 23:126. [PMID: 36890440 PMCID: PMC9996891 DOI: 10.1186/s12872-023-03143-9] [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: 12/01/2022] [Accepted: 02/22/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Patients with schizophrenia have an increased prevalence of risk factors for peripheral artery disease (PAD) and is expected to have an increased prevalence of PAD. PAD can be detected utilizing toe-brachial index (TBI) which screens for vascular pathology proximal to the toes. METHODS Using a cross-sectional design, we defined the subpopulations: (1) Patients diagnosed with schizophrenia less than 2 years before inclusion (SCZ < 2), (2) Psychiatric healthy controls matched to subpopulation 1 on sex, age, and smoking status, and (3) Patients diagnosed with schizophrenia 10 or more years before inclusion (SCZ ≥ 10). TBI was calculated by dividing toe pressures by systolic brachial blood pressure, and PAD was defined by TBI < 0.70. Logistic regression analysis with PAD as outcome and sex, age, smoking status, BMI, skin temperature, diagnosis of schizophrenia, and comorbidities as explanatory variables was conducted. RESULTS PAD was present in 26.2% of patients diagnosed with SCZ < 2 (17 of 65) and in 18.5% of psychiatric healthy controls (12 of 65) with no statistically significant difference in prevalence rates (p = 0.29). PAD was present in 22.0% of patients diagnosed with SCZ ≥ 10 (31 of 141). In logistic regression, patients diagnosed with SCZ < 2 had an increased odds of PAD with psychiatric healthy controls as reference (Odds ratio = 2.80, 95% confidence interval 1.09-7.23, p = 0.03). The analysis was adjusted for age, sex, smoking status, BMI and comorbidities such as hypertension, diabetes and heart disease. CONCLUSIONS This study did not find statistically significant increased prevalence rates of PAD in patients with schizophrenia even though patients with SCZ were compared to psychiatric healthy controls using TBI. Utilizing logistic regression PAD was associated with schizophrenia diagnosis within the last 2 years, age and skin temperature. As PAD is initially asymptomatic, screening could be relevant in patients with schizophrenia if other risk factors are prevalent. Further large-scale multicenter studies are warranted to investigate schizophrenia as a potential risk factor for PAD. TRIAL REGISTRATION Clinicaltrials.gov identifier NCT02885792.
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Affiliation(s)
| | | | - Sune P V Straszek
- Psychiatry - Aalborg University Hospital, Sdr. Skovvej 15, 9000, Aalborg, Denmark
| | - Christian Høyer
- Department of Clinical Physiology, Viborg Regional Hospital, Viborg, Denmark
| | | | - Lars J Petersen
- Department of Nuclear Medicine, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Martin Kamp Dalgaard
- Unit for Psychiatric Research, Psychiatry - Aalborg University Hospital, Aalborg, Denmark
| | - Svend Eggert Jensen
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - René Ernst Nielsen
- Psychiatry - Aalborg University Hospital, Sdr. Skovvej 15, 9000, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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10
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Muntané G, Vázquez-Bourgon J, Sada E, Martorell L, Papiol S, Bosch E, Navarro A, Crespo-Facorro B, Vilella E. Polygenic risk scores enhance prediction of body mass index increase in individuals with a first episode of psychosis. Eur Psychiatry 2023; 66:e28. [PMID: 36852609 PMCID: PMC10044301 DOI: 10.1192/j.eurpsy.2023.9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Individuals with a first episode of psychosis (FEP) show rapid weight gain during the first months of treatment, which is associated with a reduction in general physical health. Although genetics is assumed to be a significant contributor to weight gain, its exact role is unknown. METHODS We assembled a population-based FEP cohort of 381 individuals that was split into a Training (n = 224) set and a Validation (n = 157) set to calculate the polygenic risk score (PRS) in a two-step process. In parallel, we obtained reference genome-wide association studies for body mass index (BMI) and schizophrenia (SCZ) to examine the pleiotropic landscape between the two traits. BMI PRSs were added to linear models that included sociodemographic and clinical variables to predict BMI increase (∆BMI) in the Validation set. RESULTS The results confirmed considerable shared genetic susceptibility for the two traits involving 449 near-independent genomic loci. The inclusion of BMI PRSs significantly improved the prediction of ∆BMI at 12 months after the onset of antipsychotic treatment by 49.4% compared to a clinical model. In addition, we demonstrated that the PRS containing pleiotropic information between BMI and SCZ predicted ∆BMI better at 3 (12.2%) and 12 months (53.2%). CONCLUSIONS We prove for the first time that genetic factors play a key role in determining ∆BMI during the FEP. This finding has important clinical implications for the early identification of individuals most vulnerable to weight gain and highlights the importance of examining genetic pleiotropy in the context of medically important comorbidities for predicting future outcomes.
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Affiliation(s)
- Gerard Muntané
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, Reus, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Institut de Biologia Evolutiva (UPF-CSIC), Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain
| | - Javier Vázquez-Bourgon
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Psychiatry, University Hospital Marqués de Valdecilla, Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain.,Departamento de Medicina y Psiquiatría, Facultad de Medicina, Universidad de Cantabria, Santander, Spain
| | - Ester Sada
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, Reus, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Lourdes Martorell
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, Reus, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Sergi Papiol
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Psychiatry, Institute of Psychiatric Phenomics and Genomics, University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Elena Bosch
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Institut de Biologia Evolutiva (UPF-CSIC), Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain
| | - Arcadi Navarro
- Institut de Biologia Evolutiva (UPF-CSIC), Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain.,Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain.,Barcelonaβeta Brain Research Center, Fundació Pasqual Maragall, Barcelona, Spain
| | - Benedicto Crespo-Facorro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Psychiatry, Instituto de Biomedicina de Sevilla (IBiS), University Hospital Virgen del Rocío, Seville, Spain
| | - Elisabet Vilella
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, Reus, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
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11
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Ringen PA, Lund-Stenvold E, Andreassen OA, Gaarden TL, Hartberg CB, Johnsen E, Myklatun S, Osnes K, Sørensen K, Sørensen K, Vaaler A, Tonstad S, Engh JA, Høye A. Quality of clinical management of cardiometabolic risk factors in patients with severe mental illness in a specialist mental health care setting. Nord J Psychiatry 2022; 76:602-609. [PMID: 35200088 DOI: 10.1080/08039488.2022.2039288] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Cardiometabolic disease in patients with severe mental illness is a major cause of shortened life expectancy. There is sparse evidence of real-world clinical risk prevention practice. We investigated levels of assessments of cardiometabolic risk factors and risk management interventions in patients with severe mental illness in the Norwegian mental health service according to an acknowledged international standard. METHODS We collected data from 264 patients residing in six country-wide health trusts for: (a) assessments of cardiometabolic risk and (b) assessments of levels of risk reducing interventions. Logistic regressions were employed to investigate associations between risk and interventions. RESULTS Complete assessments of all cardiometabolic risk variables were performed in 50% of the participants and 88% thereof had risk levels requiring intervention according to the standard. Smoking cessation advice was provided to 45% of daily smokers and 4% were referred to an intervention program. Obesity was identified in 62% and was associated with lifestyle interventions. Reassessment of psychotropic medication was done in 28% of the obese patients. Women with obesity were less likely to receive dietary advice, and use of clozapine or olanzapine reduced the chances for patients with obesity of getting weight reducing interventions. CONCLUSIONS Nearly nine out of the ten participants were identified as being at cardiometabolic high risk and only half of the participants were adequately screened. Women with obesity and patients using antipsychotics with higher levels of cardiometabolic side effects had fewer adequate interventions. The findings underscore the need for standardized recommendations for identification and provision of cardiometabolic risk reducing interventions in all patients with severe mental illness.
