First-episode schizophrenia spectrum disorders are associated with a significantly higher prevalence of metabolic risk factors, such as smoking, dyslipidemia, and elevated body mass, compared with the general population. Those risk factors are tied to illness duration and are exacerbated by antipsychotic therapy, data from a cross-sectional study of patients with the disorders show.
Among the 394 patients with cardiometabolic data, about half smoked cigarettes, 39.9% had prehypertension, 10.0% had hypertension, and 13.2% had metabolic syndrome, and 48.3% were obese or overweight – a figure similar to that found among a similarly aged U.S. population – while 56.5% had dyslipidemia, which reflects the incidence in a general population 15-20 years older.
Dr. Christoph U. Correll
Duration of psychiatric illness was significantly associated with higher body mass index, fat mass, fat percentage, and waist circumference. Antipsychotic treatment was linked to higher measures of non-HDL-C, triglyceride levels, and triglyceride to HDL-C ratios but lower HDL-C measures and systolic blood pressure, according to a paper published online Oct. 8 in JAMA Psychiatry ([doi:10.1001/jamapsychiatry.2014.1314]).
“In patients with [first-episode schizophrenia], cardiometabolic risk factors and abnormalities are present early in the illness and likely related to the underlying illness, unhealthy lifestyle, and antipsychotic medications, which interact with each other,” wrote Dr. Christoph U. Correll, professor, psychiatry and molecular medicine at the Hofstra University, Hempstead, N.Y., and his colleagues. “Prevention of and early interventions for psychiatric illness with lower-risk agents, routine antipsychotic adverse effect monitoring, and smoking cessation interventions are needed from the earliest illness phases.”
The study was supported by the National Institute of Mental Health, and the American Recovery and Reinvestment Act. Dr. Correll disclosed acting as a consultant and/or adviser to or receiving honoraria from several companies and entities, including numerous makers of antipsychotics.