A Review of Cardiovascular Risk Factors in Women with Psychosis

González-Rodríguez, Alexandre; Seeman, Mary V.; Guàrdia, A.; Natividad, Mentxu; Román, E.; Izquierdo, E.; Monreal, José Antonio

doi:10.3390/women3020016

Cited by 3 publications

(5 citation statements)

References 41 publications

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“…Cardiovascular disease is the major human cause of mortality and affects people with schizophrenia more than others because of stress, inflammation, poor diet, excessive smoking and alcohol use, sedentary lifestyles and obesity, and the metabolic effects of antipsychotics [ 26 ]. There may also be more fundamental reasons.…”

Section: Resultsmentioning

confidence: 99%

“…Although several inconsistencies have been reported with regard to gender differences in cardiovascular risk factors (CVRFs) in the first episodes of psychoses, a general agreement is that CVRFs increase at menopause in women with chronic psychoses [ 26 ].…”

Section: Resultsmentioning

confidence: 99%

“…Primary care services are the appropriate settings to identify early CVRFs and to propose intervention strategies. Smoking cessation, a heart-healthy diet and physical activity, and regular sleep routines need to be promoted in patients with schizophrenia, and especially in women at the time of menopause [ 26 , 32 ]. There are also reports that men and women with severe mental illness who are at elevated risk of ST-elevation myocardial infarction (STEMI) are less likely than others to be treated with revascularization procedures [ 33 ], presumably because they are seen as unlikely to follow through on post-intervention instructions.…”

Section: Resultsmentioning

confidence: 99%

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Monitoring the Effectiveness of Treatment in Women with Schizophrenia: New Specialized Cooperative Approaches

Natividad,

Seeman,

Paolini

et al. 2023

Brain Sciences

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Women with schizophrenia have specific health needs that differ from those of men and that change through successive life stages. We aimed to review the biopsychosocial literature on schizophrenia that addresses clinically important questions related to the treatment of women, including somatic morbi-mortality, hyperprolactinemia, comorbid substance use disorders, social risk factors, and medication effectiveness/safety. Data search terms were as follows: (Morbidity AND mortality) OR hyperprolactinemia OR (“substance use disorders” OR addictions) OR (“social risk factors”) OR (“drug safety” OR prescription) AND women AND schizophrenia. A secondary aim was to describe a method of monitoring and interdisciplinary staff strategies. Schizophrenia patients show an increased risk of premature death from cardiovascular/respiratory disease and cancer compared to the general population. The literature suggests that close liaisons with primary care and the introduction of physical exercise groups reduce comorbidity. Various strategies for lowering prolactin levels diminish the negative long-term effects of hyperprolactinemia. Abstinence programs reduce the risk of victimization and trauma in women. Stigma associated with women who have serious psychiatric illness is often linked to reproductive functions. The safety and effectiveness of antipsychotic drug choice and dose differ between men and women and change over a woman’s life cycle. Monitoring needs to be multidisciplinary, knowledgeable, and regular.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Monitoring the Effectiveness of Treatment in Women with Schizophrenia: New Specialized Cooperative Approaches

Natividad,

Seeman,

Paolini

et al. 2023

Brain Sciences

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“…As mentioned, negative symptoms (apathy, avolition, social withdrawal) need to be targeted and smoking cessation, a heart-healthy diet, physical activity (at least 30 minutes per day), and regular sleep routines need to be actively promoted ( 127 , 134 ). Smoking, in particular, not only increases CV risk, but also complicates treatment, since the hydrocarbons in cigarette smoke accelerate the metabolism of dibenzodiazepines, clozapine and olanzapine ( 135 ).…”

Section: Discussionmentioning

confidence: 99%

Shared and unique characteristics of metabolic syndrome in psychotic disorders: a review