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Affiliation(s)
- Petter A Ringen
- Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Elisabeth Lund-Stenvold
- Department of Clinical Medicine, UiT The Arctic University of Norway and Department of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø, Norway
| | - Ole A Andreassen
- NORMENT Centre of Excellence, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Torfinn L Gaarden
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
| | - Cecilie B Hartberg
- Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Erik Johnsen
- NORMENT Centre of Excellence, Division of Psychiatry, Haukeland University Hospital and Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Silje Myklatun
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
| | - Kåre Osnes
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
| | - Kirsten Sørensen
- Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kjetil Sørensen
- Division of Mental Health, Østmarka, St Olav's University Hospital, Trondheim, Norway
| | - Arne Vaaler
- Department of acute psychiatry, St. Olavs University Hospital and Department of Mental Health, NTNU, Trondheim, Norway
| | - Serena Tonstad
- Section for Preventive Cardiology Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - John A Engh
- Division of Mental health and Addiction, Vestfold Hospital Trust, Tønsberg, Norway
| | - Anne Høye
- Department of Clinical Medicine, UiT The Arctic University of Norway and Department of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø, Norway
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12
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Exploring Lead loci shared between schizophrenia and Cardiometabolic traits. BMC Genomics 2022; 23:617. [PMID: 36008755 PMCID: PMC9414090 DOI: 10.1186/s12864-022-08766-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 07/13/2022] [Indexed: 11/10/2022] Open
Abstract
Individuals with schizophrenia (SCZ) have, on average, a 10- to 20-year shorter expected life span than the rest of the population, primarily due to cardiovascular disease comorbidity. Genome-wide association studies (GWAS) have previously been used to separately identify common variants in SCZ and cardiometabolic traits. However, genetic variants jointly influencing both traits remain to be fully characterised. To assess overlaps (if any) between the genetic architecture of SCZ and cardiometabolic traits, we used conditional false discovery rate (FDR) and local genetic correlation statistical framework analyses. A conjunctional FDR was used to identify shared genetic traits between SCZ and cardiometabolic risk factors. We identified 144 genetic variants which were shared between SCZ and body mass index (BMI), and 15 variants shared between SCZ and triglycerides (TG). Furthermore, we discovered four novel single nucleotide polymorphisms (SNPs) (rs3865350, rs9860913, rs13307 and rs9614186) and four proximate genes (DERL2, SNX4, LY75 and EFCAB6) which were shared by SCZ and BMI. We observed that the novel genetic variant rs13307 and the most proximate gene LY75 exerted potential effects on SCZ and BMI comorbidity. Also, we observed a mixture of concordant and opposite direction associations with shared genetic variants. We demonstrated a moderate to high genetic overlap between SCZ and cardiometabolic traits associated with a pattern of bidirectional associations. Our data suggested a complex interplay between metabolism-related gene pathways in SCZ pathophysiology.
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13
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Cardiovascular disease risk in people with severe mental disorders: an update and call for action. Curr Opin Psychiatry 2022; 35:277-284. [PMID: 35781467 DOI: 10.1097/yco.0000000000000797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Cardiovascular disease (CVD) is a major cause of premature death in people with severe mental disorders (SMDs). This review provides an update on the level of CVD mortality and morbidity, as well as the socioeconomic, psychosocial and genetic factors associated with the comorbidity, and offer directions for improved interventions to reduce CVD in SMDs. RECENT FINDINGS The level of CVD mortality and morbidity has sustained high in people with SMDs during the past decades, but the causal mechanism must be further elucidated. Psychosocial and socioeconomic challenges are frequent in SMDs as well as in CVD. Further, recent studies have revealed genetic variants jointly associated with SMDs, CVD risk and social factors. These findings highlight the need for more targeted interventions, prediction tools and psychosocial approaches to comorbid CVD in SMDs. SUMMARY The level of CVD comorbidity remains high in SMDs, indicating that most people with SMDs have not benefitted from recent medical advances. A complex interplay between genetic and social vulnerability to CVD, which differs across subgroups of patients, seems to be involved. Further research is required to meet the urgent need for earlier, more efficient intervention approaches and preventive strategies for comorbid CVD in SMD.
