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Relationship Between Metabolic Syndrome and Clinical Features, and Its Personal-Social Performance in Patients with Schizophrenia

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Abstract

The aim of this study was to evaluate the metabolic syndrome (MS) criteria and also to investigate the effects of MS on medical treatment, clinical course and personal and social performance in patients with schizophrenia. One hundred-sixteen patients with schizophrenia were included in the study. Measurements of MS were calculated in all patients. Brief Psychiatric Rating Scale, Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, Calgary Depression Scale for Schizophrenia, Personal and Social Performance Scale (PSP) were applied. The frequency of MS according to IDF criteria was 42.2 % among the patients. There was no significant difference between patients with and without MS in terms of age. The ratios of MS were 62.5 % for the group taking typical and atypical antipsychotics together and 35.7 % for the group taking two or more atypical antipsychotics together. The duration of disorder in patients with MS was higher than those without MS. Furthermore there was no significant difference between the schizophrenic patients with and without MS, in terms of PSP scores. Our findings showed that the duration of illness, high scores of BMI, use of clozapine or concurrent use of typical and atypical antipsychotics, depressive and negative symptoms of schizophrenia were significant risk factors for the development of MS.

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References

  1. Toalson P, Ahmed S, Hardy T, Kabinoff G: The metabolic syndrome in patient with severe mental illnesses. Primary Care Companion to the Journal of Clinical Psychiatry 60(4):152–158, 2004.

    Article  Google Scholar 

  2. Jacob R, Chowdhurry AN: Metabolic comorbidity in schizophrenia. Indian Journal of Medical Sciences 62(1):23–31, 2008.

    Article  PubMed  Google Scholar 

  3. Meyer JM, Nasrallah HA, McEvoy JP, Goff DC, Davis SM, Chakos M, et al.: The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Schizophrenia Trial: Clinical comparison of sub groups with and without the metabolic syndrome. Schizophrenia Research 80:9–18, 2005.

    Article  PubMed  Google Scholar 

  4. Newcomer JW: Second-generation (atypical) antipsychotics and metabolic effects: A comprehensive literature review. CNS Drugs 19:1–93, 2005.

    Article  CAS  PubMed  Google Scholar 

  5. Scheen A, De Hert M: Abnormal glucose metabolism in patients treated with antipsychotics. Diabetes & Metabolism 33:169–75, 2007.

    Article  CAS  Google Scholar 

  6. Haddad PM, Sharma SG: Adverse effects of atypical antipsychotics; differential risk and clinical implications. CNS Drugs 21:911–936, 2007.

    Article  CAS  PubMed  Google Scholar 

  7. De Hert M, Schreurs V, Van campfort D, Van Winkel R: Metabolic syndrome in people with schizophrenia: A review. World Psychiatry 8:15–22, 2009.

    Article  Google Scholar 

  8. Haupt DW: Differential metabolic effects of antipsychotic treatments. European Neuropsychopharmacology 16:149–155, 2006.

    Article  Google Scholar 

  9. Basu A, Meltzer HY: Differential trends in prevalence of diabetes and unrelated general medical illness for schizophrenia patients before and after the atypical antipsychotic era. Schizophrenia Research 86:99–109, 2006.

    Article  PubMed  Google Scholar 

  10. Eckel RH, Grundy SM, Zimmet PZ: The metabolic syndrome. Lancet 365(9468):1415–1428, 2005.

    Article  CAS  PubMed  Google Scholar 

  11. Birchwood M, Smith J, Cochrane R, Wetton S, Opestake S: The Social Functioning Scale. The development and validation of a new scale of social adjustment for use in family intervention programmes with schizophrenic patients. The British Journal of Psychiatry 157:853–859, 1990.

    Article  CAS  PubMed  Google Scholar 

  12. Bodén R, Sundström J, Lindström E, et al.: Association between symptomatic remission and functional outcome in first episode schizophrenia. Schizophrenia Research 107:232–237, 2009.

    Article  PubMed  Google Scholar 

  13. Lieberman JA, Stroup TS, McEvoy JP, Swartz MS, Rosenheck RA, Perkins DO, et al.: Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. New England Journal of Medicine 353:1209–23, 2005.

    Article  CAS  PubMed  Google Scholar 

  14. Stroup TS, Lieberman JA, McEvoy JP, Swartz MS, Davis SM, Rosenheck RA, et al.: Effectiveness of olanzapine, quetiapine, risperidone, and ziprasidone in patients with chronic schizophrenia following discontinuation of a previous atypical antipsychotic. American Journal of Psychiatry 163:611–22, 2006.

