Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta‐analysis

World Psychiatry - Tập 14 Số 3 - Trang 339-347 - 2015
Davy Vancampfort1,2, Brendon Stubbs3, Alex J. Mitchell4,5, Marc De Hert2, Martien Wampers2, Philip B. Ward6, Simon Rosenbaum6, Christoph U. Correll7,8
1Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
2UPC KU Leuven, Campus Kortenberg, Department of Neurosciences, KU Leuven - University of Leuven, Kortenberg, Belgium
3School of Health and Social Care, University of Greenwich, Eltham, London, UK
4Department of Cancer and Molecular Medicine, University of Leicester, Leicester, UK
5Department of Psycho-oncology, Leicestershire Partnership NHS Trust, Leicester, UK
6School of Psychiatry; University of New South Wales; Sydney; NSW; Australia
7Hofstra North Shore LIJ School of Medicine, Hempstead, NY, USA
8Zucker Hillside Hospital, Glen Oaks, NY, USA

Tóm tắt

Metabolic syndrome (MetS) and its components are highly predictive of cardiovascular diseases. The primary aim of this systematic review and meta‐analysis was to assess the prevalence of MetS and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder, comparing subjects with different disorders and taking into account demographic variables and psychotropic medication use. The secondary aim was to compare the MetS prevalence in persons with any of the selected disorders versus matched general population controls. The pooled MetS prevalence in people with severe mental illness was 32.6% (95% CI: 30.8%‐34.4%; N = 198; n = 52,678). Relative risk meta‐analyses established that there was no significant difference in MetS prevalence in studies directly comparing schizophrenia versus bipolar disorder, and in those directly comparing bipolar disorder versus major depressive disorder. Only two studies directly compared people with schizophrenia and major depressive disorder, precluding meta‐analytic calculations. Older age and a higher body mass index were significant moderators in the final demographic regression model (z = −3.6, p = 0.0003, r2 = 0.19). People treated with all individual antipsychotic medications had a significantly (p<0.001) higher MetS risk compared to antipsychotic‐naïve participants. MetS risk was significantly higher with clozapine and olanzapine (except vs. clozapine) than other antipsychotics, and significantly lower with aripiprazole than other antipsychotics (except vs. amisulpride). Compared with matched general population controls, people with severe mental illness had a significantly increased risk for MetS (RR = 1.58; 95% CI: 1.35‐1.86; p<0.001) and all its components, except for hypertension (p = 0.07). These data suggest that the risk for MetS is similarly elevated in the diagnostic subgroups of severe mental illness. Routine screening and multidisciplinary management of medical and behavioral conditions is needed in these patients. Risks of individual antipsychotics should be considered when making treatment choices.

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World Psychiatry

Tập 14 Số 3

339-347

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