Prevalence and severity of antipsychotic related constipation in patients with schizophrenia: a retrospective descriptive study.

BACKGROUND: Antipsychotic are the cornerstone in the treatment of schizophrenia. They also have a number of side-effects. Constipation is thought to be common, and a potential serious side-effect, which has received little attention in recent literature. METHOD: We performed a retrospective study in consecutively admitted patients, between 2007 and 2009 and treated with antipsychotic medication, linking different electronic patient data to evaluate the prevalence and severity of constipation in patients with schizophrenia under routine treatment conditions. RESULTS: Over a period of 22 months 36.3% of patients (99) received at least once a pharmacological treatment for constipation. On average medication for constipation was prescribed for 273 days. Severe cases (N = 50), non-responsive to initial treatment, got a plain x-ray of the abdomen. In 68.4% fecal impaction was found. CONCLUSION: A high prevalence of constipation, often severe and needing medical interventions, was confirmed during the study period. Early detection, monitoring over treatment and early intervention of constipation could prevent serious consequences such as ileus.

Body weight and self-esteem in patients with schizophrenia evaluated with B-WISE.

BACKGROUND: Metabolic abnormalities and weight gain are an important problem in patients with schizophrenia. An instrument to evaluate body image and self-esteem related to weight has recently been developed (B-WISE). The first objective was to evaluate whether the findings of the original validation study could be confirmed in a European sample. The second objective was to explore the association of B-WISE scores with the metabolic syndrome and glucose abnormalities. METHODS: A Dutch translation of B-WISE was tested in a large sample of patients with schizophrenia (n=300) who underwent an extensive metabolic screening. RESULTS: The original findings with B-WISE were confirmed in an independent sample. Scores on B-WISE differed significantly as a function of BMI. Scores on B-WISE also differentiated patients with and without the metabolic syndrome and glucose abnormalities. Patients experiencing a recent weight gain had lower self-esteem and poorer psychosocial adaptation. CONCLUSION: B-WISE could be a useful instrument to evaluate the subjective psychosocial consequences associated with current weight and weight gain in patients with schizophrenia.