Body mass index and prevalence of obesity in a French cohort of patients with schizophrenia (original) (raw)
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Neuropsychiatric Disease and Treatment, 2008
To describe the association between obesity and the use of antipsychotic drugs (APDs) in adult outpatients followed-up on in fi ve Primary Care settings. Methods: A longitudinal, retrospective design study carried out between July 2004 and June 2005, in patients who were included in a claim database and for whom an APD treatment had been registered. A body mass index (BMI) Ͻ30 kg/m 2 was defi ned as obesity. The main measurements were: use of APDs, demographics, medical background and co-morbidities, and clinical parameters. Logistic regression analysis and ANCOVA with Bonferroni adjustment were applied to correct the model. Results: A total of 42,437 subjects (mean age: 50.8 (18.4) years; women: 54.5%; obesity: 27.3% [95% confi dence intervals (CI), 26.9%-27.7%]) were analyzed. A total of 1.3% of the patients were receiving APDs, without statistical differences in distribution by type of drug (typical: 48.8%; atypical: 51.2%). Obesity was associated with the use of APDs [OR = 1.5 (CI: 1.3-1.8)], hypertension [OR = 2.4 (CI: 2.2-2.5)], diabetes [OR = 1.4 (CI: 1.3-1.5)] and dyslipidemia [OR = 1.3 (CI: 1.2-1.4)], p Ͻ 0.0001 in all cases. BMI was signifi cantly higher in subjects on APDs; 28.8 vs. 27.3 kg/m 2 , p = 0.002, and remained higher after adjusting by age and sex (mean difference 0.4 (CI: 0.1-0.7), p Ͻ 0.01). After adjusting by age, sex and the Charlson index, obese subjects generated higher average annual total costs than nonobese subjects; 811 (CI: 787-835) vs. 694 (CI: 679-709), respectively, p Ͻ 0.001. Conclusions: Obesity was associated with the use of APDs, regardless of the type of drug, and with the presence of hypertension, diabetes and dyslipidemia. Obesity was also associated with substantially higher health care costs.
Effects of long-term antipsychotics treatment on body weight: A population-based cohort study
Journal of Psychopharmacology, 2019
Background: Antipsychotics are often prescribed for long-term periods, however, most evidence of their impact on body weight comes from short-term clinical trials. Particularly, impact associated with dosage has been barely studied. Aims: The aim of this study was to describe the short- and long-term change in body weight of people initiated on high or low doses of the three most commonly prescribed second-generation antipsychotics. Methods: Retrospective cohorts of individuals with a diagnosed psychotic disorder observed from 2005 to 2015 in the UK primary care. The exposure was the first prescription of olanzapine, quetiapine or risperidone. The main outcome was change in body weight four years before and four years after initiation of antipsychotic treatment, stratified on sex and ‘low’ or ‘high’ dose. Results: In total, 22,306 women and 16,559 men were observed. Olanzapine treatment was associated with the highest change in weight, with higher doses resulting in more weight gain...
The Association between Schizophrenia Clinical Severity and Obesity Risk: A Literature Review
Journal of Student Research
Obesity is a highly prevalent illness in schizophrenia patients. This review evaluates recent literature on the relationship between obesity risk and schizophrenia psychopathology. Ten studies were gathered using online resources like Google Scholar, PubMed, and the Brown University Library. Nine of the ten studies analyzed the relationship between obesity and schizophrenia severity with the factor of antipsychotics, while the last study excluded antipsychotic influence. While the nine studies with antipsychotic treatment indicate an association between improvement in overall symptom severity and weight gain, five studies specify negative symptoms to be more indicative of weight gain than positive symptoms, and two studies state the opposite. The last (tenth) study implies the existence of a relationship between weight and clinical severity independent from antipsychotic use. More research needs to be done on the connection between obesity and schizophrenia severity prior to antipsy...
Borneo Journal of Medical Sciences (BJMS), 2019
Approximately 50% patients with psychotic illnesses on antipsychotic drugs have an increased risk of obesity. This study aimed to determine changes in body weight, body fat percentage and lipid profiles and to stress the importance of early nutrition intervention in the management of psychotic illness patient treated with antipsychotic drugs. This is a prospective longitudinal study conducted for 3 months in Hospital Mesra Bukit Padang, Kota Kinabalu, Sabah. A total of 150 patients with Diagnostic and Statistical Manual IV (DSM-IV) diagnosis of psychotic illness (either Olanzapine or Risperidone only at any dosage) first started or restarted after a treatment gap of at least 6 months were recruited. Weight, height and body fat percentage were measured using Bioelectrical Impedance Analysis (BIA) (Model Omron HBF-375) and blood fasting lipid test were taken from the point of starting medication for 12 weeks. Data were analysed using repeated measures of ANOVA for statistical method...
