ABSTRACT
BACKGROUND: Although the validity and safety of antipsychotic polypharmacy remains unclear, it is commonplace in the treatment of schizophrenia. This study aimed to investigate the degree that antipsychotic polypharmacy contributed to metabolic syndrome in outpatients with schizophrenia, after adjustment for the effects of lifestyle. METHODS: A cross-sectional survey was carried out between April 2007 and October 2007 at Yamanashi Prefectural KITA hospital in Japan. 334 patients consented to this cross-sectional study. We measured the components consisting metabolic syndrome, and interviewed the participants about their lifestyle. We classified metabolic syndrome into four groups according to the severity of metabolic disturbance: the metabolic syndrome; the pre-metabolic syndrome; the visceral fat obesity; and the normal group. We used multinomial logistic regression models to assess the association of metabolic syndrome with antipsychotic polypharmacy, adjusting for lifestyle. RESULTS: Seventy-four (22.2%) patients were in the metabolic syndrome group, 61 (18.3%) patients were in the pre-metabolic syndrome group, and 41 (12.3%) patients were in visceral fat obesity group. Antipsychotic polypharmacy was present in 167 (50.0%) patients. In multinomial logistic regression analyses, antipsychotic polypharmacy was significantly associated with the pre-metabolic syndrome group (adjusted odds ratio [AOR], 2.348; 95% confidence interval [CI], 1.181-4.668), but not with the metabolic syndrome group (AOR, 1.269; 95%CI, 0.679-2.371). CONCLUSIONS: These results suggest that antipsychotic polypharmacy, compared with monotherapy, may be independently associated with an increased risk of having pre-metabolic syndrome, even after adjusting for patients' lifestyle characteristics. As metabolic syndrome is associated with an increased risk of cardiovascular mortality, further studies are needed to clarify the validity and safety of antipsychotic polypharmacy.
Subject(s)
Antipsychotic Agents/adverse effects , Drug Therapy, Combination/adverse effects , Life Style , Metabolic Syndrome/chemically induced , Schizophrenia/drug therapy , Adult , Antipsychotic Agents/therapeutic use , Cross-Sectional Studies , Female , Humans , Male , Metabolic Syndrome/complications , Metabolic Syndrome/diagnosis , Metabolic Syndrome/psychology , Middle Aged , Schizophrenia/complicationsSubject(s)
Antipsychotic Agents/adverse effects , Benzodiazepines/adverse effects , Hyperglycemia/chemically induced , Hyperglycemia/ethnology , Schizophrenia/drug therapy , Adult , Female , Humans , Hyperglycemia/diagnosis , Incidence , Japan , Male , Middle Aged , Olanzapine , Severity of Illness IndexABSTRACT
People with mental disorders often cause distress among their family members. We examined a total of 25 pairs of newly referred psychiatric patients and their family members to investigate the correlations between family burden and patient diagnosis (using the Structured Clinical Interview for DSM-III-R [SCID] axis I disorders), symptomatic severity (Positive and Negative Symptoms Scales [PANSS]), global function (Global Assessment of Functioning [GAF]), and the general level of family function (Family Adaptability and Cohesion Evaluation Scale [FACES]). The subjective and objective burdens on the family were assessed by self-report. The subjective and objective burdens were significantly predicted only by the GAF score.