Saccaro,

Aimo,

Panichella

et al. 2024

Front. Psychiatry

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IntroductionPeople with psychosis spectrum disorders (PSD) face an elevated risk of metabolic syndrome (MetS), which may reduce their life expectancy by nearly 20%. Pinpointing the shared and specific characteristics and clinical implications of MetS in PSD is crucial for designing interventions to reduce this risk, but an up-to-date review on MetS across the psychosis spectrum is lacking.MethodsThis narrative review fills this gap by examining the clinical literature on characteristics and implications of MetS in both distinct PSD and transdiagnostically, i.e., across traditional categorical diagnoses, with a focus on psychiatric and cardio-metabolic management.ResultsWe discuss common and specific characteristics of MetS in PSD, as well as factors contributing to MetS development in PSD patients, including unhealthy lifestyle factors, genetic predisposition, pro-inflammatory state, drugs consumption, antipsychotic medication, and psychotic symptoms. We highlight the importance of early identification and management of cardio-metabolic risk in PSD patients, as well as the existing gaps in the literature, for instance in the screening for MetS in younger PSD patients. We compare hypotheses-generating clinical associations and characteristics of MetS in different PSD, concluding by reviewing the existing recommendations and challenges in screening, monitoring, and managing MetS in PSD.ConclusionEarly identification and management of MetS are crucial to mitigate the long-term cardio-metabolic toll in PSD patients. Interventions should focus on healthy lifestyle and appropriate pharmacological and behavioral interventions. Further translational and clinical research is needed to develop targeted interventions and personalized treatment approaches for this vulnerable population, aiming at improving physical health and overall well-being.

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“…Achieving optimal physical healthcare has been considered a major challenge in the management of individuals with severe mental illness; this is being increasingly recognized and addressed. A recent example is the introduction of exercise programs into standard care for schizophrenia patients, an intervention that benefits cognition by reversing hippocampal volume loss and improving memory scores [86]. Exercise-induced weight loss also protects against antipsychotic-induced metabolic complications.…”

Section: Oestrogen/raloxifene In Schizophreniamentioning

confidence: 99%

Improving treatment of women with schizophrenia: a review of the recent literature

González-Rodríguez,

Cobo,

Seeman

2023

Exploration of Medicine

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Effective clinical management of women with schizophrenia is therapeutically challenging. While there have been recent advances in the understanding of neurobiological, hormonal, and female reproductive cycle factors that play a decisive role in the development and progression of schizophrenia in women, this knowledge has not yet been fully translated into treatment practice. The aim was to apply the best evidence available to optimally treat women with schizophrenia at various periods of the lifespan. A narrative review was conducted of recent advances (2018–2023) in aspects of schizophrenia in women that demand sex-specific treatment. Sex steroids impact antipsychotic absorption, distribution, metabolism, elimination, passage through the blood-brain barrier, and blood flow rate to the brain. For these reasons, premenopausal women with schizophrenia, as compared to male age peers, require lower doses of most antipsychotic drugs and suffer comparatively more adverse events (metabolic, sexual, and cardiovascular) at similar doses. Apart from pharmacologic treatment, women have specific reproductive planning needs and need protection from sexual exploitation and domestic abuse. In addition, when pregnant, schizophrenia women show a high risk of gestational diabetes and pre-eclampsia/eclampsia that requires prevention. Prevention is also needed against long-term health hazards for their offspring. Another period of therapeutic challenge specific to women is menopause. The collected evidence points to women-specific recommendations for both biological and psychosocial treatment strategies for schizophrenia.

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A Review of Cardiovascular Risk Factors in Women with Psychosis

Cited by 3 publications

References 41 publications

Monitoring the Effectiveness of Treatment in Women with Schizophrenia: New Specialized Cooperative Approaches

Monitoring the Effectiveness of Treatment in Women with Schizophrenia: New Specialized Cooperative Approaches

Shared and unique characteristics of metabolic syndrome in psychotic disorders: a review

Improving treatment of women with schizophrenia: a review of the recent literature

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