Diabetes, hyperlipidemia risk increased in severe mental disorders
medwireNews: Asian patients with bipolar disorder (BD) or schizophrenia are at increased long-term risk for developing diabetes and hyperlipidemia, Taiwanese research shows.
Indeed, over a follow-up period of 10 years, Ya-Mei Bai (Taipei Veterans General Hospital, Taipei) and colleagues found that BD and schizophrenia patients were around 70% more likely to start taking antidiabetic medications than mentally healthy individuals (controls).
By contrast, patients with major depressive disorder (MDD) were no more likely to start taking antidiabetic or antihyperlipidemia medications over the follow-up period than controls.
"Although many psychiatric and medical associations have established guideline[s] and emphasize that comprehensive care should include routine evaluation of the risk and presence of metabolic syndrome for bipolar disorder and schizophrenia, the clinical application for systematic evaluation of preventative and targeted treatments are still insufficient," the authors comment in the Journal of Affective Disorders.
"Therefore, the clinical implication of this study is to remind physicians and psychiatrists of the importance of integrated medical and psychiatric care for these [BD and schizophrenia] patients," they add.
The team studied 367 patients with BD (mean age 45.3 years), 1993 with schizophrenia (mean age 45.9 years), and 417 with MDD (mean age 46.5 years) who were followed up from 2001 through 2010. The controls comprised 11,108 age- and gender-matched mentally healthy individuals (four for each patient in the study cohort).
The researchers found that 10.1% of BD patients and 13.3% of schizophrenia patients started taking antidiabetic medications during the study period, compared with a respective 6.3% and 7.2% of controls.
In addition, 15.8% of BD and 12.2% of schizophrenia patients initiated antihyperlipidemia medication during follow up versus a respective 10.5% and 12.1% of controls.
After accounting for age, gender, urbanization, and income, the team found that BD and schizophrenia patients were at significantly increased risk for initiating antidiabetic treatment during follow up, at hazard ratios (HRs) of 1.70 and 1.79, respectively. They were also at increased risk for initiation of antihyperlipidemia medications, at HRs of 1.51 and 1.15, respectively.
Bai and team conclude: "This first 10-year nationwide population-based matched control cohort study found increased risks of initiation of anti-diabetic medications and anti-hyperlipidemia medications among patients with BD and schizophrenia."
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By Mark Cowen, Senior medwireNews Reporter