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14
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Johansen IT, Steen NE, Haram M, Rødevand L, Werner MCF, Lunding SH, Hjell G, Agartz I, Melle I, Lagerberg TV, Nerhus M, Andreassen OA. Sex differences in antipsychotic-related triglyceride levels are associated with metabolic hormone differences in patients with severe mental disorders. Schizophr Res 2022; 243:55-63. [PMID: 35240428 DOI: 10.1016/j.schres.2022.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 01/06/2022] [Accepted: 02/09/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Adverse effects of antipsychotics (AP) contribute to cardiovascular disease (CVD) risk in patients with severe mental disorders (SMD). We investigated sex differences in AP-related CVD risk factors and the role of metabolic hormones. METHODS Patients with SMD (N = 1791) receiving AP with different CVD risk were recruited and grouped into olanzapine and/or clozapine (N = 532), other APs (N = 744) or no use of APs (N = 515). Associations between CVD risk factor (total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), body mass index (BMI), glucose, blood pressure), sex and AP groups were tested in multiple linear regression with interactions, controlling for diagnostic group, lifestyle factors, polypharmacy, age and ethnicity. Next, we tested associations between sex differences in AP-related CVD risk factors and metabolic regulatory hormones. RESULTS AP groups and male sex were significantly associated with higher levels of LDL-C, TG and BMI, and lower levels of HDL-C. Significant interaction between AP groups and sex were found for TG (p = 0.017), with larger increase in males. Serum adiponectin, insulin, cortisol, leptin, testosterone, free thyroxine and thyroid-stimulating hormone (TSH) were associated with TG levels (all p ≤ 0.001), and a significant interaction with sex for insulin (p = 0.005), cortisol (p = 0.016), leptin (p < 0.001) and TSH (p = 0.001). CONCLUSIONS We found more severe AP-related CVD risk factors in male patients with SMD. The male-dependent increase in TG levels was associated with leptin, insulin, cortisol and TSH levels. Clinicians treating patients with SMD should be aware of increased vulnerability for AP-related lipid abnormalities in males.
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Affiliation(s)
- Ingrid Torp Johansen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Nils Eiel Steen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Marit Haram
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Linn Rødevand
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Maren C F Werner
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Synve Hoffart Lunding
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gabriela Hjell
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatry, Ostfold Hospital, Graalum, Norway
| | - Ingrid Agartz
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institute & Stockholm Health Care Services, Stockholm, Stockholm Region, Sweden
| | - Ingrid Melle
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trine V Lagerberg
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mari Nerhus
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Akershus University Hospital, Division of Psychiatry, Department for Specialized Psychiatry, Lorenskog, Norway
| | - Ole A Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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15
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Buzea CA, Dima L, Correll CU, Manu P. Drug-drug interactions involving antipsychotics and antihypertensives. Expert Opin Drug Metab Toxicol 2022; 18:285-298. [PMID: 35658798 DOI: 10.1080/17425255.2022.2086121] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Antipsychotics represent the mainstay in the treatment of patients diagnosed with major psychiatric disorders. Hypertension, among other components of metabolic syndrome, is a common finding in these patients. For their psychiatric and physical morbidity, many patients receive polypharmacy, exposing them to the risk of clinically relevant drug-drug interactions. AREAS COVERED This review summarizes the knowledge regarding the known or potential drug-drug interactions between antipsychotics and the main drug classes used in the treatment of hypertension. We aimed to provide the clinician an insight into the pharmacokinetic and pharmacodynamic interactions between these drugs for a better choice of combinations of drugs to treat both the mental illness and cardiovascular risk factors. For this, we performed a literature search in PubMed and Scopus databases, up to 31 July 2021. EXPERT OPINION The main pharmacokinetic interactions between antipsychotics and antihypertensive drugs involve mainly the cytochrome P450 system. The pharmacodynamic interactions are produced by multiple mechanisms, leading to concurrent binding to the same receptors. The data available regarding drug-drug interactions is mostly based on case reports and small studies and therefore should be interpreted with caution. The current knowledge is sufficiently strong to guide clinicians in selecting safer drug combinations as summarized here.
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Affiliation(s)
- Catalin Adrian Buzea
- Department 5 Internal Medicine, Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania.,Cardiology, Clinical Hospital Colentina, Bucharest, Romania
| | - Lorena Dima
- Department of Fundamental Disciplines and Clinical Prevention, Faculty of Medicine, Transilvania University of Brasov, Brașov, Romania
| | - Christoph U Correll
- Department of Child and Adolescent Psychiatry, Charite Universitaetsmedizin, Berlin, Germany.,Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.,Department of Psychiatry, Zucker Hillside Hospital, Northwell Health System, Glen Oaks, NY, USA
| | - Peter Manu
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.,Department of Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.,Medical Services, South Oaks Hospital, Northwell Health System, Amityville, NY, USA
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16
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Beck D, de Lange AG, Pedersen ML, Alnæs D, Maximov II, Voldsbekk I, Richard G, Sanders A, Ulrichsen KM, Dørum ES, Kolskår KK, Høgestøl EA, Steen NE, Djurovic S, Andreassen OA, Nordvik JE, Kaufmann T, Westlye LT. Cardiometabolic risk factors associated with brain age and accelerate brain ageing. Hum Brain Mapp 2022; 43:700-720. [PMID: 34626047 PMCID: PMC8720200 DOI: 10.1002/hbm.25680] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 09/02/2021] [Accepted: 09/25/2021] [Indexed: 11/17/2022] Open
Abstract
The structure and integrity of the ageing brain is interchangeably linked to physical health, and cardiometabolic risk factors (CMRs) are associated with dementia and other brain disorders. In this mixed cross-sectional and longitudinal study (interval mean = 19.7 months), including 790 healthy individuals (mean age = 46.7 years, 53% women), we investigated CMRs and health indicators including anthropometric measures, lifestyle factors, and blood biomarkers in relation to brain structure using MRI-based morphometry and diffusion tensor imaging (DTI). We performed tissue specific brain age prediction using machine learning and performed Bayesian multilevel modeling to assess changes in each CMR over time, their respective association with brain age gap (BAG), and their interaction effects with time and age on the tissue-specific BAGs. The results showed credible associations between DTI-based BAG and blood levels of phosphate and mean cell volume (MCV), and between T1-based BAG and systolic blood pressure, smoking, pulse, and C-reactive protein (CRP), indicating older-appearing brains in people with higher cardiometabolic risk (smoking, higher blood pressure and pulse, low-grade inflammation). Longitudinal evidence supported interactions between both BAGs and waist-to-hip ratio (WHR), and between DTI-based BAG and systolic blood pressure and smoking, indicating accelerated ageing in people with higher cardiometabolic risk (smoking, higher blood pressure, and WHR). The results demonstrate that cardiometabolic risk factors are associated with brain ageing. While randomized controlled trials are needed to establish causality, our results indicate that public health initiatives and treatment strategies targeting modifiable cardiometabolic risk factors may also improve risk trajectories and delay brain ageing.
