09 Oct Cardiometabolic Risks Begin Early in Schizophrenic Spectrum Disorders

Posted at 20:12h in Author Interviews, JAMA, Schizophrenia by

Christoph U. Correll, MD Professor of Psychiatry and Molecular Medicine Hofstra North Shore LIJ School of Medicine Medical Director, Recognition and Prevention (RAP) Program The Zucker Hillside Hospital Investigator Feinstein Institute for Medical Research North Shore Long Island Jewish Health SystemMedicalResearch.com Interview with:
Christoph U. Correll, MD
Professor of Psychiatry and Molecular Medicine
Hofstra North Shore LIJ School of Medicine
Medical Director, Recognition and Prevention (RAP) Program
The Zucker Hillside Hospital Investigator
Feinstein Institute for Medical Research
North Shore Long Island Jewish Health System

Medical Research: What are the main findings of the study?

Dr. Correll: The main findings of the study of 398 patients with first-episode schizophrenia-spectrum disorders who were on average in their mid twenties are that:

  • 1) despite their young age, an average of only 47 days lifetime antipsychotic exposure and overweight/obesity figures that were comparable to similarly aged US population members, there was a clear pattern of increased smoking and several metabolic risk parameters compared to similarly aged persons in the general US population;
  • 2) dyslipidemia, a constellation of at least one relevant abnormal blood fat value, was as frequent as in a 15-20 years older general US population;
  • 3) body composition related risk markers were significantly associated with longer total psychiatric illness duration, whereas metabolic risk markers were significantly associated with the overall very short mean lifetime antipsychotic treatment duration; and
  • 4) relevant for treatment choice and recommendations for patients, significantly higher continuous metabolic risk factor values were associated with olanzapine treatment and, less so, with quetiapine treatment.

    Medical Research: What was most surprising about the results?Dr. Correll:  Two findings were most surprising to us.
  • First, the cardiometabolic burden was this strong this early in the disease course.
  • Second, certain antipsychotics already differentiated as having worse effects than the others after only 47 days of lifetime antipsychotic exposure.
    Medical Research: What should clinicians and patients take away from your report?

    Dr. Correll: Clinicians should routinely and proactively assess all patients on antipsychotics for cardiometabolic risk prior to and throughout treatment, promote healthy lifestyle behaviors, choose low-risk antipsychotics early on and whenever possible, and manage cardiometabolic adverse effects that emerge in the care of patients with first-episode psychosis and other severe mentally disorders.

    Medical Research: What recommendations do you have for future research as a result of this study?

    Dr. Correll: Future research is sorely needed to assess the trajectory of cardiometabolic risk over time, identify underlying mechanisms and mediating variables, detect safer treatments, and test interventions to reduce or reverse cardiometabolic burden.

Citation:

Last Updated on October 9, 2014 by Marie Benz MD FAAD

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