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Improvements in metabolic abnormalities among overweight schizophrenia and bipolar disorder patients

Published online by Cambridge University Press:  15 April 2020

A. Ventriglio ,
A. Gentile ,
R.J. Baldessarini ,
S. Martone ,
G. Vitrani ,
A. La Marca  and
A. Bellomo
A. Ventriglio*
Affiliation:
Section of Psychiatry, University of Foggia, Department of Clinical and Experimental Medicine, Via Gugliemo Marconi 3, 71041 Carapelle (FG), Foggia, Italy
A. Gentile
Affiliation:
Section of Psychiatry, University of Foggia, Department of Clinical and Experimental Medicine, Via Gugliemo Marconi 3, 71041 Carapelle (FG), Foggia, Italy
R.J. Baldessarini
Affiliation:
Department of Psychiatry, Harvard Medical School, International Consortium for Bipolar and Psychotic Disorders Research, McLean Hospital, Belmont, Massachusetts, USA
S. Martone
Affiliation:
Section of Psychiatry, University of Foggia, Department of Clinical and Experimental Medicine, Via Gugliemo Marconi 3, 71041 Carapelle (FG), Foggia, Italy
G. Vitrani
Affiliation:
Section of Psychiatry, University of Foggia, Department of Clinical and Experimental Medicine, Via Gugliemo Marconi 3, 71041 Carapelle (FG), Foggia, Italy
A. La Marca
Affiliation:
Section of Psychiatry, University of Foggia, Department of Clinical and Experimental Medicine, Via Gugliemo Marconi 3, 71041 Carapelle (FG), Foggia, Italy
A. Bellomo
Affiliation:
Section of Psychiatry, University of Foggia, Department of Clinical and Experimental Medicine, Via Gugliemo Marconi 3, 71041 Carapelle (FG), Foggia, Italy
*
*Corresponding author. Tel.: +39 339 646 6525; fax: +39 088 579 9096. E-mail address: a.ventriglio@libero.it (A. Ventriglio).
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Abstract

Purpose

As weight-gain and metabolic abnormalities during treatment with psychotropic drugs are of great concern, we evaluated effects of psycho-education and medical monitoring on metabolic changes among severely mentally ill patients.

Materials and methods

During repeated, systematic psycho-education about general health among 66 consecutive patients diagnosed with DSM-IV-TR schizophrenia (n = 33) or type-I bipolar disorder (n = 33), we evaluated (at intake 1, 2, 3, and 6 months) clinical psychiatric status, treatments and doses, recorded physiological parameters, and assessed attitudes about medication.

Results

At intake, patients with schizophrenia vs bipolar disorder were receiving 3–7 times more psychotropic medication, with 14% higher initial body-mass index (BMI: 29.1 vs 25.6 kg/m2), 12 times more obesity, and significantly higher serum lipid concentrations. During 6-months follow-up, among bipolar disorder patients, polytherapy and serum lipid concentrations declined more than among schizophrenia patients (e.g., total cholesterol + triglycerides, by 3.21 vs 1.75%/month). BMI remained stable. Declining lipid levels were associated with older age, bipolar disorder, being unemployed, higher antipsychotic doses, and lower initial BPRS scores (all P ≤ 0.001).

Conclusions

Psychotropic treatments were more complex, and metabolic measures more abnormal among bipolar disorder than schizophrenia patients. Intensive psycho-education, clinical monitoring, and encouragement of weight-control for six months were associated with improvements in metabolic measures (but not to BMI), and more realistic attitudes about medication.

Keywords

Antipsychotic drugsBipolar disorderMetabolic syndromeObesitySchizophreniaWeight-gain
Type
Original article
Information
European Psychiatry , Volume 29 , Issue 7 , September 2014 , pp. 402 - 407
Copyright
Copyright © 2013 Elsevier Masson SAS

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Footnotes

1

Via Paolo Telesforo 33, 71100 Foggia, Italy. Tel.: +39 320 865 2708.

2

Mailman Research Center, McLean Hospital, 115 Mill Street, Belmont, MA, USA 02478-9106. Tel.: +1 617 855 3203; fax: 1 617 855 3479.

3

Via Padre Antonio da Olivadi 12, 71100 Foggia, Italy. Tel.: +39 339 707 4547.

4

Vle G. Di Vittorio 14, 71121 Foggia, Italy. Tel.: +39 349 759 8555.

5

V. le Francia 40, 71122 Foggia, Italy. Tel.: +39 329 427 5189.

6

SPDC presso OORR di Foggia, Vl.le Pinto, 71100 Foggia, Italy. Tel.: +39 080 521 1926.

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