Evolution of metabolic risk factors over a two-year period in a cohort of first episodes of psychosis

SCHIZOPHRENIA RESEARCH

卷:193

Article

Bioque, Miquel^1,2  Paz Garcia-Portilla, Ma^2,3  Garcia-Rizo, Clemente^1,2,4  Cabrera, Bibiana¹  Lobo, Antonio⁵  Gonzalez-Pinto, Ana^2,6  Diaz-Caneja, Covadonga M.⁷  Corripio, Iluminada^2,8  Vieta, Eduard^2,4,9  Castro-Fornieles, Josefina^2,10  Bobes, Julio³  Gutierrez-Fraile, Miguel^2,11  Rodriguez-Jimenez, Roberto^2,12  Mezquida, Gisela¹  Llerena, Adrian^2,13  Saiz-Ruiz, Jeronimo^2,14  Bernardo, Miguel^4,15,16,17 

[1] Hosp Clin Barcelona, Barcelona Clin, Schizophrenia Unit, Barcelona, Spain

[2] Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain

[3] Univ Oviedo, Dept Psychiat, Oviedo, Spain

[4] IDIBAPs, Barcelona, Spain

[5] Univ Zaragoza, IIS Aragon, Dept Med & Psychiat, Zaragoza, Spain

[6] Univ Basque Country, Univ Hosp, BIOARABA Hlth Res Inst, OSI Araba, Vitoria, Spain

[7] Univ Complutense, Hosp Gen Univ Gregorio Maranon, Dept Child & Adolescent Psychiat, IiSGM,Sch Med, Madrid, Spain

[8] Hosp Santa Creu & Sant Pau, Dept Psychiat, Barcelona, Spain

[9] Univ Barcelona, Hosp Clin Barcelona, Psychiat & Dept, Barcelona, Spain

[10] Univ Barcelona, Child & Adolescent Psychiat & Psychol Dept, Hosp Clin Barcelona, SGR489,Inst Neurosci, Barcelona, Spain

[11] Univ Basque Country, Hosp Santiago Apostol, Dept Psychiat, Vitoria, Spain

[12] Inst Invest Hosp 12 Octubre Imas12, Madrid, Spain

[13] Univ Extremadura, CICAB CAIBER Ctr Invest Clin, Hosp Univ, SES,Fac Med, Badajoz, Spain

[14] Hosp Univ Ramon y Cajal, IRYCIS, Dept Psychiat, Madrid, Spain

[15] Hosp Clin Barcelona, Barcelona Clin Schizophrenia Unit, Neurosci Inst, Barcelona, Spain

[16] Univ Barcelona, Dept Psychiat & Clin Psychobiol, Barcelona, Spain

[17] Ctr Invest Biomed Red Salud Mental CIBERSAM, G04, Barcelona, Spain

关键词: Psycosis;    Metabolism;    Metabolic syndrome;    Diabetes;    Schizophrenia;    Antipsychotics;   

DOI  :  10.1016/j.schres.2017.06.032

来源: Elsevier

【 摘 要 】

Patients with a first episode of psychosis (FEP) display a broad range of metabolic risk factors related to the development of diverse medical comorbidities. Initial stages of these disorders are essential in understanding the increased vulnerability of developing cardiometabolic disturbances, associated with a reduced life expectancy. This study aimed to evaluate the metabolic profile of a cohort of patients with a FEP and its evolution during a two year follow-up, as well as the factors that influence the changes in their metabolic status. 16 participating centers from the PEPs Project recruited 335 subjects with a FEP and 253 matched healthy controls, aged 9-35 years. We investigated a set of anthropometric measures, vital signs and laboratory data obtained from each participant over two years in a prospective, naturalistic study. From the beginning of the study the FEP group showed differences in the metabolic profile compared to the control group, together with a progressive worsening in the major part of the analyzed variables during the followup period, with higher rates of obesity and metabolic syndrome. Certain risk factors were related to determinate clinical variables such as male gender, the presence of affective symptoms or an early onset or to treatment variables such as the use of antipsychotic polypharmacy, antidepressants or mood stabilizers. Our results highlight the extremely high risk of patients at early phases of schizophrenia and other psychotic disorders of developing cardiovascular comorbidity and the fast worsening of the metabolic profile during the first two years. (c) 2017 Elsevier B.V. All rights reserved.

【 授权许可】

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