This study assesses cardiometabolic risk in patients with first-episode schizophrenia spectrum disorders.
Lasserre and colleagues aimed to determine whether the subtypes of major depressive disorder (MDD; melancholic, atypical, combined, or unspecified) are predictive of adiposity in terms of the incidence of obesity and changes in body mass index (calculated as weight in kilograms divided by height in meters squared), waist circumference, and fat mass.
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This Viewpoint discusses the effect of air pollutants on the brain and the benefits of environmental regulations and compliance and enforcement actions.
This case control study suggests that oleoylethanolamide-mediated signaling plays an important role for hedonic regulation of food-craving and obesity in humans and, thus, may be a valuable target for developing novel antiobesity drugs.
Eraly et al evaluate whether plasma concentration of the inflammatory marker C-reactive protein helps to predict posttraumatic stress disorder symptoms.
Choong et al for the ODEX team determine whether polymorphisms within CRTC1 are associated with adiposity markers in psychiatric patients and the general population.
Sullivan et al determine whether comorbid depression in patients with type 2 diabetes accelerates cognitive decline.
The increased mortality associated with schizophrenia is largely due to cardiovascular disease. Treatment with antipsychotics is associated with weight gain and changes in other cardiovascular risk factors. Early identification of modifiable cardiovascular risk factors is a clinical imperative but prospective longitudinal studies of the early cardiometabolic adverse effects of antipsychotic drug treatment other than weight gain have not been previously reviewed.
To assess the methods and reporting of cardiometabolic outcome studies of the first treated episode of psychosis, review key findings, and suggest directions for future research.
PsycINFO, MEDLINE, and Scopus from January 1990 to June 2010.
Subjects were experiencing their first treated episode of psychosis. Subjects were antipsychotic naive or had been exposed to antipsychotics for a short known period at the beginning of the study. Cardiometabolic indices were assessed. Studies used a longitudinal design.
Sixty-four articles were identified describing 53 independent studies; 25 studies met inclusion criteria and were retained for detailed review.
Consolidated Standards of Reporting Trials and Strengthening the Reporting of Observational Studies in Epidemiology checklists were used to assess the methods and reporting of studies. A qualitative review of findings was conducted.
Two key hypotheses were identified based on this review: (1) in general, there is no difference in cardiovascular risk assessed by weight or metabolic indices between individuals with an untreated first episode of psychosis and healthy controls and (2) cardiovascular risk increases after first exposure to any antipsychotic drug. A rank order of drugs can be derived but there is no evidence of significant class differences. Recommended directions for future research include assessing the effect on cardiometabolic outcomes of medication adherence and dosage effects, determining the therapeutic window for antipsychotic use in adults and youth, and testing for moderation of outcomes by demographic factors, including sex and age, and clinical and genetic factors.