Low rates of treatment of cardiovascular risk factors in patients treated with antipsychotics

Abstract

IntroductionCardiovascular disease is the most common cause of death in patients with severe mental illness (SMI). Patients are more likely to be overweight and to have hypertension, dyslipidemia, hyperglycemia and diabetes mellitus. Antipsychotic medication can induce or worsen these cardiovascular risk factors.ObjectivesAccessibility to healthcare and adequate somatic treatment is limited in patients with SMI.AimsPrevalence of inadequate treatment for metabolic cardiovascular risk factors in patients treated with antipsychotic medication.MethodsA health monitor was introduced as a screening instrument in a schizophrenia treatment and recovery program (so called F-ACT) at the outpatient departments. Assesment included physical and laboratory examination, demographics, DSM-IV diagnoses, remission-criteria, social functioning, use of medication and drugs.ResultsOver a period of 18 months (2009–2010), 520 of the 600 patients included in the F-ACT were evaluated. Preliminary analysis shows that 452 patients met DSM-IV criteria of schizophrenia and other psychotic disorders. All patients were treated with at least one antipsychotic agent. Metabolic syndrome according to ATP-III was present in 50% of patients (60% abdominal obesity, 58% hypertension, 24% hyperglycemia, 52% high triglycerides, 49% low HDL-cholesterol). Rates of non-treatment ranged from 78% for hypertension, 85% for dyslipidemia and 48% for diabetes mellitus. Rates of inadequate treatment ranged from 69% for hypertension and 83% for dyslipidemia.Conclusions1.Metabolic cardiovascular risk factors are highly prevalent in patients treated with antipsychotics2.Inadequate treatment of metabolic cardiovascular risk factors is common3.There is a need to improve the cooperation between psychiatrists and general practitioners

Metabolic Syndrome in Schizophrenia

“…Though a few researchers have studied the change in prevalence rates over time, largely the estimates have been cross-sectional. Amongst the cross sectional studies, as depicted in Table 1,[101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899] most studies have evaluated the patients who are already on treatment and only a few have assessed the prevalence of MetS in drug naive population. Most of the studies have ...…”

“…NCEP ATP III 32 38 (BPAD) 48 (Depression) 5 (Alcohol dependence) 23 Other psychiatric disorders Tirupati and Chua [89] 231 Australia IDF 69 Van Der Heiden et al [90] 452 (Schizophrenia and other psychotic disorders)…”