Objectives: The study was designed to assess and compare the changes in the body mass index of patients on typical and atypical antipsychotics in a tertiary hospital in Nigeria. Materials and Methods: Consenting psychiatric patients who were antipsychotic naive before the commencement of the study and who attended the hospital between February 2014 and October 2014 were enlisted in the study. The SCAN and a socio-demographic questionnaire were administered to the subjects. BMI of each subject was calculated before the administration of antipsychotic and after 1 month, 2 months and 3months intervals. Results: 138 out of 140 subjects enlisted in the study were analyzed. The mean BMI changes derived were 23.7461 ± 3.58270, 25.0074 ± 3.99667, 25.960 ± 4.24540 and 27.1261 ± 4.66810. The atypical antipsychotics caused relatively higher mean BMI increases more than the typical ones and the mean BMl differences between the two groups of antipsychotic users is consistently statistically significant (df=l, F=48.354, p=0.000, df=I, F=51.082, P=0.000, df=I, F=77.451, p=0.000). Conclusion: Considering the invaluable role of antipsychotics in the treatment of psychiatric patients, non-pharmacologic interventions are highly recommended to help control the weight of patients on antipsychotic treatment.
Journal of Clinical Psychopharmacology, 2012
Objective: Although weight gain is one of the most widely studied adverse effects of second-generation antipsychotics, only relatively few studies have specifically evaluated the long-term effect of switching antipsychotic medication on body weight. We aimed to evaluate the impact of switching antipsychotics on body mass index (BMI) during a 6-month follow-up period in a large cohort of patients with schizophrenia. Method: Data came from a 6-month prospective naturalistic survey in 6007 patients with schizophrenia. Results: We prospectively studied the effect on BMI of initiating or switching antipsychotic medication after 6 months of treatment among 3801 patients with schizophrenia in a real-life setting. Patients who were being treated with clozapine or olanzapine at baseline were more likely to experience a decrease in BMI during the follow-up period than the patients who were being treated with a conventional antipsychotic (odds ratio, 2.25 and 1.68, respectively). Patients treated with aripiprazole and, to a lesser extent, those treated with risperidone were more likely to experience a decrease in BMI during follow-up than patients treated with conventional antipsychotics (odds ratio, 2.96 and 2.06, respectively). Conclusions: Our findings suggest that switching antipsychotics could be an effective strategy for reducing or preventing weight gain.
Journal of Child and Adolescent Psychopharmacology, 2018
Background: Antipsychotic-related weight gain is a common clinically relevant side effect when treating psychotic disorders in pediatric populations, yet few predictors and no moderators of antipsychotic-related weight gain are known. Methods: The Treatment of Early-Onset Schizophrenia Spectrum Disorders (TEOSS) study randomized 119 youths (age 8-19 years) with schizophrenia or schizoaffective disorder to 8 weeks of antipsychotic treatment with molindone, risperidone, or olanzapine and assessed treatment response and side effects. In this secondary analysis, we used multivariable linear regression and receiver operating characteristic analysis to investigate predictors and moderators of weight change and percent weight change from baseline to week 8. Results: Treatment assignment was the most discriminant predictor of weight change [F(2, 66) = 17.00, p < 0.001] and percent weight change [F(2, 66) = 16.85, p < 0.001]. Mean weight gain was 0.74 (standard deviation-3.51) kg for molindone, 4.13-3.79 kg for risperidone, and 7.29-3.44 kg for olanzapine. After adjusting for treatment assignment, lower pretreatment hemoglobin A1C (HgbA1C) predicted more weight gain [F(1, 55) = 4.71, p = 0.03]. Diagnosis (schizoaffective vs. schizophrenia) moderated weight change [F(2, 63) = 6.02, p = 0.004] and percent weight change [F(2, 63) = 5.26, p = 0.008] such that schizoaffective diagnosis predicted larger weight gain for youths in the risperidone treatment arm. Age, sex, family income, baseline weight, and symptoms neither predicted nor moderated weight change or percent weight change. Conclusion: We identified prognostic subgroups and novel risk factors for antipsychotic-related weight gain. We confirmed that antipsychotic choice is extremely important for predicting future weight gain. We also found that younger age did not predict greater weight gain, in contrast to prior studies. Our findings require replication in an independent sample because we did not adjust for multiple comparisons to minimize false negatives. ClinicalTrials.gov Identifier: NCT00053703
Weight gain from novel antipsychotic drugs: need for action
General Hospital Psychiatry, 2000
Obesity is common in schizophrenia, and people with schizophrenia appear to be at increased risk for certain obesity-related conditions, such as type 2 diabetes and cardiovascular disease. Antipsychotic drugs, used chronically to control symptoms of schizophrenia, are associated with oftensubstantial weight gain, a side effect that is a special concern with the latest generation of highly effective "novel" agents. That the most effective (e.g., novel) antipsychotic medications lead to substantial weight gain presents the field with a critical public health problem. Although preliminary data have been reported regarding the beneficial use of behavior therapy programs for short-term weight control in patients with schizophrenia, the available data are quite limited, and there are no data regarding the long-term beneficial effects of these programs in this population. The obesity field recently has developed programs emphasizing "lifestyle changes" (e.g., diet, exercise, and problem-solving skills) to successfully manage weight in patients without schizophrenia. Such programs can be adapted for patients with schizophrenia through the use of highly structured and operationalized modules emphasizing medication compliance, social skills development, and participation in outpatient programs. Moreover, these programs can potentially be combined with the use of adjunctive pharmacotherapy to maximize and maintain weight loss. The field must solve the paradox that some of our most effective medications for schizophrenia produce substantial weight gain and its associated troubling health risks.