    Article  PubMed  Google Scholar 

  15. van Winkel R, De Hert M, Wampers M, Van Eyck D, Hanssens L, Scheen A, et al.: Major changes in glucose metabolism including new onset diabetes within 3 months after initiation or switch of atypical antipsychotic medication in patients with schizophrenia and schizoaffective disorder. Journal of Clinical Psychiatry 69:472–479, 2008.

    Article  PubMed  Google Scholar 

  16. De Hert M, Hanssens L, Wampers M: Prevalence and incidence rates of metabolic abnormalities and diabetes in a prospective study of patients treated with second-generation antipsychotics. Schizophrenia Bulletin 33:560, 2007.

    Google Scholar 

  17. Metabolik Sendrom Kılavuzu: Türkiye Endokrinoloji Ve Metabolizma Derneği. Ankara, Tuna Matbaacılık, pp. 8–11, 2009.

    Google Scholar 

  18. The IDF Consensus Worldwide Definition of the Metabolic Syndrome. IDF Communications. International Diabetes Federation, Belgium, pp. 10–16, 2006.

  19. Overall JE, Gorham DR: The brief psychiatric rating scale. Psychological Reports 10:799–812, 1962.

    Article  Google Scholar 

  20. Erkoç Ş, Arkonaç O, Ataklı C, Özmen E: Negatif semptomları değrlendirme ölçeğinin güvenirliliği ve geçerliliği. Düşünen Adam 4:16–19, 1991.

    Google Scholar 

  21. Erkoç Ş, Arkonaç O, Ataklı C, Özmen E: Pozitif semptomları değrlendirme ölçeğinin güvenirliliği ve geçerliliği. Düşünen Adam 4:20–24, 1991.

    Google Scholar 

  22. Addington D, Addington J, Joyce J: Reliability and validity of a depression rating scale for schizophrenics. Schizophrenia Research 6:201–208, 1992.

    Article  CAS  PubMed  Google Scholar 

  23. Aydemir Ö, Esen Danacı A, Deveci A: Calgary şizofrenide depreyon ölçeğinin Türkçe versiyonunun güvenirliliği ve geçerliliği. Nöropsikiyatri Arşivi 37:82–86, 2000.

    Google Scholar 

  24. Morosini PL, Magliano M, Brambilla L, et al.: Development, reliability and acceptability of a new version of the DSM-IV Social and Occupational Functioning Assessment Scale (SOFAS) to ases routine social functioning. Acta Psychiatrica Scandinavica 101:323–329, 2000.

    CAS  PubMed  Google Scholar 

  25. De Hert M, Van Eyck D, De Nayer A: Metabolic abnormalities associated with second generation antipsychotics: Fact or fiction? Development of guidelines for screening and monitoring. International Clinical Psychopharmacology 21(Suppl. 2):11–15, 2006.

    Article  Google Scholar 

  26. Kato MM, Currier MB, Gomez CM, et al.: Prevalence of metabolic syndrome in hispanic and non-hispanic patients with schizophrenia. Primary Care Companion to the Journal of Clinical Psychiatry 6(2):74–77, 2004.

    Article  PubMed  PubMed Central  Google Scholar 

  27. McEvoy JP, Meyer JM, Goff DC, Nasrallah HA, Davis SM, Sullivan L, et al.: Prevalence of the metabolic syndrome in patients with schizophrenia: Baseline results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III B. Schizophrenia Research 80:19–32, 2005.

    Article  PubMed  Google Scholar 

  28. Heiskanen T, Niskanen L, Lyytikainen R, et al.: Metabolic syndrome in patients with schizophrenia. Journal of Clinical Psychiatry 64(5):575–579, 2003.

    Article  PubMed  Google Scholar 

  29. Cohn T, Prudhome D, Streiner D, et al.: Characterizing coronary heart disease risk in chronic schizophrenia: High prevalence of the metabolic syndrome. Canadian Journal of Psychiatry 49:753–760, 2004.

    PubMed  Google Scholar 

  30. Cerit C, Özten E, Yıldız M: Sizofreni hastalarında metabolik sendrom sıklıgı ve iliskili etmenler. Türk Psikiyatri Dergisi 19(2):124–132, 2008.

    PubMed  Google Scholar 

  31. Öyekçin DG: Bir grup şlizofreni ve şlizoaffektif bozukluk hastasında metabolik sendrom sıklığı. Anadolu Psikiyatri Dergisi 10:26–33, 2009.

