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Br J Psychiatry Suppl. 2004 Apr;47:S76-9.

Metabolic disturbance in first-episode schizophrenia.

Author information

1
Senior Lecturer in Psychiatry, Royal College of Surgeons in Ireland, Dublin. jthakore@rcsi.ie

Abstract

BACKGROUND:

Schizophrenia shortens life, e.g. through suicide and obesity-related diseases such as type 2 diabetes mellitus. It is assumed that medications play a major role, but most of the evidence for this comes from studies poorly controlled for variables such as lifestyle and medication status.

AIMS:

To determine whether schizophrenia is associated (independently of medication) with the development of certain metabolic disturbances and whether these might be explained by stress axis dysfunction.

METHOD:

Literature review.

RESULTS:

Most studies did not control for confounding factors such as previous usage of medication, lifestyle, age and ethnicity. A few conducted in drug-naïve patients with first-episode schizophrenia appear to indicate that these patients have higher than expected rates of visceral obesity and impaired fasting glucose concentrations, which may be related to a subtle disturbance of the hypothalamic-pituitary-adrenal axis.

CONCLUSIONS:

Schizophrenia is independently associated with physical illnesses that have a metabolic signature. Therefore, patients need to have a thorough physical assessment at diagnosis and at regular intervals thereafter. Metabolic disturbances have been found in drug-naïve patients with first-episode illness and may be an inherent part of the illness.

PMID:
15056598
[Indexed for MEDLINE]
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