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Affiliation(s)
- Dani Beck
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Sunnaas Rehabilitation Hospital HTNesodden
| | - Ann‐Marie G. de Lange
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- LREN, Centre for Research in Neurosciences‐Department of Clinical NeurosciencesCHUV and University of LausanneLausanneSwitzerland
- Department of PsychiatryUniversity of OxfordOxfordUK
| | - Mads L. Pedersen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
| | - Dag Alnæs
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Bjørknes CollegeOsloNorway
| | - Ivan I. Maximov
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Department of Health and FunctioningWestern Norway University of Applied SciencesBergenNorway
| | - Irene Voldsbekk
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
| | - Geneviève Richard
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
| | - Anne‐Marthe Sanders
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Sunnaas Rehabilitation Hospital HTNesodden
| | - Kristine M. Ulrichsen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Sunnaas Rehabilitation Hospital HTNesodden
| | - Erlend S. Dørum
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Sunnaas Rehabilitation Hospital HTNesodden
| | - Knut K. Kolskår
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Sunnaas Rehabilitation Hospital HTNesodden
| | - Einar A. Høgestøl
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
| | - Nils Eiel Steen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
| | - Srdjan Djurovic
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
| | - Ole A. Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- KG Jebsen Centre for Neurodevelopmental DisordersUniversity of OsloOsloNorway
| | | | - Tobias Kaufmann
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of Psychiatry and PsychotherapyUniversity of TübingenTubingenGermany
| | - Lars T. Westlye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- KG Jebsen Centre for Neurodevelopmental DisordersUniversity of OsloOsloNorway
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17
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Reininghaus EZ, Manchia M, Dalkner N, Bonkat N, Squassina A, Hodl I, Vieta E, Reif A, Hajek T, Landén M, Correll CU, Scott J, Etain B, Rietschel M, Bergink V, Martinez-Cengotitabengoa M, Kessing LV, Fagiolini A, Bauer M, Goodwin G, Gonzalez-Pinto A, Kupka RW, Schulze TG, Lagerberg TV, Yildiz A, Henry C, Morken G, Ritter P, Nieslen RE, Licht RW, Bechdolf A, Andreassen OA, Fellendorf FT. Outcomes associated with different vaccines in individuals with bipolar disorder and impact on the current COVID-19 pandemic- a systematic review. Eur Neuropsychopharmacol 2022; 54:90-99. [PMID: 34607722 PMCID: PMC8429356 DOI: 10.1016/j.euroneuro.2021.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/26/2021] [Accepted: 09/01/2021] [Indexed: 12/17/2022]
Abstract
Bipolar disorder (BD) might be associated with higher infection rates of coronavirus disease (COVID-19) which in turn could result in worsening the clinical course and outcome. This may be due to a high prevalence of somatic comorbidities and an increased risk of delays in and poorer treatment of somatic disease in patients with severe mental illness in general. Vaccination is the most important public health intervention to tackle the ongoing pandemic. We undertook a systematic review regarding the data on vaccinations in individuals with BD. Proportion of prevalence rates, efficacy and specific side effects of vaccinations and in individuals with BD were searched. Results show that only five studies have investigated vaccinations in individuals with BD, which substantially limits the interpretation of overall findings. Studies on antibody production after vaccinations in BD are very limited and results are inconsistent. Also, the evidence-based science on side effects of vaccinations in individuals with BD so far is poor.
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Affiliation(s)
- Eva Z Reininghaus
- Medical University Graz, Department of Psychiatry & Psychotherapeutic Medicine
| | - Mirko Manchia
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari,Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy; Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Nina Dalkner
- Medical University Graz, Department of Psychiatry & Psychotherapeutic Medicine
| | - Nina Bonkat
- Medical University Graz, Department of Psychiatry & Psychotherapeutic Medicine
| | - Alessio Squassina
- Laboratory of Pharmacogenomics, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Isabel Hodl
- Medical University Graz, Klinische Abteilung für Rheumatologie und Immunologie
| | - Eduard Vieta
- Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy; University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Tomas Hajek
- Dalhousie University, Department of Psychiatry, Canada National Institute of Mental Health Klecany, Czech Republic; National Institute of Mental Health Klecany, Czech Republic
| | - Mikael Landén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Christoph U Correll
- Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA; The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA
| | - Jan Scott
- Institute of Neuroscience, Newcastle University, Newcastle, UK
| | - Bruno Etain
- Universite de Paris - INSERM UMRS 1144 - DMU Neurosciences, GHU Lariboisière Fernand Widal, Departement de Psychiatrie, APHP - Paris - France
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, University Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Veerle Bergink
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA; Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Monica Martinez-Cengotitabengoa
- Osakidetza, Basque Health Service, Health Service, BioAraba Research Institute, University of the Basque Country, Vitoria, Spain; The Psychology Clinic of East Anglia, Norwich, England
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder research Center (CADIC), Psychiatric Center Copenhagen, Copenhagen Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital Dresden, Technische Universität Dresden, Dresden, Germany
| | - Guy Goodwin
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | | | - Ralph W Kupka
- Dept. of Psychiatry, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, Netherlands
| | - Thomas G Schulze
- LMU University Hospital, Institute of Psychiatric Phenomics and Genomics (IPPG), Ludwig-Maximilians-University of Munich,Germany
| | - Trine V Lagerberg
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ayşegül Yildiz
- Dokuz Eylul University Izmir, Turkey Department of Psychiatry
| | - Chantal Henry
- Departement of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, Paris, France, Université de Paris, Paris, France
| | - Gunnar Morken
- St Olav University Hospital and Norwegian University of Science and Technology - NTNU, Faculty of Medicine and Health Sciences
| | - Phillip Ritter
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital Dresden, Technische Universität Dresden, Dresden, Germany
| | - René Ernst Nieslen
- Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Rasmus W Licht
- Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Andreas Bechdolf
- Department for Psychiatry, Psychotherapy and Psychosomatic, Vivantes Hospital am Urban and Friedrichshain; Charité Universitätsmedizin, Berlin, Germany
| | - Ole A Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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18
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Rødevand L, Bahrami S, Frei O, Chu Y, Shadrin A, O'Connell KS, Smeland OB, Elvsåshagen T, Hindley GFL, Djurovic S, Dale AM, Lagerberg TV, Steen NE, Andreassen OA. Extensive bidirectional genetic overlap between bipolar disorder and cardiovascular disease phenotypes. Transl Psychiatry 2021; 11:407. [PMID: 34301917 PMCID: PMC8302675 DOI: 10.1038/s41398-021-01527-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 06/29/2021] [Accepted: 07/05/2021] [Indexed: 12/13/2022] Open
Abstract
Patients with bipolar disorder (BIP) have a high risk of cardiovascular disease (CVD), despite considerable individual variation. The mechanisms underlying comorbid CVD in BIP remain largely unknown. We investigated polygenic overlap between BIP and CVD phenotypes, including CVD risk factors and coronary artery disease (CAD). We analyzed large genome-wide association studies of BIP (n = 51,710) and CVD phenotypes (n = 159,208-795,640), using bivariate causal mixture model (MiXeR), which estimates the total amount of shared genetic variants, and conjunctional false discovery rate (FDR), which identifies specific overlapping loci. MiXeR revealed polygenic overlap between BIP and body mass index (BMI) (82%), diastolic and systolic blood pressure (20-22%) and CAD (11%) despite insignificant genetic correlations. Using conjunctional FDR < 0.05, we identified 129 shared loci between BIP and CVD phenotypes, mainly BMI (n = 69), systolic (n = 53), and diastolic (n = 53) blood pressure, of which 22 are novel BIP loci. There was a pattern of mixed effect directions of the shared loci between BIP and CVD phenotypes. Functional analyses indicated that the shared loci are linked to brain-expressed genes and involved in neurodevelopment, lipid metabolism, chromatin assembly/disassembly and intracellular processes. Altogether, the study revealed extensive polygenic overlap between BIP and comorbid CVD, implicating shared molecular genetic mechanisms. The mixed effect directions of the shared loci suggest variation in genetic susceptibility to CVD across BIP subgroups, which may underlie the heterogeneity of CVD comorbidity in BIP patients. The findings suggest more focus on targeted lifestyle interventions and personalized pharmacological treatment to reduce CVD comorbidity in BIP.
