Prevention of Metabolic Syndrome in Serious Mental Illness

Ganguli, Rohan; Strassnig, Martin

doi:10.1016/j.psc.2010.11.004

Cited by 16 publications

(16 citation statements)

References 95 publications

(57 reference statements)

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“…Our results, together with previous observations of increased body fat content5,23 and prevalent sedentary behavior2 in schizophrenia, facilitate an unfavorable CVD risk factor constellation24 that is already present early in the course of schizophrenia and can have considerable negative impact on health-related QoL, as well 2. The CVD risk, emerging after relatively brief exposure to antipsychotic medication, warrants attention and suggests that more preventative action is required 25,26…”

Section: Discussionsupporting

confidence: 66%

Health-related quality of life, adiposity, and sedentary behavior in patients with early schizophrenia: preliminary study

Strassnig¹,

Brar²,

Ganguli³

2012

DMSO

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Objective:To examine adiposity and sedentary behavior in relation to health-related quality of life (QoL) in patients with early schizophrenia.Methods:A cross-sectional study was used to assess adiposity by dual-energy X-ray absorptiometry scans, habitual physical activity and idle sitting time by the Short Form International Physical Activity Questionnaire, and health-related QoL by the RAND Medical Outcomes Study SF-36. QoL scores were compared with age-adjusted Canadian normative population data.Results:There were 36 participants with early schizophrenia, average age 25.1 (±3.6). Twenty-nine (72.5%) were males. Mean illness duration was 30 (±18) months, and mean body mass index was 28.3 (±5). Females had higher body fat content than males (30.8 ±6.9 vs 24.7 ± 10.6; t = −2.6, df = 34; P = 0.015). Total body fat (F = 14; P = 0.001), lean body mass (F = 10.2; P = 0.001), and sedentary behavior (F = 5; P = 0.013) significantly increased across body mass index categories. Total body fat was correlated with sedentary behavior (r = 0.62; P = 0.001), and total lean body mass was negatively correlated with sedentary behavior (r = 0.39; P = 0.03). Based on SF-36 scores, participants had significantly lower physical functioning (P = 0.0034), role physical (P = 0.0003), general health (P < 0.0001), vitality (P = 0.03), and physical component scores (P = 0.003) than Canadian population comparisons. Habitual sedentary behavior, more than activity or adiposity levels, was associated with health-related QoL in early schizophrenia.Conclusion:Health-related QoL is lower in early schizophrenia and is predominantly experienced in the physical domain. QoL in early schizophrenia relates to sedentary behavior more than to activity and adiposity levels.

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Section: Discussionsupporting

confidence: 66%

Health-related quality of life, adiposity, and sedentary behavior in patients with early schizophrenia: preliminary study

Strassnig¹,

Brar²,

Ganguli³

2012

DMSO

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“…The attitudes of psychiatric patients toward weight gain and their desire to lose weight are consistent with those of the general population (Strassnig et al, 2005; Ganguli and Strassnig, 2011). The WAIST study introduced weight loss behavioral therapy in a group setting in a schizophrenia patient population (Brar et al, 2005).…”

Section: Introductionsupporting

confidence: 56%

Recent advances in understanding and mitigating adipogenic and metabolic effects of antipsychotic drugs

et al. 2012

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Although offering many benefits for several psychiatric disorders, antipsychotic drugs (APDs) as a class have a major liability in their tendency to promote adiposity, obesity, and metabolic dysregulation in an already metabolically vulnerable population. The past decade has witnessed substantial research aimed at investigating the mechanisms of these adverse effects and mitigating them. On July 11 and 12, 2011, with support from 2 NIH institutes, leading experts convened to discuss current research findings and to consider future research strategies. Five areas where significant advances are being made emerged from the conference: (1) methodological issues in the study of APD effects; (2) unique characteristics and needs of pediatric patients; (3) genetic components underlying susceptibility to APD-induced metabolic effects; (4) APD effects on weight gain and adiposity in relation to their acute effects on glucose regulation and diabetes risk; and (5) the utility of behavioral, dietary, and pharmacological interventions in mitigating APD-induced metabolic side effects. This paper summarizes the major conclusions and important supporting data from the meeting.

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“…Patients with schizophrenia appear especially vulnerable to this environment, as they consume more food than mentally healthy population comparisons, and their food choices are poorer still [26]. In addition, very few patients follow a regular physical exercise routine [33,34], and amongst those who do, erroneous assumptions about the constitution of healthy and goal-directed 'exercise' prevail [35]. At the same time, There are substantial and consistent data that specifically address the translation of cognitive impairments into the critical deficits into eating-related activities.…”

Section: Introductionmentioning

confidence: 99%

Cognitive deficits, obesity and disability in schizophrenia

Strassnig

Cáceda

Newcomer

et al. 2012

Translational Neuroscience

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Despite 50 years of pharmacological and psychosocial interventions schizophrenia remains one of the leading causes of disability. The inability to function in everyday settings includes deficits in performance of social, occupational, and independent living activities. Schizophrenia is also a life-shortening illness, caused mainly by poor physical health and its complications. Dysfunctional lifestyles including sedentary behavior and lack of physical activity prevail, while treatment with adipogenic antipsychotic medication interacts with poor performance in screening, monitoring, and intervention that result in shortening of life expectancies by 25-30 years. Disability interferes with self-care and medical care, further worsening physical health to produce a vicious cycle of disability. Further, the neurobiological impact of obesity on brain functioning is substantial and relevant to schizophrenia. Decision making deficits that lead to choices resulting in obesity themselves have neurobiological determinants. Simultaneous treatment of cognitive deficits and related deficits in functional skills, ubiquitous determinants of everyday functioning in schizophrenia, and targeted interventions aimed at poor physical health, especially obesity and associated comorbidities, may lead to additive or even interactive gains in everyday functioning in patients with schizophrenia not previously realized with other interventions.

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Prevention of Metabolic Syndrome in Serious Mental Illness

Cited by 16 publications

References 95 publications

Health-related quality of life, adiposity, and sedentary behavior in patients with early schizophrenia: preliminary study

Health-related quality of life, adiposity, and sedentary behavior in patients with early schizophrenia: preliminary study

Recent advances in understanding and mitigating adipogenic and metabolic effects of antipsychotic drugs

Cognitive deficits, obesity and disability in schizophrenia

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