Cardiovascular mortality in schizophrenia: Defining a critical period for prevention

Srihari, Vinod H.; Phutane, Vivek H.; Ozkan, Banu; Chwastiak, Lydia; Ratliff, Joseph C.; Woods, Scott W.; Tek, Cenk

doi:10.1016/j.schres.2013.01.014

Cited by 49 publications

(48 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4,62 Lifestyle change incorporated in phase-specific FEP care could reap significant health and quality of life benefits several decades later for the FEP population. However, first and foremost, care in initial medication choice represents a relatively easy and inexpensive preventive health intervention for FEP.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Antipsychotic-Induced Weight Gain in First-Episode Psychosis Patients: A Meta-Analysis of Differential Effects of Antipsychotic Medications

Tek

Küçükgöncü

Gülöksüz

et al. 2016

FOC

Self Cite

View full text Add to dashboard Cite

Aim-The first-episode psychosis (FEP) represents a critical period to prevent cardiovascular and metabolic morbidity decades later. Antipsychotic (AP)-induced weight gain is one modifiable factor in this period. The purpose of this study is to conduct a meta-analysis of AP-induced weight and body mass index (BMI) change in FEP.Methods-A comprehensive literature search identified 28 articles that reported data on APspecific weight or BMI change in FEP. We conducted a meta-analysis of short-and long-term mean weight and BMI differences between placebo and AP medications. We also performed subgroup and meta-regression analysis to examine weight, BMI outcomes and their relationship with location (Asian vs. Western), sponsorship and baseline weight and BMIs.Results-Compared to placebo, AP-caused mean weight gain was 3.22 kg and 1.4 points BMI in the short-term, and 5.30 kg and 1.86 points BMI in the long term. Clinically significant weight gain risk increased about twofold with AP use. Weight gain was associated with duration of AP use. AP medications were associated with more weight gain in Western samples as opposed to Asian samples. Most AP medications were associated with significant body weight gain and BMI increase in FEP patients, except for ziprasidone. Olanzapine and clozapine caused the highest weight gain compared to placebo.Conclusion-Except for ziprasidone, most AP medications were associated with body weight gain and BMI increase in FEP patients. Early and continuing effects of various AP medications on weight gain and BMI increase should be taken into consideration by clinicians.

show abstract

Section: Discussionmentioning

confidence: 99%

“…We have previously shown that cardiovascular risk doubles in the first year of psychotic illness. 4 This presents a rare opportunity for a 'critical period' of intervention to prevent morbidity and mortality and improve quality of life for psychosis early intervention programmes several decades later.…”

Section: Introductionmentioning

confidence: 99%

Antipsychotic-Induced Weight Gain in First-Episode Psychosis Patients: A Meta-Analysis of Differential Effects of Antipsychotic Medications

Tek

Küçükgöncü

Gülöksüz

et al. 2016

FOC

Self Cite

View full text Add to dashboard Cite

show abstract

“…For a long time, clinicians have speculated about the potential options to exert therapeutic interventions during the early stages of SZ, with the goal of delaying or averting the illness and/or its complications (Sullivan, 1994; Srihari et al, 2013). However, effective early interventions require the ability to correctly identify the patients that will have a poor clinical course and more comorbid conditions, like MS.…”

Section: Schizophrenia and Sphingolipidsmentioning

confidence: 99%

From Molecules to the Clinic: Linking Schizophrenia and Metabolic Syndrome through Sphingolipids Metabolism

et al. 2016

View full text Add to dashboard Cite

Metabolic syndrome (MS) is a prevalent and severe comorbidity observed in schizophrenia (SZ). The exact nature of this association is controversial and very often accredited to the effects of psychotropic medications and disease-induced life-style modifications, such as inactive lifestyle, poor dietary choices, and smoking. However, drug therapy and disease-induced lifestyle factors are likely not the only factors contributing to the observed converging nature of these conditions, since an increased prevalence of MS is also observed in first episode and drug-naïve psychosis populations. MS and SZ share common intrinsic susceptibility factors and etiopathogenic mechanisms, which may change the way we approach clinical management of SZ patients. Among the most relevant common pathogenic pathways of SZ and MS are alterations in the sphingolipids (SLs) metabolism and SLs homeostasis. SLs have important structural functions as they participate in the formation of membrane “lipid rafts.” SLs also play physiological roles in cell differentiation, proliferation, and inflammatory processes, which might be part of MS/SZ common pathophysiological processes. In this article we review a plausible mechanism to explain the link between MS and SZ through a disruption in SL homeostasis. Additionally, we provide insights on how this hypothesis can lead to the developing of new diagnostic/therapeutic technologies for SZ patients.

show abstract

“…Patients and healthy controls showed comparable adaptations to endurance training, as assessed by physical working capacity cardiovascular health, for example, in people without a psychiatric disorder [3]. Patients with schizophrenia are on average less active, less fit and at higher risk of cardiovascular and metabolic diseases than people without psychiatric disorders [4,5] and consequently show a higher excess mortality [6]. Endurance training might be beneficial for patients with schizophrenia via multiple ways.…”

Section: Introductionmentioning

confidence: 99%

Endurance training in patients with schizophrenia and healthy controls: differences and similarities

Keller-Varady

Hasan

Schneider‐Axmann

et al. 2015

Eur Arch Psychiatry Clin Neurosci

View full text Add to dashboard Cite

The aims were to examine the feasibility of and adaptations to endurance training in persons diagnosed with schizophrenia and to address the question whether the principles and beneficial effects of endurance training established in the healthy population apply also to patients with schizophrenia. In this controlled interventional study, 22 patients with schizophrenia and 22 healthy controls performed a standardized aerobic endurance training on bicycle ergometers over 12 weeks. Another group of 21 patients with schizophrenia played table soccer. Endurance capacity was measured with incremental cycle ergometry before and after the intervention and 3 months later. A specific set of outcome parameters was defined. The training stimuli can be assumed to be similar in both endurance groups. Endurance capacity improved significantly in the endurance groups, but not in the table soccer group. Patients and healthy controls showed comparable adaptations to endurance training, as assessed by physical working capacity and maximal achieved power. Differences were found in changes of performance at a lactate concentration of 3 mmol/l. Endurance training was feasible and effective in both groups. The principles and types of training that are usually applied to healthy controls need to be verified in patients with schizophrenia. Nevertheless, patients benefited from endurance training in terms of improvement of endurance capacity and reduction in the baseline deficit in comparison with healthy controls. Therefore, endurance training should be implemented in future therapy programs. These programs need to pay special attention to the differences between patients with schizophrenia and healthy controls.

show abstract

Cardiovascular mortality in schizophrenia: Defining a critical period for prevention

Cited by 49 publications

References 27 publications

Antipsychotic-Induced Weight Gain in First-Episode Psychosis Patients: A Meta-Analysis of Differential Effects of Antipsychotic Medications

Antipsychotic-Induced Weight Gain in First-Episode Psychosis Patients: A Meta-Analysis of Differential Effects of Antipsychotic Medications

From Molecules to the Clinic: Linking Schizophrenia and Metabolic Syndrome through Sphingolipids Metabolism

Endurance training in patients with schizophrenia and healthy controls: differences and similarities

Contact Info

Product

Resources

About