Metabolic syndrome among older adults with schizophrenia spectrum disorder: Prevalence and associated factors in a multicenter study

Kassm, Sandra Abou; Hoertel, Nicolas; Naja, Wadih; McMahon, Kibby; Barrière, Sarah; Blumenstock, Yvonne; Portefaix, Christophe; Raucher‐Chéné, Delphine; Béra-Potelle, Céline; Cuervo-Lombard, Christine; Guérin-Langlois, Christophe; Lemogne, Cédric; Peyre, Hugo; Kaladjian, Arthur; Limosin, Frédéric

doi:10.1016/j.psychres.2019.03.036

Cited by 37 publications

(21 citation statements)

References 63 publications

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“…This is contrary to other evidence which suggests that the rates of hypertension in patients with psychosis are higher than the general population perhaps in part due to several shared etiological pathways between hypertension and mental illness [41]. For example, a nationwide survey in Japan in patients with schizophrenia found a prevalence of hypertension of 30% [42], and a multisite study done in France reported a prevalence of 43% [43]. The lower prevalence of hypertension in the current study might be accounted for by the relatively younger age of the participants.…”

Section: Plos Onementioning

confidence: 63%

Prevalence and correlates of metabolic syndrome and its components in adults with psychotic disorders in Eldoret, Kenya

et al. 2021

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Background A high prevalence of metabolic syndrome and its components in patients with psychotic disorders may increase the risk for cardiovascular diseases. Unfortunately, relatively little work in this field has emerged from low-resourced contexts. This study investigated the prevalence, correlates, and treatment patterns of metabolic disorders in patients with psychotic disorders in Western Kenya. Methods 300 patients with psychosis and 300 controls were recruited at Moi Teaching and Referral Hospital in Eldoret, Kenya. Data on demographic characteristics, weight, height, abdominal circumference, blood pressure, blood glucose, lipid profile, and treatments were collected. Categorical and continuous data were compared between the patient and control groups using Pearson’s chi-squared tests and t-tests, respectively. Variables found to be significantly different between these groups were included in logistic regression models to determine potential predictors of metabolic syndrome. Results Compared to controls, patients with psychosis were found to have a higher mean random blood glucose [5.23 vs 4.79, p = 0.003], higher body mass index [5.23 vs 4.79, p = 0.001], higher triglycerides [1.98 vs 1.56, p<0.001], larger waist circumference [89.23 vs 86.39, p = 0.009] and lower high density lipoprotein [1.22 vs 1.32, p<0.001]. The odds of developing metabolic syndrome were increased with age [OR = 1.05, CI: 1.02–1.07] and presence of a psychotic disorder [OR = 2.09 [CI 1.23–3.55]; and were reduced with female gender [OR 0.41, CI 0.25–0.67], among those who were never married [OR 0.52, CI 0.28–0.94] and among the widowed/separated/ divorced marital status [OR 0.38, CI 0.17–0.81]. While the majority of patients received treatment with olanzapine, there was no association between olanzapine use and metabolic syndrome and its components. More than half of the patients in this study sample were not receiving treatment for the various components of metabolic syndrome. Conclusion In the study setting of Eldoret, metabolic syndrome and its components were more prevalent among patients with psychotic disorders than in controls; and a clear treatment gap for these disorders was evident. There is a need for efforts to ensure adequate screening and treatment for these physical disorders in resource-limited settings.

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Section: Plos Onementioning

confidence: 63%

Prevalence and correlates of metabolic syndrome and its components in adults with psychotic disorders in Eldoret, Kenya

et al. 2021

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“…Cross-sectional data was drawn from the CSA study, a cohort of 353 inpatients (34.1%, mean duration of hospitalization = 134.7 days [SD = 133.0]) or outpatients (65.9%) aged 55 years or more with schizophrenia spectrum disorder, which included people with an International Classification of Diseases, tenth edition (ICD-10) diagnosis of schizophrenia (82.4%) or schizoaffective disorder (17.6%) (Hoertel et al, 2019;Abou Kassm et al, 2019). In France, state hospitalization services are organized into "sectors."…”

Section: Samplementioning

confidence: 99%

Benzodiazepine use among older adults with schizophrenia spectrum disorder: prevalence and associated factors in a multicenter study

Schuster

Hoertel

Gunten

et al. 2019

Int. Psychogeriatr.

