Clinical management of comorbid diabetes and psychotic disorders

Chwastiak, Lydia; Freudenreich, Oliver; Tek, Cenk; McKibbin, Christine L.; Han, Jaesu; McCarron, Robert M.; Wisse, Brent E.

doi:10.1016/s2215-0366(15)00105-4

Cited by 31 publications

(40 citation statements)

References 107 publications

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“…However, current guidelines for the treatment of diabetes provide few recommendations on the psychological monitoring and suicide prevention in diabetes patients. The findings from our meta-analysis suggest a great need to identify high-risk patients, and effective psychological support is necessary to decrease suicide risk among those patients (1,2,82,83). Increased awareness of suicide risk associated with diabetes is also needed in clinical practice (11,84).…”

Section: Discussionmentioning

confidence: 93%

MANAGEMENT OF ENDOCRINE DISEASE: Suicide risk in patients with diabetes: a systematic review and meta-analysis

Wang

Shi

et al. 2017

European Journal of Endocrinology

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Background: Previous studies investigating the risk of suicide in diabetes patients reported controversial findings. We did a systematic review and meta-analysis to comprehensively estimate the risk and incidence rate of suicide in diabetic patients. Methods: PubMed, EMBASE and PsycINFO were searched for eligible studies. Random-effects meta-analysis was used to calculate the relative risk (RR) and the incidence rate of suicide in diabetes patients. We also calculated the proportion of deaths attributable to suicide among diabetes patients. Results: 54 studies were finally included, including 28 studies on the suicide risk associated with diabetes, 47 studies on the incidence rate of suicide and 45 studies on the proportion of deaths attributable to suicide. Meta-analysis showed that diabetes could significantly increase the risk of suicide (RR = 1.56; 95% CI: 1.29-1.89; P < 0.001). Subgroup analysis showed that the RR of suicide associated with type 1 diabetes was 2.25 (95% CI: 1.50-3.38; P < 0.001). The pooled incidence rate of suicide in patients with diabetes was 2.35 per 10 000 person-years (95% CI: 1.51-3.64). The pooled proportions of long-term deaths attributable to suicide in type 1 diabetes patients and type 2 diabetes patients were 7.7% (95% CI: 6.0-9.8) and 1.3% (95% CI: 0.6-2.6), respectively. Conclusion: This meta-analysis suggests that diabetes can significantly increase the risk of suicide. Suicide has an obvious contribution to mortality in diabetic patients, especially among type 1 diabetes patients. Effective strategies to decrease suicide risk and improve mental health outcomes in diabetes patients are needed.

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Section: Discussionmentioning

confidence: 93%

MANAGEMENT OF ENDOCRINE DISEASE: Suicide risk in patients with diabetes: a systematic review and meta-analysis

Wang

Shi

et al. 2017

European Journal of Endocrinology

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“…Additionally, there are few targeted diabetes interventions for people with SMI, and little understanding about how to effectively support this vulnerable patient group (Chwastiak et al . ).…”

Section: Why Is It An Important Area?mentioning

confidence: 97%

“…It may also be preferable to the alternative of switching from an antipsychotic that has proven effectiveness in preventing relapse in SMI for an individual, to one which has uncertain efficacy, but a more favourable metabolic profile (Chwastiak et al . ). Multiple drug therapy is increasingly used for managing SMI and is associated with poorer health outcomes (Correll et al .…”

Section: Why Focus On Diabetes Self‐management Education (Dsme)?mentioning

confidence: 97%

Improving health outcomes for adults with severe mental illness and comorbid diabetes: is supporting diabetes self‐management the right approach?

Taylor

Siddiqi

2016

Psychiatric Ment Health Nurs

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“…In this respect, the need for psychiatrists to improve the integration of medical and psychiatric care has recently been re-emphasized, and there is emerging interest in the value of collocating physical healthcare in community mental health settings (Chwastiak et al, 2015).…”

Section: A Potential Solution To An Enduring Problemmentioning

confidence: 99%

Addressing the physical health of people with serious mental illness: A potential solution for an enduring problem

Happell

Gaskin

Stanton

2015

Int J Soc Psychiatry

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People with serious mental illness face significant inequalities in physical health care. As a result, the risk of cardiometabolic disorders and premature mortality is far greater than that observed in the general population. Contributiung to this disparity, is the lack of routine physical health screening by mental health clinicians. One possible solution is the implimentation of a physical health nurse consultant, whose role is to monitor and coordinate the physical health care of people with serious mental illness. Current evidence supports the implimentation of such a role, and a failure to address the widening gaps in physical health care will only serve to increase the disparities faced by people with serious mental illness.

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Clinical management of comorbid diabetes and psychotic disorders

Cited by 31 publications

References 107 publications

MANAGEMENT OF ENDOCRINE DISEASE: Suicide risk in patients with diabetes: a systematic review and meta-analysis

MANAGEMENT OF ENDOCRINE DISEASE: Suicide risk in patients with diabetes: a systematic review and meta-analysis

Improving health outcomes for adults with severe mental illness and comorbid diabetes: is supporting diabetes self‐management the right approach?

Addressing the physical health of people with serious mental illness: A potential solution for an enduring problem

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