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Metabolic syndrome or glucose challenge in first episode of psychosis?

Published online by Cambridge University Press:  03 February 2017

C. Garcia-Rizo
Affiliation:
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic, Barcelona, Spain Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Madrid, Spain Institute of Biomedical Research Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain
E. Fernandez-Egea
Affiliation:
Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Madrid, Spain Department of Psychiatry, University of Cambridge, Addenbrooke's HospitalCB2 0QQCambridge, UK Cambridgeshire and Peterborough NHS Foundation Trust, PE29 3RJHuntingdon, UK
C. Oliveira
Affiliation:
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic, Barcelona, Spain
A. Meseguer
Affiliation:
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic, Barcelona, Spain
B. Cabrera
Affiliation:
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic, Barcelona, Spain Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Madrid, Spain
G. Mezquida
Affiliation:
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic, Barcelona, Spain
M. Bioque
Affiliation:
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic, Barcelona, Spain Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Madrid, Spain
R. Penades
Affiliation:
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic, Barcelona, Spain Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Madrid, Spain Institute of Biomedical Research Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain Department of Medicine, University of Barcelona, Barcelona, Spain
E. Parellada
Affiliation:
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic, Barcelona, Spain Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Madrid, Spain Institute of Biomedical Research Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain Department of Medicine, University of Barcelona, Barcelona, Spain
M. Bernardo
Affiliation:
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic, Barcelona, Spain Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Madrid, Spain Institute of Biomedical Research Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain Department of Medicine, University of Barcelona, Barcelona, Spain
B. Kirkpatrick
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Nevada School of Medicine, Reno, Nevada, USA
Corresponding
E-mail address:
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Abstract

Patients with schizophrenia exhibit a reduced life expectancy. Although unhealthy lifestyle or suicide risk plays a role, the main causes are diverse medical conditions such as cardiovascular diseases, type 2 diabetes mellitus and metabolic syndrome. Albeit pharmacological secondary side effects might also trigger previous conditions, studies in naïve patients reflect diverse anomalies at the onset. Patients with a first episode of psychosis, display a wide scope of metabolic abnormalities, ranging from normality till pathological values depending on the parameters studied. We attempted to evaluate the metabolic syndrome and glycemic homeostasis in a subset of antipsychotic-naïve patients with a first episode of non-affective psychosis. Patients (n = 84) showed a similar prevalence of metabolic syndrome compared with a matched control sample (n = 98) (6% vs 4%, P = 0.562), while glucose homeostasis values differed significantly (14% vs. 5%, P = 0.034). Our results suggest that metabolic syndrome is not a useful clinical condition to be evaluated in patients before pharmacological treatment. Abnormal glycemic homeostasis at the onset of the disease requires specific diagnostic tools and preventive measures in order to avoid future cardiovascular events. New strategies must be implemented in order to evaluate the cardiovascular risk and subsequent morbidity in patients at the onset of the disease.

Type
Original article
Copyright
Copyright © European Psychiatric Association 2017

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