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Affiliation(s)
- Linn Rødevand
- NORMENT, Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Shahram Bahrami
- NORMENT, Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Oleksandr Frei
- NORMENT, Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo, Norway
| | - Yunhan Chu
- NORMENT, Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Alexey Shadrin
- NORMENT, Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kevin S O'Connell
- NORMENT, Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Olav B Smeland
- NORMENT, Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Torbjørn Elvsåshagen
- NORMENT, Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Guy F L Hindley
- NORMENT, Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
- NORMENT Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Anders M Dale
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
- Multimodal Imaging Laboratory, University of California San Diego, La Jolla, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Department of Neurosciences, University of California San Diego, La Jolla, CA, USA
| | - Trine V Lagerberg
- NORMENT, Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Nils Eiel Steen
- NORMENT, Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
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19
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Lunding SH, Simonsen C, Aas M, Rødevand L, Werner MCF, Laskemoen JF, Hjell G, Ringen PA, Lagerberg TV, Melle I, Andreassen OA, Ueland T, Steen NE. Childhood trauma and cardiometabolic risk in severe mental disorders: The mediating role of cognitive control. Eur Psychiatry 2021; 64:e24. [PMID: 33775258 PMCID: PMC8084596 DOI: 10.1192/j.eurpsy.2021.14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Cardiometabolic risk is increased in severe mental disorders (SMDs), and there appears to be a relationship between childhood trauma and cardiometabolic risk, possibly related to adverse health behavior. The current study examined the association between childhood trauma and serum lipids and adiposity in SMDs and the potential mediating role of cognitive and personality characteristics. Methods Participants with schizophrenia and bipolar spectrum disorders (N = 819) were included, cardiometabolic risk factors (serum lipids, body mass index, and waist circumference) were measured, and history of childhood trauma was assessed by the Childhood Trauma Questionnaire. Cognitive and personality characteristics were available in subsamples, with assessments of cognitive control, impulsiveness, self-esteem, and affective lability. Linear regressions and mediation analyses with Hayes’ PROCESS were performed, adjusting for age, sex, antipsychotic agent propensity of metabolic side-effect, and diagnostic group. Results Experience of three or more subtypes of childhood trauma was positively associated with waist circumference in patients with SMDs (p = 0.014). There were no other significant associations between trauma variables and lipid or adiposity measures in the total sample. Cognitive control was a significant mediator between experience of one or two subtypes of childhood trauma and waist circumference. Conclusions The results indicate childhood trauma as a predisposing factor for increased waist circumference in individuals with SMDs. Poorer cognitive control, suggestive of adverse health behavior, might be a mediating factor of the association, and the findings indicate the potential importance of increased focus on these factors in prevention and treatment regimens targeting cardiometabolic health.
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Affiliation(s)
- Synve Hoffart Lunding
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Carmen Simonsen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Early Intervention in Psychosis Advisory Unit for South East Norway, Oslo University Hospital, Oslo, Norway
| | - Monica Aas
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Linn Rødevand
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Maren Caroline Frogner Werner
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jannicke Fjæra Laskemoen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gabriela Hjell
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Psychiatry, Ostfold Hospital, Graalum, Norway
| | - Petter Andreas Ringen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trine Vik Lagerberg
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Melle
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Torill Ueland
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Nils Eiel Steen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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20
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Bulteau S, Le Pierres M, Artarit P, Forestier B, Michaud E, Chaslerie A, Bonnot O, Victorri-Vigneau C. Advocacy for better metabolic monitoring after antipsychotic initiation: based on data from a French health insurance database. Expert Opin Drug Saf 2020; 20:225-233. [PMID: 33225754 DOI: 10.1080/14740338.2021.1851678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Nearly 3% of the population is treated by antipsychotic. The aim of this study was to assess the conformity of monitoring with guidelines to prevent Metabolic Syndrome. Research design and method: The analysis was conducted using SNIIRAM data (2013 to 2017) on a cohort of patients who received at least eight antipsychotic dispensings in the first year. Glucose and lipid testings were recorded according to refunds at initiation [between -3 and 0.5 months], 3 months [between 2 and 4 months], and 12 months [between 11 and 13 months] after, and assuming optimal testing during hospitalization (exclusive of psychiatric unit). Descriptive and comparative analysis, «chi-squared test or Student's t-test», were performed as well as multivariate analysis with logistic regression. Results: 18 760 patients were selected, 14 421 were still alive and monitored at the end of the follow up. In the recommended period, only 2.89% of patients had three complete testings and 50.6% one or two complete testings Non-optimal testing was more likely to occur in children and adults (vs elderly), in patients with less than 3 prescribers, and with universal medical coverage. Conclusion: Monitoring remains dramatically insufficient. New actions involving patients, practitioners, and authorities are warranted.
