Are metabolic disorders part of a severe mental illness? Historical and current perspective

Abstract

Introduction and purpose: People with severe mental illness (SMI) live shorter lives than general population. The main cause of mortality in this group is not psychiatric tax diseases, but comorbidities, which are mainly classified as diseases associated with metabolic disorders, such as: obesity, metabolic syndrome (MetS), diabetes type 2, CVDs, coronary artery disease (CAD), cerebrovascular disease. The aim of this review was to identify the factor relating to relationship between metabolic disorders and mental illness. Description of the state of knowledge: People with SMI are characterized by a higher level of adipose tissue in the visceral region (abdominal obesity) compared to the control group, without any mental disorders. Current studies indicate, that persons with SMI have a genetic tendency of to accumulate adipose tissue in the abdominal area. They are also characterized by higher level of body mass index (BMI), overweight or obesity, than general population. This is mostly caused by 103 lifestyle and specific pharmacological treatment using antipsychotic drug, especially atypical (second generation), which cause weight gain and disturbed carbohydrate metabolism. The fact is, that carbohydrate metabolic disorders were observed in patients with schizophrenia before the first neuroleptic was discovered. Last studies indicated that overweight, obesity may has the same genetic loci as SMI. Summary: SMI seems to be part of a metabolic disorder. This relationship mostly results from the lifestyle, pharmacological treatment, and also the genetic factors. It should be taken into account that the treatment of SMI always requires monitoring of metabolic indicators. Additionally, motivating patients to a healthy lifestyle and physical activity should be the standard of treatment.