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J Clin Psychiatry. 2018 Sep 18;79(6). pii: 17m12007. doi: 10.4088/JCP.17m12007.

Metabolic Syndrome and Illness Severity Predict Relapse at 1-Year Follow-Up in Schizophrenia: The FACE-SZ Cohort.

Author information

1
Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMR_S 1136, Hôpital La Salpêtriere, 75651 Paris Cédex 13, France. ophelia.godin@upmc.fr.
2
FondaMental Fondation, Créteil, France.
3
Sorbonne University, UPMC University Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique and INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France.
4
INSERM, U955, Equipe 15 Genetic Psychiatry, Creteil; University Paris-Est, UMR-S955, UPEC, Creteil, France.
5
CMP B, CHU, EA 7280 Faculté de Médecine, Auvergne University, Clermont-Ferrand France.
6
Psychiatric Department University, CHU Sainte-Marguerite, Marseille, France.
7
Psychiatric Emergency Department, CHRU Montpellier and INSERM U1061, Montpellier University, Montpellier.
8
Charles Perrens Hospital, Bordeaux University, Bordeaux, France.
9
INSERM, Physiopathology of Neuronal Plasticity Unit, U862, Bordeaux, France.
10
Strasbourg Hospital, Strasbourg University, INSERM U1114, Strasbourg, France.
11
INSERM U1028, CNRS UMR5292, Claude Bernard Lyon 1 University, Team PSYR2, Le Vinatier Hospital, Bron, France.
12
AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, INSERM U894, Paris Diderot University, Sorbonne, Paris, France.
13
Psychosocial Rehabilitation Expert Center, CH Alpes Isère, Grenoble, France.
14
Marseille Hospital (AP-HM), University Department of Psychiatry, Marseille, France.
15
CNRS UMR 5287-INCIA, Bordeaux, France.
16
Versailles Hospital, Versailles Saint-Quentin-en-Yvelines University, Versailles, France.

Abstract

OBJECTIVE:

Predicting relapse is a major challenge in schizophrenia from a clinical and medico-economic point of view. During recent decades, major psychiatric disorders have been found to be extensively associated with metabolic disorders, even before the illness onset, with a prevalence estimated to be 35% in this population. However, no study to date has, to our knowledge, explored the potential impact of metabolic syndrome (MetS) on relapse.

METHODS:

From 2010 to 2016, 185 patients (mean age = 32 years) with a DSM-IV-TR diagnosis of schizophrenia were included in the FondaMental Academic Centers of Expertise for Schizophrenia (FACE-SZ) cohort and followed up for 1 year. Multivariable logistic regression was performed to estimate the adjusted odds ratio for relapse.

RESULTS:

Thirty-seven percent of stabilized outpatients with schizophrenia (mean illness duration = 11 years) experienced a relapse at least once during the 1 year of follow-up. MetS strongly predicted relapse at 1 year, independently of illness severity, insight into illness, and treatment characteristics (including medication compliance). Patients with MetS at baseline had a 3 times higher risk (95% CI, 1.1-8.4) of experiencing a new episode of psychosis during the 12 months of follow-up.

CONCLUSIONS:

Further studies should determine if reducing or preventing MetS could help to protect subjects with schizophrenia from relapse.

PMID:
30257079
DOI:
10.4088/JCP.17m12007
[Indexed for MEDLINE]

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