Body mass index and quality of life in community-dwelling patients with schizophrenia

Strassnig, Martin; Brar, Jaspreet S.; Ganguli, Rohan

doi:10.1016/s0920-9964(02)00441-3

Cited by 117 publications

(99 citation statements)

References 12 publications

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“…Individuals with schizophrenia with higher weight showed a significant association with lower scores in the mental domain, and those with a higher BMI revealed a significant association with lower scores in the physical domain. Similarly, Strassnig et al 17 reported that excess body weight negatively influenced QoL. Light PA also yielded low scores in the physical and mental domains.…”

Section: Discussionmentioning

confidence: 89%

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Quality of life and physical activity levels in outpatients with schizophrenia

Gomes

Bastos

Probst

et al. 2016

Rev. Bras. Psiquiatr.

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Objectives: To assess quality of life (QoL) and physical activity (PA) levels of outpatients with schizophrenia and healthy controls matched for age, gender, body mass index (BMI), hip circumference, waist circumference, and waist-to-hip ratio. Additionally, the present study investigated associations between PA levels, QoL, and anthropometric and behavioral measures among outpatients with schizophrenia. Methods: Thirty-two outpatients with schizophrenia and 32 individuals without mental illness were included in the study. QoL and PA levels were assessed by the World Health Organization Quality of Life InstrumentAbbreviated version (WHOQOL-Bref) and by GT3X triaxial accelerometers, respectively. Results: Outpatients with schizophrenia had poorer QoL and lower vigorous PA levels compared with healthy controls (p o 0.05). The group with schizophrenia showed a significant association between higher weight and lower scores in the mental health domain of the WHOQOL-Bref. A higher BMI was also significantly associated with lower scores in the physical health domain of the WHOQOL-Bref. Schizophrenic patients with smoking behaviors were associated with fewer steps per day and with less moderate to vigorous PA. Conclusions: This study seeks to shed some light upon the lifestyle of patients with schizophrenia. New psychosocial approaches should focus on PA, weight, and smoking management, thereby helping these patients to improve their QoL.

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Section: Discussionmentioning

confidence: 89%

“…Our findings suggest that QoL could be potentially improved with the practice of regular PA, i.e., by reducing inactivity. 17 Likewise, Pesek et al 9 found that higher PA scores were associated with better QoL in the physical domain.…”

Section: Discussionmentioning

confidence: 98%

Quality of life and physical activity levels in outpatients with schizophrenia

Gomes

Bastos

Probst

et al. 2016

Rev. Bras. Psiquiatr.

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“…Obesity and adiposity represent a complex pathophysiological condition that could result from increased caloric intake (Strassnig et al, 2003a, b) and decreased energy expenditure owing to reduced physical activity (Strassnig et al, 2003a) or a combination of both (Peet, 2004a). Dietary intake, a relatively easily modifiable behavioral phenomenon, could provide a rich framework for preventive/therapeutic clinical interventions.…”

Section: Dietary Habits Of Schizophrenic Patientsmentioning

confidence: 99%

“…A rather scarce (relatively to the scope of the problem) literature on schizophrenic eating habits describes exag-gerated preference for unhealthy predominately fast foodtype (Peet, 2004a, c;Strassnig et al, 2005) palatable nutrition, poor in fiber (Brown et al, 1999;McCreadie et al, 1998), in fruits and in vegetables (McCreadie et al, 1998(McCreadie et al, , 2005McCreadie, 2003), but excessive in saturated fat (Brown et al, 1999;Strassnig et al, 2003aStrassnig et al, , 2005Ryan et al, 2003Ryan et al, , 2004, in carbohydrates (Strassnig et al, 2003b), and in high glycemic index (Foster-Powell et al, 2002) foodstuffs such as cereal (McCreadie, 2003). These patterns may be further worsened by treatment with SGAs such as clozapine, olanzapine, and to lesser degree quetiapine and risperidone, but not ziprasidone or aripiprazole (Allison et al, 1999b;American Diabetes Association, 2004;Kane et al, 2004;Newcomer 2005).…”

Section: Dietary Habits Of Schizophrenic Patientsmentioning

confidence: 99%

Food Intake and Reward Mechanisms in Patients with Schizophrenia: Implications for Metabolic Disturbances and Treatment with Second-Generation Antipsychotic Agents

