Citation

Thakore JH. Br. J. Psychiatry Suppl. 2004; 47: S76-79.

Copyright

(Copyright © 2004, Royal College of Psychiatrists)

DOI

10.1192/bjp.184.47.s76

PMID

15056598

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.

Language: en

Keywords

Glucose Metabolism Disorders; Humans; Obesity; Schizophrenia; Stress, Psychological