    Google Scholar 

  32. Kaya M, Vırıt O, Altındağ A, ve ark.: Şizofrenide Metabolik Sendrom Sıklığı, Metabolik Sendromun Özellikleri ve Kullanılan Antipsikotiklerle ilişkisi. Nöropsikiyatri Arşivi 46:13–8, 2009.

    Google Scholar 

  33. Vural M. Şizofreni ve bipolar affektif bozukluk hastalar›nda antipsikotik ilaç kullanımı ile Metabolik Sendrom ve diğer metabolik süreçlerin ilişkisinin incelenmesi. Uzmanlık Tezi, İstanbul, Haydarpaşla Numune Eğitim ve Araştırma Hastanesi, Psikiyatri Kliniği, 2007.

    Google Scholar 

  34. Nurkalem Z, Orhan AL, Alper AT, ve ark.: Akut koroner sendromlu, diyabetik olmayan hastalarda metabolik sendrom ile TIMI risk skoru arasındaki ilişki. Türk Kardiyol Dern Arşivi 35:231–236, 2007.

    Google Scholar 

  35. Hagg S, Lindblom Y, Mjörndal T, Adolfsson R: High prevalence of the metabolic syndrome among a Swedish cohort of patients with schizophrenia. International Clinical Psychopharmacology 21(2):93–98, 2006.

    Article  PubMed  Google Scholar 

  36. Bermudes RA, Keck PE JR, Welge JA: The prevalence of metabolic syndrome in psychiatric inpatients with primary psychotic and mood disorders. Psychosomatics 47(6):491–499, 2006.

    Article  PubMed  Google Scholar 

  37. Henderson DC, Cagliero E, Gray C: Clozapine, diabetes mellitus,weight gain and lipid abnormalities: A five year naturalistic study. American Journal of Psychiatry 157:975–981, 2000.

    Article  CAS  PubMed  Google Scholar 

  38. Hagg S, Joelson L, Mjörndal T, et al.: Prevalence of diabetes and impaired glucose tolerance in patients treated with clozapine compared with patients treated with conventional depot neuroleptic medications. Journal of Clinical Psychiatry 59:294–299, 1998.

    Article  CAS  PubMed  Google Scholar 

  39. Van Gaal LF: Long-term health considerations in schizophrenia: Metabolic effects and the role of abdominal adiposity. European Neuropsychopharmacology 16:142–148, 2006.

    Article  Google Scholar 

  40. Wirshing DA, Boyd JA, Meng LR, et al.: The effect of novel antipsychotics on glucose and lipid levels. Journal of Clinical Psychiatry 63:856–865, 2002.

    Article  CAS  PubMed  Google Scholar 

  41. Usta E, Metin Ö, Birsöz S: Sizofreni ve diyabet: Yeni kusak antipsikotiklerin yol açtıgı diyabet veya metabolik sendrom. Klinik Psikofarmakoloji Bülteni 17:207–216, 2007.

    Google Scholar 

  42. Thakore JH: Metabolic Syndrome and schizophrenia. The British Journal of Psychiatry 186:455–456, 2005.

    Article  PubMed  Google Scholar 

  43. Schatzberg AF, Nemeroff CB: Treatment of Schizophrenia, Weight Gain, Diabetes, and Hiperlipidemia, Textbook of Psychopharmacology, 3rd edn. The American Psychiatric Publishing, Washington, DC, pp. 897–898, 2004.

  44. American Diabetes Association/American Psychiatric Association: Consensus development conference on antipsychotic drugs and obesity and diabetes. Diabetes Care 27:596–601, 2004.

    Article  Google Scholar 

  45. Jin H, Meyer JM, Jeste DV: Phenomenology of and risk factors for new-onset diabetes mellitus and diabetic ketoacidosis associated with atypical antipsychotics: An analysis of 45 published cases. Annals of Clinical Psychiatry 14:59–64, 2002.

    Article  PubMed  Google Scholar 

  46. Danacı AE, Mızrak S, Hekimsoy Z, ve ark.: Olanzapin’e bağlı diabetes mellitus: Bir olgu sunumu. Klinik Psikofarmakoloji Bülteni 13:94–96, 2003.

    Google Scholar 

  47. Tsai AG, Wadden TA, Sarwer DB, et al.: Metabolic syndrome and health related quality of life in obese individuals seeking weight reduction. Obesity 16(1):59–63, 2008.

    Article  PubMed  Google Scholar 

  48. Kolotkin RL, Crosby RD, Corey-Lisle PK, et al.: Performance of a weight-related measure of quality of life in a psychiatric sample. Quality of Life Research 15:587–596, 2006.