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Affiliation(s)
- Samuel Bulteau
- CHU de Nantes, Addictology and Liaison-Psychiatry Department, Nantes, France.,INSERM UMR 1246, SPHERE, Methods in Patient-Centered Outcomes and Health Research, Nantes and Tours University , Nantes, France
| | | | - Pascal Artarit
- Medical Department, French Health Insurance, Pays-de-la-Loire, Nantes, France
| | - Bastien Forestier
- INSERM UMR 1246, SPHERE, Methods in Patient-Centered Outcomes and Health Research, Nantes and Tours University , Nantes, France.,CHU De Nantes, Public Health Department, Nantes, France
| | - Emmanuelle Michaud
- Medical Department, French Health Insurance, Pays-de-la-Loire, Nantes, France
| | - Anicet Chaslerie
- Medical Department, French Health Insurance, Pays-de-la-Loire, Nantes, France
| | - Olivier Bonnot
- CHU De Nantes, Department of Child and Adolescent Psychiatry, Nantes, France
| | - Caroline Victorri-Vigneau
- INSERM UMR 1246, SPHERE, Methods in Patient-Centered Outcomes and Health Research, Nantes and Tours University , Nantes, France.,CHU De Nantes, Clinical Pharmacology Department, Nantes, France
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21
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Abstract
Individuals diagnosed with schizophrenia or bipolar disorder have a life expectancy 15-20 years shorter than that in the general population. The rate of unnatural deaths, such as suicide and accidents, is high for these patients. Despite this increased proportion of unnatural deaths, physical conditions account for approximately 70% of deaths in patients with either schizophrenia or bipolar disorder, with cardiovascular disease contributing 17.4% and 22.0% to the reduction in overall life expectancy in men and women, respectively. Risk factors for cardiovascular disease, such as smoking, unhealthy diet and lack of exercise, are common in these patients, and lifestyle interventions have been shown to have small effects. Pharmacological interventions to reduce risk factors for cardiovascular disease have been proven to be effective. Treatment with antipsychotic drugs is associated with reduced mortality but also with an increased risk of weight gain, dyslipidaemia and diabetes mellitus. These patients have higher risks of both myocardial infarction and stroke but a lower risk of undergoing interventional procedures compared with the general population. Data indicate a negative attitude from clinicians working outside the mental health fields towards patients with severe mental illness. Education might be a possible method to decrease the negative attitudes towards these patients, thereby improving their rates of diagnosis and treatment.
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22
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Mazereel V, Detraux J, Vancampfort D, van Winkel R, De Hert M. Impact of Psychotropic Medication Effects on Obesity and the Metabolic Syndrome in People With Serious Mental Illness. Front Endocrinol (Lausanne) 2020; 11:573479. [PMID: 33162935 PMCID: PMC7581736 DOI: 10.3389/fendo.2020.573479] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/23/2020] [Indexed: 12/12/2022] Open
Abstract
People with serious mental illness (SMI), including schizophrenia, bipolar disorder, and major depressive disorder, have a higher mortality rate and shortened life expectancy. This is mainly attributable to physical diseases, particularly cardiovascular diseases (CVDs). Important risk factors for CVDs are obesity and other metabolic abnormalities, which are especially prevalent in people with SMI. Several factors contribute to this increased risk, including unhealthy lifestyles. Psychotropic medication independently further increases this risk. In this review we want to examine the relationship between obesity and other components of the metabolic syndrome and psychotropic medication in people with SMI.
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Affiliation(s)
- Victor Mazereel
- Department of Neurosciences, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium
- University Psychiatric Center, KU Leuven, Kortenberg, Belgium
| | - Johan Detraux
- University Psychiatric Center, KU Leuven, Kortenberg, Belgium
| | - Davy Vancampfort
- University Psychiatric Center, KU Leuven, Kortenberg, Belgium
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Ruud van Winkel
- Department of Neurosciences, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium
- University Psychiatric Center, KU Leuven, Kortenberg, Belgium
| | - Marc De Hert
- Department of Neurosciences, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium
- University Psychiatric Center, KU Leuven, Kortenberg, Belgium
- Antwerp Health Law and Ethics Chair, AHLEC University Antwerpen, Antwerp, Belgium
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23
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Tacey A, Millar S, Qaradakhi T, Smith C, Hayes A, Anderson S, Zulli A, O'Sullivan S, Levinger I. Undercarboxylated osteocalcin has no adverse effect on endothelial function in rabbit aorta or human vascular cells. J Cell Physiol 2020; 236:2840-2849. [PMID: 32936958 PMCID: PMC7891339 DOI: 10.1002/jcp.30048] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/31/2020] [Indexed: 12/15/2022]
Abstract
Undercarboxylated osteocalcin (ucOC) improves glucose metabolism; however, its effects on endothelial cell function are unclear. We examined the biological effect of ucOC on endothelial function in animal models ex vivo and human cells in vitro. Isometric tension and immunohistochemistry techniques were used on the aorta of male New Zealand white rabbits and cell culture techniques were used on human aortic endothelial cells (HAECs) to assess the effect of ucOC in normal and high-glucose environments. Overall, ucOC, both 10 and 30 ng/ml, did not significantly alter acetylcholine-induced blood vessel relaxation in rabbits (p > .05). UcOC treatment did not cause any significant changes in the immunoreactivity of cellular signalling markers (p > .05). In HAEC, ucOC did not change any of the assessed outcomes (p > .05). UcOC has no negative effects on endothelial function which is important to reduce the risks of off target adverse effects if it will be used as a therapeutic option for metabolic disease in the future.
