Coronary Heart Disease Risk in Patients with Schizophrenia: A Lebanese Cross-Sectional Study

Abstract

Background:Coronary heart disease (CHD) is a leading cause of premature death in patients with schizophrenia. CHD risk in Lebanese patients with schizophrenia remains unknown.Objectives:To (i) evaluate CHD risk of patients with schizophrenia in Lebanon; and (ii) detect the modifiable and non-modifiable factors affecting this risk.Methods:Cross-sectional study of 329 patients with schizophrenia aged 20–75 years. Ten-year hard CHD risk was calculated using the Framingham risk score. A logistic regression was conducted taking the dichotomous hard CHD (<10% and ≥10%) as the dependent variable.Results:Ten-year hard CHD risk was low (<10%) in 60.8% of patients, intermediate (10–20%) in 31.6%, and high (>20%) in 7.6%. Multivariate analysis showed that the mean 10-year hard CHD risk was 8.76±6.92 (10.82±6.83 in men and 3.18±2.90 in women). Ten-year hard CHD risk was higher in patients with the metabolic syndrome (odds ratio [OR] 2.67, confidence interval [CI] 1.54–4.64), a longer duration of schizophrenia (OR 1.03, CI 1.01–1.05), a history of other medical illnesses (OR 2.02, CI 1.18–3.47), and in those participating in art therapy (OR 2.13, CI 1.25–3.64) or therapeutic education (OR 1.93, CI 0.93–4.01). Ten-year hard CHD risk was lower in patients receiving risperidone (OR 0.23, CI 0.08–0.68), any anti-epileptic (OR 0.41, CI 0.24–0.73), or any benzodiazepine (OR 0.33, CI 0.17–0.66) medication.Conclusion:CHD is prevalent in patients with schizophrenia in Lebanon. Physicians are recommended to monitor the components of the metabolic syndrome to identify patients with increased risk of cardiovascular diseases.

COVID-19 outbreak in a psychiatric hospital: what makes it worse?

“…These populations are at increased risk of infectious disease outbreaks as they reside in close overcrowded environment and interact closely and frequently with nursing staff, and use shared spaces, such as bathrooms and dining room [6]. In addition, psychiatric patients has high rates of physical health comorbidities, such as obesity, hypertension, and metabolic syndrome, as well as high rates of neurocognitive impairment [7][8][9][10]. They are more likely than the general population to become infected with COVID-19, and they are more than twice as likely to develop a severe outcome of COVID-19 infection [11,12].…”

“…Risk factors among psychiatric patients for severe infection are highly prevalent, such as increased rates of obesity, cardiovascular disease and chronic obstructive pulmonary disease [8,[13][14][15]. In addition, gender is a risk factor for increased severity and death in individuals with COVID-19.…”

Prevalence of comorbidities and correlates of hospital readmission rate in patients with acute mania: A one‐year retrospective data from a tertiary care

“…Mania, the most typical phase of bipolar disorder type I (BD‐I) also known as disabling disorder, is characterized by functional impairment leading to high rates of morbidity and mortality, and an increased risk of suicide, contributing to reduced life expectancy, and lower quality of life . Several studies had showed an excess mortality in people with severe mental illness (SMI), two to three times higher than that of the general population . About 60% of this excess mortality is due to one or more physical illnesses that are frequent in manic patients; one physical comorbidity is seen in over 80% of patients, while 19% to 23% have 2, and 35% to 40% suffer from 3 or more .…”

Factors associated with overweight and obesity in Lebanese male patients with schizophrenia

“…Patients with serious mental illness, including schizophrenia, have metabolic abnormalities and cardiovascular diseases [20][21][22] being largely attributed to increased mortality rates, more than the factors directly associated with the psychiatric illness. In addition, obesity is a major public health problem and negatively affects the life of affected individuals.…”