    Article  PubMed  Google Scholar 

  49. Allison DB, Casey DE: Antipsychotic-induced weight gain: A review of the literature. Journal of Clinical Psychiatry 62:22–31, 2001.

    CAS  PubMed  Google Scholar 

  50. Altındağ A, Demirbağ R, Saraçoğlu G: Metabolik Sendromda Yaşam Kalitesi: Komorbid Psikiyatrik Bozuklukların Etkisi. Türkiye’de Psikiyatri 10:1, 2008.

    Google Scholar 

  51. Bechdolf A, Klosterkotter J, Hambrecht M, et al.: Determinants of subjective quality of life in post acute patients with schizophrenia. European Archives of Psychiatry and Clinical Neuroscience 253:228–235, 2003.

    Article  PubMed  Google Scholar 

  52. Franz M, Lis S, Plüddemann K, Gallhofer B: Conventional versus atypical neuroleptics: Subjective quality of life in schizophrenic patients. The British Journal of Psychiatry 170:422–425, 1997.

    Article  CAS  PubMed  Google Scholar 

  53. Carpiniello B, Lai GL, Pariante CM, et al.: Symptoms, standards of living and subjective quality of life: A comparative study of schizophrenic and depressed out-patients. Acta Psychiatrica Scandinavica 96:235–241, 1997.

    Article  CAS  PubMed  Google Scholar 

  54. Sullivan G, Wells KB, Leake B: Clinical factors associated with better quality of life in a seriously mentally ill population. Hospital and Community Psychiatry 43(8):794–798, 1992.

    CAS  PubMed  Google Scholar 

  55. Ford ES, Li C: Metabolic syndrome and health related quality of life among U.S. adults. Annals of Epidemiology 18(3):165–171, 2008.

    Article  PubMed  Google Scholar 

  56. Ritsner M, Modai I, Endicott J, et al.: Differences in quality of life domains and psychopathologic and psychosocial factors in psychiatric patients. The Journal of Clinical Psychiatry 61:880–888, 2000.

    Article  CAS  PubMed  Google Scholar 

  57. Huppert JD, Weiss KA, Lim R, et al.: Quality of life in schizophrenia: Contributions of anxiety and depression. Schizophrenia Research 51:171–180, 2001.

    Article  CAS  PubMed  Google Scholar 

  58. Browne S, Clarke M, Gervin M, et al.: Determinants of quality of life at first presentation with schizophrenia. The British Journal of Psychiatry 176:173–176, 2000.

    Article  CAS  PubMed  Google Scholar 

  59. Eren İ, Simsek D, Çalıskan AM: Sizofreni hastalarında yetiyitimi ve belirti siddetinin yasam kalitesine etkisi. Düsünen Adam 20(2):68–78, 2007.

    Google Scholar 

  60. Prudo R, Monroe Blum H: Five year outcome and prognosis in schizophrenia: A report from the London field centre of the international pilot study of schizophrenia. The British Journal of Psychiatry 150:345–354, 1987.

    Article  CAS  PubMed  Google Scholar 

  61. Kugo A, Terada S, Ishizu H, et al.: Quality of life patients with schizophrenia in a Japanese psychiatric hospital. Psychiatry Research 144:49–56, 2006.

    Article  PubMed  Google Scholar 

  62. By Mayo Clinic Staff: Metabolic syndrome and risk factors. Mayo Foundation for Medical Education and Research 37:454–474, 2004.

    Google Scholar 

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Authors and Affiliations

  1. Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Bakırköy Prof. Dr. Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları E. A. Hastanesi, Bakırköy, 34147, Istanbul, Turkey

    Murat Kalkan, Nurhan Fistikci & Sakire Erek

  2. Ankara Numune Training and Research Hospital Psychiatry Clinic, Altındağ, 06100, Ankara, Turkey

    Kasim Candas Kilic

  3. Department of Psychology, Işık University, 34398 , Istanbul, Turkey

    Omer Saatcioglu

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  1. Omer Saatcioglu
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  2. Murat Kalkan
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  3. Nurhan Fistikci
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  4. Sakire Erek
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  5. Kasim Candas Kilic
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Correspondence to Nurhan Fistikci.

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Saatcioglu, O., Kalkan, M., Fistikci, N. et al. Relationship Between Metabolic Syndrome and Clinical Features, and Its Personal-Social Performance in Patients with Schizophrenia. Psychiatr Q 87, 265–280 (2016). https://doi.org/10.1007/s11126-015-9384-0

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