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Objectives:Data on psychotropic medications of older patients with schizophrenia spectrum disorder are scarce. Specifically, information about the use of benzodiazepines among older patients with schizophrenia spectrum disorder is very limited. Because benzodiazepine use in older patients has been associated with many disabling side effects, its use in actual practice must be described and questioned. This study aimed at exploring the prevalence of benzodiazepine use and the clinical factors associated with such use among older patients with schizophrenia spectrum disorder.Methods/Design:Data from the Cohort of individuals with Schizophrenia Aged 55 years or more (CSA) were used to examine the prevalence of benzodiazepine use among older patients with schizophrenia spectrum disorder. Demographic and clinical characteristics associated with benzodiazepine prescription were also explored.Results:The prevalence of benzodiazepine use was 29.8% of older patients with schizophrenia spectrum disorder. These patients were significantly more likely to have medical comorbidities, cognitive and social functioning impairments, to report a lifetime history of suicide attempt, to be institutionalized, and to have been hospitalized in a psychiatric service in the past year compared to those without a benzodiazepine prescription (all p<0.05). There were no between-group differences in schizophrenia severity and psychiatric comorbidity.Conclusions:Although it can be hypothesized that benzodiazepine prescription is part of a short-term therapeutic strategy toward patients with more severe trouble or comorbid disorders, our results suggest a strong link between benzodiazepine prescription and a particularly vulnerable subpopulation of older patients with schizophrenia spectrum disorder.

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“…Alcohol-related disorders [ 61 ], withdrawal [ 62 – 64 ], and co-occurring MD/SRD [ 65 , 66 ] have been shown to elevate the risk of hospital readmission. Higher hospitalization rates may also be explained by higher rates of physical illnesses in patients with co-occurring MD/SRD [ 25 , 67 , 68 ], such as cardiovascular diseases [ 69 ], metabolic syndrome [ 70 , 71 ], obesity [ 72 ] and liver diseases [ 73 ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors of hospitalization for any medical condition among patients with prior emergency department visits for mental health conditions

et al. 2020

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Background This longitudinal study identified risk factors for frequency of hospitalization among patients with any medical condition who had previously visited one of six Quebec (Canada) emergency departments (ED) at least once for mental health (MH) conditions as the primary diagnosis. Methods Records of n = 11,367 patients were investigated using administrative databanks (2012–13/2014–15). Hospitalization rates in the 12 months after a first ED visit in 2014–15 were categorized as no hospitalizations (0 times), moderate hospitalizations (1–2 times), and frequent hospitalizations (3+ times). Based on the Andersen Behavioral Model, data on risk factors were gathered for the 2 years prior to the first visit in 2014–15, and were identified as predisposing, enabling or needs factors. They were tested using a hierarchical multinomial logistic regression according to the three groups of hospitalization rate. Results Enabling factors accounted for the largest percentage of total variance explained in the study model, followed by needs and predisposing factors. Co-occurring mental disorders (MD)/substance-related disorders (SRD), alcohol-related disorders, depressive disorders, frequency of consultations with outpatient psychiatrists, prior ED visits for any medical condition and number of physicians consulted in specialized care, were risk factors for both moderate and frequent hospitalizations. Schizophrenia spectrum and other psychotic disorders, bipolar disorders, and age (except 12–17 years) were risk factors for moderate hospitalizations, while higher numbers (4+) of overall interventions in local community health service centers were a risk factor for frequent hospitalizations only. Patients with personality disorders, drug-related disorders, suicidal behaviors, and those who visited a psychiatric ED integrated with a general ED in a separate site, or who visited a general ED without psychiatric services were also less likely to be hospitalized. Less urgent and non-urgent illness acuity prevented moderate hospitalizations only. Conclusions Patients with severe and complex health conditions, and higher numbers of both prior outpatient psychiatrist consultations and ED visits for medical conditions had more moderate and frequent hospitalizations as compared with non-hospitalized patients. Patients at risk for frequent hospitalizations were more vulnerable overall and had important biopsychosocial problems. Improved primary care and integrated outpatient services may prevent post-ED hospitalization.

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Metabolic syndrome among older adults with schizophrenia spectrum disorder: Prevalence and associated factors in a multicenter study

Cited by 37 publications

References 63 publications

Prevalence and correlates of metabolic syndrome and its components in adults with psychotic disorders in Eldoret, Kenya

Prevalence and correlates of metabolic syndrome and its components in adults with psychotic disorders in Eldoret, Kenya

Benzodiazepine use among older adults with schizophrenia spectrum disorder: prevalence and associated factors in a multicenter study

Risk factors of hospitalization for any medical condition among patients with prior emergency department visits for mental health conditions

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