Improvements in metabolic abnormalities among overweight schizophrenia and bipolar disorder patients |
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| Affiliation: | 1. University of Illinois at Chicago, UIC Medical Center, 912 South Wood Street, MC 913, Chicago, IL 60612, USA;2. New York Medical College, 40 Sunshine Cottage Road, Valhalla, NY 10595, USA;3. ATP Clinical Research, 3151 Airway Avenue, Building T, Suite 3, Costa Mesa, CA 92626, USA;4. Memorial Park Psychiatry, 550 Westcott, Suite 520, Houston, TX 77007, USA;5. University School of Medicine Stanford, 251 Campus Drive, Stanford, CA 94305, USA;6. Wayne State University, Scott Hall, 540 East Canfield, Detroit, MI 48201, USA;7. Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 63110, USA;8. Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ 07936, USA;1. Division of Cardiology, Boston Medical Center and Boston University School of Medicine;2. Division of Cardiology, Massachusetts General Hospital and Harvard Medical School;3. Department of Epidemiology, Division of Cardiology, University of Pittsburgh;4. Division of Cardiology, St James''s Hospital and Trinity College, Dublin, Ireland;5. Division of Cardiology, Michael E. DeBakey VA Medical Center and Baylor College of Medicine;6. Division of Cardiology, University of Pittsburgh Medical Center;7. Division of Cardiology, The University of New Mexico School of Medicine |
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| Abstract: | PurposeAs weight-gain and metabolic abnormalities during treatment with psychotropic drugs are of great concern, we evaluated effects of psycho-education and medical monitoring on metabolic changes among severely mentally ill patients.Materials and methodsDuring repeated, systematic psycho-education about general health among 66 consecutive patients diagnosed with DSM-IV-TR schizophrenia (n = 33) or type-I bipolar disorder (n = 33), we evaluated (at intake 1, 2, 3, and 6 months) clinical psychiatric status, treatments and doses, recorded physiological parameters, and assessed attitudes about medication.ResultsAt intake, patients with schizophrenia vs bipolar disorder were receiving 3–7 times more psychotropic medication, with 14% higher initial body-mass index (BMI: 29.1 vs 25.6 kg/m2), 12 times more obesity, and significantly higher serum lipid concentrations. During 6-months follow-up, among bipolar disorder patients, polytherapy and serum lipid concentrations declined more than among schizophrenia patients (e.g., total cholesterol + triglycerides, by 3.21 vs 1.75%/month). BMI remained stable. Declining lipid levels were associated with older age, bipolar disorder, being unemployed, higher antipsychotic doses, and lower initial BPRS scores (all P ≤ 0.001).ConclusionsPsychotropic treatments were more complex, and metabolic measures more abnormal among bipolar disorder than schizophrenia patients. Intensive psycho-education, clinical monitoring, and encouragement of weight-control for six months were associated with improvements in metabolic measures (but not to BMI), and more realistic attitudes about medication. |
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| Keywords: | Antipsychotic drugs Bipolar disorder Metabolic syndrome Obesity Schizophrenia Weight-gain |
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