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Marche JC, Bannay A, Baillot S, Dauriac-Le Masson V, Leveque P, Schmitt C, Laprévote V, Schwan R, Dobre D. Prevalence of severe cardiovascular disease in patients with schizophrenia. Encephale 2021; 48:125-131. [PMID: 34024498 DOI: 10.1016/j.encep.2021.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/20/2021] [Accepted: 02/24/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVES We assessed the prevalence of severe cardiovascular (CV) disease requiring hospitalization among patients with schizophrenia in France. METHOD We included patients hospitalized with schizophrenia or psychotic disorder during 2015, in five French psychiatric hospitals. Patients with CV disease were defined as those with a correspondent ICD-10 code during a hospital stay in any general hospital, five years before or three years after the psychiatric hospitalization. CV disease included myocardial infarction (MI), stroke, heart failure (HF), coronary artery disease (CAD) or peripheral artery disease. Risk factors such as hypertension, obesity and diabetes were recorded. RESULTS In total, 4424 patients with schizophrenia were included. Overall, 203 (4,6%) patients were diagnosed with CV disease, 93 (2.1%) with CAD, 86 (1.9%) with HF and 49 (1.1%) with stroke. The prevalence of hypertension, obesity and diabetes was 11.3%, 9.7% and 7.8%. The median (interquartile range) age of patients with MI and diabetes was 57 (49-70) and 56 (48-66) years. CONCLUSION Patients with schizophrenia develop severe CV disease requiring hospitalization at an early age. These severe events are associated with a high prevalence of risk factors. Early screening and treatment of CV disease and risk factors is important to improve life expectancy and quality of life of these patients.
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Affiliation(s)
- J-C Marche
- Psychiatry and Clinical Psychology Service (G06), Psychotherapeutic Center of Nancy, 1, rue Dr-Archambault, BP 11010, 54521 Laxou cedex, France; University of Lorraine, Lorraine, France.
| | - A Bannay
- Department of Evaluation and Medical Informatics, CHRU-Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France
| | - S Baillot
- Department of Evaluation and Medical Informatics, CHRU-Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France
| | - V Dauriac-Le Masson
- Department of Medical Informatics, GHU Paris "Psychiatrie & Neurosciences", 1, rue Cabanis, 75014 Paris, France
| | - P Leveque
- Department of Medical Informatics, Ravenel Hospital Center, 1115, avenue René-Porterat, 88500 Mirecourt, France
| | - C Schmitt
- Department of Medical Informatics, Jury Hospital Center, centre hospitalier de Jury, BP 75088, 57073 Metz cedex 3, France
| | - V Laprévote
- Grand Nancy Hospital-university Center for Adult Psychiatry and Addictology, Psychotherapeutic Center of Nancy, 1, rue Dr-Archambault, BP 11010, 54521 Laxou cedex, France; University of Lorraine, Lorraine, France; Inserm U1114, France
| | - R Schwan
- Department of Medical Informatics and Clinical Research and Investigation Unit, Psychotherapeutic Center of Nancy, 1, rue Dr-Archambault, 54520 Laxou, France; University of Lorraine, Lorraine, France; Inserm U1254, France
| | - D Dobre
- Department of Medical Informatics and Clinical Research and Investigation Unit, Psychotherapeutic Center of Nancy, 1, rue Dr-Archambault, 54520 Laxou, France
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Monitoring and prevalence rates of metabolic syndrome in military veterans with serious mental illness. PLoS One 2011; 6:e19298. [PMID: 21541294 PMCID: PMC3082569 DOI: 10.1371/journal.pone.0019298] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Accepted: 04/01/2011] [Indexed: 11/20/2022] Open
Abstract
Background Cardiovascular disease is the leading cause of mortality among patients with serious mental illness (SMI) and the prevalence of metabolic syndrome—a constellation of cardiovascular risk factors—is significantly higher in these patients than in the general population. Metabolic monitoring among patients using second generation antipsychotics (SGAs)—a risk factor for metabolic syndrome—has been shown to be inadequate despite the release of several guidelines. However, patients with SMI have several factors independent of medication use that predispose them to a higher prevalence of metabolic syndrome. Our study therefore examines monitoring and prevalence of metabolic syndrome in patients with SMI, including those not using SGAs. Methods and Findings We retrospectively identified all patients treated at a Veterans Affairs Medical Center with diagnoses of schizophrenia, schizoaffective disorder or bipolar disorder during 2005–2006 and obtained demographic and clinical data. Incomplete monitoring of metabolic syndrome was defined as being unable to determine the status of at least one of the syndrome components. Of the 1,401 patients included (bipolar disorder: 822; schizophrenia: 222; and schizoaffective disorder: 357), 21.4% were incompletely monitored. Only 54.8% of patients who were not prescribed SGAs and did not have previous diagnoses of hypertension or hypercholesterolemia were monitored for all metabolic syndrome components compared to 92.4% of patients who had all three of these characteristics. Among patients monitored for metabolic syndrome completely, age-adjusted prevalence of the syndrome was 48.4%, with no significant difference between the three psychiatric groups. Conclusions Only one half of patients with SMI not using SGAs or previously diagnosed with hypertension and hypercholesterolemia were completely monitored for metabolic syndrome components compared to greater than 90% of those with these characteristics. With the high prevalence of metabolic syndrome seen in this population, there appears to be a need to intensify efforts to reduce this monitoring gap.
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Rezaei O, Khodaie-Ardakani MR, Mandegar MH, Dogmehchi E, Goodarzynejad H. Prevalence of metabolic syndrome among an Iranian cohort of inpatients with schizophrenia. Int J Psychiatry Med 2010; 39:451-62. [PMID: 20391865 DOI: 10.2190/pm.39.4.i] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cardiovascular disease is an important cause among natural causes of death in schizophrenic patients. The metabolic syndrome (MetS) has been associated with an increased risk of morbidity and mortality due to cardiovascular disease. There are limited if any data on prevalence of MetS in Iranian patients with schizophrenia. METHODS Between December 2007 and May 2008, all consecutive patients with schizophrenia hospitalized at our university psychiatry hospital were entered in the study. The prevalence of MetS was evaluated based on the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP-III), the adapted ATP-III guidelines (ATP-III A), and the recently suggested criteria by International Diabetes Federation (IDF). RESULTS Of the study participants, 223 were men (59.9%) and 149 women (40.1%). Overall prevalence of the MetS according to the different definitions were 27.4% (ATP-III), 37.6% (ATP-III A), and 38.7% (IDF), which was over 30% more than the prevalence of MetS in the Iranian general population. The MetS was much more prevalent in women which mainly related to the fact that women had central obesity more frequently. CONCLUSIONS Our results confirm the high prevalence of MetS in schizophrenic patients. These results clearly suggest the necessity for a careful monitoring and management of metabolic risk factors in this high-risk population.
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Affiliation(s)
- Omid Rezaei
- University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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