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Affiliation(s)
- Alexander Tacey
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Victoria, Australia
| | | | - Tawar Qaradakhi
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Cassandra Smith
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Victoria, Australia
| | - Alan Hayes
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Victoria, Australia
| | - Susan Anderson
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, Royal Derby Hospital, University of Nottingham, Derby, UK
| | - Anthony Zulli
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Saoirse O'Sullivan
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, Royal Derby Hospital, University of Nottingham, Derby, UK
| | - Itamar Levinger
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Victoria, Australia
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24
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Hjell G, Mørch-Johnsen L, Holst R, Tesli N, Bell C, Lunding SH, Rødevand L, Werner MCF, Melle I, Andreassen OA, Lagerberg TV, Steen NE, Haukvik UK. Disentangling the relationship between cholesterol, aggression, and impulsivity in severe mental disorders. Brain Behav 2020; 10:e01751. [PMID: 32681586 PMCID: PMC7507477 DOI: 10.1002/brb3.1751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 06/26/2020] [Accepted: 06/28/2020] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE Low total cholesterol has been linked with adverse mental symptoms such as aggression and impulsivity in severe mental disorders (SMDs). This putative association may affect the clinician's decision making about cholesterol lowering in this patient group. Here, we investigated the associations between cholesterol levels, aggression, and impulsivity in a large representative sample of in- and outpatients with SMD. METHODS Patients with schizophrenia- or bipolar spectrum disorders (N = 1 001) underwent thorough clinical characterization and blood sampling (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol). Aggression was characterized by the Positive and Negative Syndrome Scale Excited Component. Impulsivity was measured with the Barratt Impulsiveness Scale in a subsample of patients (N = 288). We used a multinomial logistic regression model to analyze the association between cholesterol and aggression and a multiple linear regression model to analyze the association between cholesterol and impulsivity, while controlling for confounders. RESULTS We found no significant associations between cholesterol levels and aggression or impulsivity. There were no significant interactions between cholesterol and diagnostic group or inpatient versus outpatient status. Controlling for medication use, body mass index, alcohol or illicit substance use did not affect the results. CONCLUSION In this large sample of patients with schizophrenia- and bipolar spectrum disorders, we found no associations between cholesterol levels and aggression or impulsivity. This has clinical implications as patients with SMD are at increased CVD risk and currently undertreated with statins.
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Affiliation(s)
- Gabriela Hjell
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Departments of Psychiatry and Clinical Research, Ostfold Hospital, Gralum, Norway
| | - Lynn Mørch-Johnsen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Departments of Psychiatry and Clinical Research, Ostfold Hospital, Gralum, Norway
| | - René Holst
- Departments of Psychiatry and Clinical Research, Ostfold Hospital, Gralum, Norway.,Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Natalia Tesli
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Christina Bell
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Synve Hoffart Lunding
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Linn Rødevand
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Maren Caroline Frogner Werner
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Melle
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole Andreas Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trine Vik Lagerberg
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Nils Eiel Steen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Unn Kristin Haukvik
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Adult Psychiatry, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Centre of Research and Education in Forensic Psychiatry, Oslo University Hospital, Oslo, Norway
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25
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The Effect of an Atherogenic Diet and Acute Hyperglycaemia on Endothelial Function in Rabbits Is Artery Specific. Nutrients 2020; 12:nu12072108. [PMID: 32708633 PMCID: PMC7400854 DOI: 10.3390/nu12072108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/30/2020] [Accepted: 07/15/2020] [Indexed: 02/07/2023] Open
Abstract
Hyperglycaemia has a toxic effect on blood vessels and promotes coronary artery disease. It is unclear whether the dysfunction caused by hyperglycaemia is blood vessel specific and whether the dysfunction is exacerbated following an atherogenic diet. Abdominal aorta, iliac, and mesenteric arteries were dissected from New Zealand White rabbits following either a 4-week normal or atherogenic diet (n = 6–12 per group). The arteries were incubated ex vivo in control or high glucose solution (20 mM or 40 mM) for 2 h. Isometric tension myography was used to determine endothelial-dependent vasodilation. The atherogenic diet reduced relaxation as measured by area under the curve (AUC) by 25% (p < 0.05), 17% (p = 0.06) and 40% (p = 0.07) in the aorta, iliac, and mesenteric arteries, respectively. In the aorta from the atherogenic diet fed rabbits, the 20 mM glucose altered EC50 (p < 0.05). Incubation of the iliac artery from atherogenic diet fed rabbits in 40 mM glucose altered EC50 (p < 0.05). No dysfunction occurred in the mesentery with high glucose incubation following either the normal or atherogenic diet. High glucose induced endothelial dysfunction appears to be blood vessel specific and the aorta may be the optimal artery to study potential therapeutic treatments of hyperglycaemia induced endothelial dysfunction.
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26
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Bahrami S, Steen NE, Shadrin A, O’Connell K, Frei O, Bettella F, Wirgenes KV, Krull F, Fan CC, Dale AM, Smeland OB, Djurovic S, Andreassen OA. Shared Genetic Loci Between Body Mass Index and Major Psychiatric Disorders: A Genome-wide Association Study. JAMA Psychiatry 2020; 77:503-512. [PMID: 31913414 PMCID: PMC6990967 DOI: 10.1001/jamapsychiatry.2019.4188] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 10/30/2019] [Indexed: 01/02/2023]
Abstract
Importance People with major psychiatric disorders (MPDs) have a 10- to 20-year shorter life span than the rest of the population, and this difference is mainly due to comorbid cardiovascular diseases. Genome-wide association studies have identified common variants involved in schizophrenia (SCZ), bipolar disorder (BIP), and major depression (MD) and body mass index (BMI), a key cardiometabolic risk factor. However, genetic variants jointly influencing MPD and BMI remain largely unknown. Objective To assess the extent of the overlap between the genetic architectures of MPDs and BMI and identify genetic loci shared between them. Design, Setting, and Participants Using a conditional false discovery rate statistical framework, independent genome-wide association study data on individuals with SCZ (n = 82 315), BIP (n = 51 710), MD (n = 480 359), and BMI (n = 795 640) were analyzed. The UK Biobank cohort (n = 29 740) was excluded from the MD data set to avoid sample overlap. Data were collected from August 2017 to May 2018, and analysis began July 2018. Main Outcomes and Measures The primary outcomes were a list of genetic loci shared between BMI and MPDs and their functional pathways. Results Genome-wide association study data from 1 380 284 participants were analyzed, and the genetic correlation between BMI and MPDs varied (SCZ: r for genetic = -0.11, P = 2.1 × 10-10; BIP: r for genetic = -0.06, P = .0103; MD: r for genetic = 0.12, P = 6.7 × 10-10). Overall, 63, 17, and 32 loci shared between BMI and SCZ, BIP, and MD, respectively, were analyzed at conjunctional false discovery rate less than 0.01. Of the shared loci, 34% (73 of 213) in SCZ, 52% (36 of 69) in BIP, and 57% (56 of 99) in MD had risk alleles associated with higher BMI (conjunctional false discovery rate <0.05), while the rest had opposite directions of associations. Functional analyses indicated that the overlapping loci are involved in several pathways including neurodevelopment, neurotransmitter signaling, and intracellular processes, and the loci with concordant and opposite association directions pointed mostly to different pathways. Conclusions and Relevance In this genome-wide association study, extensive polygenic overlap between BMI and SCZ, BIP, and MD were found, and 111 shared genetic loci were identified, implicating novel functional mechanisms. There was mixture of association directions in SCZ and BMI, albeit with a preponderance of discordant ones.