Elman

Borsook

Lukas

2006

Neuropsychopharmacol

138

142

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Obesity is highly prevalent among patients with schizophrenia and is associated with detrimental health consequences. Although excessive consumption of fast food and pharmacotherapy with such second-generation antipsychotic agents (SGAs) as clozapine and olanzapine has been implicated in the schizophrenia/obesity comorbidity, the pathophysiology of this link remains unclear. Here, we propose a mechanism based on brain reward function, a relevant etiologic factor in both schizophrenia and overeating. A comprehensive literature search on neurobiology of schizophrenia and of eating behavior was performed. The collected articles were critically reviewed and relevant data were extracted and summarized within four key areas: (1) energy homeostasis, (2) food reward and hedonics, (3) reward function in schizophrenia, and (4) metabolic effects of the SGAs. A mesolimbic hyperdopaminergic state may render motivational/incentive reward system insensitive to low salience/palatability food. This, together with poor cognitive control from hypofunctional prefrontal cortex and enhanced hedonic impact of food, owing to exaggerated opioidergic drive (clinically manifested as pain insensitivity), may underlie unhealthy eating habits in patients with schizophrenia. Treatment with SGAs purportedly improves dopamine-mediated reward aspects, but at the cost of increased appetite and worsened or at least not improved opiodergic capacity. These effects can further deteriorate eating patterns. Pathophysiological and therapeutic implications of these insights need further validation via prospective clinical trials and neuroimaging studies. INTRODUCTIONObesity has reached pandemic proportions and it is rapidly surpassing smoking as a number one killer in the industrialized world (Sturm, 2002;Skidmore and Yarnell, 2004). Its annual cost to the American society is staggering, and is estimated to be around $117 billion owing to related illnesses and loss of productivity (National Institute of Diabetes and Digestive and Kidney Diseases, 2005).In schizophrenia, obesity is twice as prevalent as in the general public, afflicting over half this patient population (Allison et al, 1999a;Dixon et al, 2000; American Diabetes Association, 2004;Marder et al, 2004;Wirshing, 2004). Besides negative psychosocial impacts (distorted selfesteem and societal stigmatization) and medications noncompliance, schizophrenics appear to be particularly susceptible to the detrimental medical sequelae of obesity such as the 'Metabolic Syndrome', which is a cluster of cardiovascular risk factors, including abdominal adiposity, insulin resistance, impaired, glucose tolerance, dyslipidemia, and hypertension (McKee et al, 1986;Mukherjee et al, 1996;Brown et al, 2000;Haupt and Newcomer, 2002;Ryan and Thakore, 2002;Ryan et al, 2003;Holt et al, 2004;Kohen, 2004;Marder et al, 2004;Lieberman et al, 2005).Excessive body weight gain (BWG) could be attributed to a constellation of endocrine, molecular, genetic, demographic, and lifestyle-related factors. Provided that a common tra...

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“…In addition, among SGAs, varying degrees of treatment-associated weight gain and related consequences still represent a significant concern (Tarricone et al, 2006). Increased adiposity has been associated with alterations in fasting blood glucose, insulin, low-density lipoprotein levels, and cholesterol Ebenbichler et al, 2003;Henderson et al, 2005;Muoio and Newgard, 2006;Wofford et al, 2006), and a subsequent increased risk for diabetes, morbidity, and mortality (Fontaine et al, 2001;Newcomer, 2005;Strassnig et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Zonisamide Prevents Olanzapine-Associated Hyperphagia, Weight Gain, and Elevated Blood Glucose in Rats

Wallingford

Sinnayah

Bymaster

et al. 2008

Neuropsychopharmacol

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Olanzapine (OLZ), one of the second-generation atypical antipsychotics (SGAs), has shown relative advantages in patient adherence and outcomes. However, OLZ has also been associated with a higher incidence of weight gain than most other SGAs. Excessive weight gain may in turn contribute to long-term health concerns for some individuals. Zonisamide (ZNS), a medication approved in the United States as an adjunct in the management of epilepsy, has a diverse pharmacological profile, including sodium channel blockade, monoamine enhancement, and inhibition of carbonic anhydrase. ZNS has also been reported to cause weight loss in both humans and rodents. We hypothesized that this profile might be beneficial when co-administered with OLZ. To test this hypothesis, we evaluated the effects of OLZ on body weight, as well as the pathways known to regulate feeding behavior and arousal in the Sprague-Dawley rat. As indicated via c-Fos expression, we found an OLZ-induced activation in the nucleus accumbens and orexin neurons in the lateral hypothalamus. An OLZ-associated development of hyperphagia, weight gain and elevated blood glucose in the rat was also found. These outcomes were attenuated and reversed in the presence of concomitant ZNS. These results suggest the hypothesis that ZNS may effectively treat or prevent weight gain or metabolic changes associated with the SGAs. Future studies of this combination in patients through appropriately designed human clinical studies are encouraged.

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Body mass index and quality of life in community-dwelling patients with schizophrenia

Cited by 117 publications

References 12 publications

Quality of life and physical activity levels in outpatients with schizophrenia

Quality of life and physical activity levels in outpatients with schizophrenia

Food Intake and Reward Mechanisms in Patients with Schizophrenia: Implications for Metabolic Disturbances and Treatment with Second-Generation Antipsychotic Agents

Zonisamide Prevents Olanzapine-Associated Hyperphagia, Weight Gain, and Elevated Blood Glucose in Rats

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