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Affiliation(s)
- Shahram Bahrami
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Nils Eiel Steen
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Alexey Shadrin
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Kevin O’Connell
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Oleksandr Frei
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Francesco Bettella
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | | | - Florian Krull
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Chun C. Fan
- Department of Radiology, University of California, San Diego, La Jolla
- Department of Cognitive Science, University of California, San Diego, La Jolla
| | - Anders M Dale
- Department of Radiology, University of California, San Diego, La Jolla
- Multimodal Imaging Laboratory, University of California, San Diego, La Jolla
- Department of Psychiatry, University of California, San Diego, La Jolla
- Department of Neurosciences, University of California, San Diego, La Jolla
| | - Olav B. Smeland
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
- NORMENT Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Ole A. Andreassen
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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27
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Heiberg IH, Nesvåg R, Balteskard L, Bramness JG, Hultman CM, Næss Ø, Reichborn‐Kjennerud T, Ystrom E, Jacobsen BK, Høye A. Diagnostic tests and treatment procedures performed prior to cardiovascular death in individuals with severe mental illness. Acta Psychiatr Scand 2020; 141:439-451. [PMID: 32022895 PMCID: PMC7317477 DOI: 10.1111/acps.13157] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/02/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To examine whether severe mental illnesses (i.e., schizophrenia or bipolar disorder) affected diagnostic testing and treatment for cardiovascular diseases in primary and specialized health care. METHODS We performed a nationwide study of 72 385 individuals who died from cardiovascular disease, of whom 1487 had been diagnosed with severe mental illnesses. Log-binomial regression analysis was applied to study the impact of severe mental illnesses on the uptake of diagnostic tests (e.g., 24-h blood pressure, glucose/HbA1c measurements, electrocardiography, echocardiography, coronary angiography, and ultrasound of peripheral vessels) and invasive cardiovascular treatments (i.e., revascularization, arrhythmia treatment, and vascular surgery). RESULTS Patients with and without severe mental illnesses had similar prevalences of cardiovascular diagnostic tests performed in primary care, but patients with schizophrenia had lower prevalences of specialized cardiovascular examinations (prevalence ratio (PR) 0.78; 95% CI 0.73-0.85). Subjects with severe mental illnesses had lower prevalences of invasive cardiovascular treatments (schizophrenia, PR 0.58; 95% CI 0.49-0.70, bipolar disorder, PR 0.78; 95% CI 0.66-0.92). The prevalence of invasive cardiovascular treatments was similar in patients with and without severe mental illnesses when cardiovascular disease was diagnosed before death. CONCLUSION Better access to specialized cardiovascular examinations is important to ensure equal cardiovascular treatments among individuals with severe mental illnesses.
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Affiliation(s)
- I. H. Heiberg
- Center for Clinical Documentation and Evaluation (SKDE)TromsøNorway
| | - R. Nesvåg
- Norwegian Medical AssociationOsloNorway,Department of Clinical MedicineUiT – The Arctic University of NorwayTromsøNorway
| | - L. Balteskard
- Center for Clinical Documentation and Evaluation (SKDE)TromsøNorway
| | - J. G. Bramness
- Department of Clinical MedicineUiT – The Arctic University of NorwayTromsøNorway,Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health DisordersInnlandet Hospital TrustHamarNorway
| | - C. M. Hultman
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden,Icahn School of MedicineMt Sinai HospitalNew YorkNYUSA
| | - Ø. Næss
- Institute of Clinical MedicineUniversity of OsloOsloNorway,Institute of Health and SocietyUniversity of OsloOsloNorway
| | - T. Reichborn‐Kjennerud
- Institute of Clinical MedicineUniversity of OsloOsloNorway,Department of Mental DisordersNorwegian Institute of Public HealthOsloNorway
| | - E. Ystrom
- Department of Mental DisordersNorwegian Institute of Public HealthOsloNorway,Department of PsychologyPROMENTA Research CenterUniversity of OsloOsloNorway,PharmacoEpidemiology and Drug Safety Research GroupSchool of PharmacyUniversity of OsloOsloNorway
| | - B. K. Jacobsen
- Center for Clinical Documentation and Evaluation (SKDE)TromsøNorway,Department of Community MedicineUiT – The Arctic University of NorwayTromsøNorway,Department of Community MedicineCentre for Sami Health ResearchUiT – The Arctic University of NorwayTromsøNorway
| | - A. Høye
- Center for Clinical Documentation and Evaluation (SKDE)TromsøNorway,Department of Clinical MedicineUiT – The Arctic University of NorwayTromsøNorway,Division of Mental Health and Substance AbuseUniversity Hospital of North NorwayTromsøNorway
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28
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Abstract
Individuals with schizophrenia die, on average, 20 years before their peers, with 'natural causes' accounting for 80% of premature deaths. The aim of this narrative review is to address this phenomenon from the perspective of known factors that contribute to long life. The relevant literature from the last decade was searched in PubMed and Google Scholar databases. Four factors have been shown to be common to centarians, people who live to be a hundred: genes, life style behaviors that favor a healthy heart, social support, and a subjective purpose in life. The latter three factors are potentially modifiable but, in the context of schizophrenia, there are barriers to change, namely poverty, illness symptoms, stress, stigma, and side effects of antipsychotic medication. Barriers to change need to be addressed before substantial progress can be made in increasing the health and mortality risk of people with schizophrenia.
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Affiliation(s)
- Mary V Seeman
- Department of Psychiatry, University of Toronto, 260 Heath St. West, Suite #605, Toronto, Ontario, M5P 3L6, Canada.
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