Are metabolic disorders part of a severe mental illness? Historical and current perspective
DOI:
https://doi.org/10.12775/JEHS.2020.10.10.010Keywords
metabolic syndrome, diabetes type 2, obesity, severe mental illnessAbstract
Introduction and purpose: People with severe mental illness (SMI) live shorter lives than general population. The main cause of mortality in this group is not psychiatric tax diseases, but comorbidities, which are mainly classified as diseases associated with metabolic disorders, such as: obesity, metabolic syndrome (MetS), diabetes type 2, CVDs, coronary artery disease (CAD), cerebrovascular disease. The aim of this review was to identify the factor relating to relationship between metabolic disorders and mental illness.
Description of the state of knowledge: People with SMI are characterized by a higher level of adipose tissue in the visceral region (abdominal obesity) compared to the control group, without any mental disorders. Current studies indicate, that persons with SMI have a genetic tendency of to accumulate adipose tissue in the abdominal area. They are also characterized by higher level of body mass index (BMI), overweight or obesity, than general population. This is mostly caused by lifestyle and specific pharmacological treatment using antipsychotic drug, especially atypical (second generation), which cause weight gain and disturbed carbohydrate metabolism. The fact is, that carbohydrate metabolic disorders were observed in patients with schizophrenia before the first neuroleptic was discovered. Last studies indicated that overweight, obesity may has the same genetic loci as SMI.
Summary: SMI seems to be part of a metabolic disorder. This relationship mostly results from the lifestyle, pharmacological treatment, and also the genetic factors. It should be taken into account that the treatment of SMI always requires monitoring of metabolic indicators. Additionally, motivating patients to a healthy lifestyle and physical activity should be the standard of treatment.
References
Choo CC, Chew PKH, Ho CS, Ho RC. Quality of Life in Patients With a Major Mental Disorder in Singapore. Front Psychiatry. 2019;9:727. DOI http://dx.doi.org/10.3389/fpsyt.2018.00727
Etkin A, Gyurak A, O'Hara R. A neurobiological approach to the cognitive deficits of psychiatric disorders. Dialogues Clin Neurosci. 2013;15(4):419-429.
Richardson T, Elliott P, Roberts R, Jansen M. A Longitudinal Study of Financial Difficulties and Mental Health in a National Sample of British Undergraduate Students. Community Ment Health J. 2017;53(3):344-352. DOI http://dx.doi.org/10.1007/s10597-016-0052-0
Luciano A, Meara E. Employment status of people with mental illness: national survey data from 2009 and 2010. Psychiatr Serv. 2014;65(10):1201-1209. DOI http://dx.doi.org/10.1176/appi.ps.201300335
Lomholt LH, Andersen DV, Sejrsgaard-Jacobsen C, et al. Mortality rate trends in patients diagnosed with schizophrenia or bipolar disorder: a nationwide study with 20 years of follow-up. Int J Bipolar Disord. 2019;7(1):6. DOI http://dx.doi.org/10.1186/s40345-018-0140-x
Viron MJ, Stern TA. The impact of serious mental illness on health and healthcare. Psychosomatics. 2010;51(6):458-65. DOI http://dx.doi.org/10.1176/appi.psy.51.6.458
De Hert M, Correll ChU, Bobes J, Cetkovich-Bakmas M, Cohen D, et al. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care, Wolrd Psychiatry 2011, 52-77. DOI http://dx.doi.org/10.1002/j.2051-5545.2011.tb00014.x
Heald A, Pendlebury J, Anderson S, et al. Lifestyle factors and the metabolic syndrome in Schizophrenia: a cross-sectional study. Ann Gen Psychiatry. 2017;16:12. DOI http://dx.doi.org/10.1186/s12991-017-0134-6
Lake J, Turner MS. Urgent Need for Improved Mental Health Care and a More Collaborative Model of Care. Perm J. 2017;21:17-024. DOI http://dx.doi.org/10.7812/TPP/17-024
Lawrence D, Kisely S. Inequalities in healthcare provision for people with severe mental illness. J Psychopharmacol. 2010;24(4 Suppl):61-68. DOI http://dx.doi.org/10.1177/1359786810382058
Holt RIG. The Management of Obesity in People with Severe Mental Illness: An Unresolved Conundrum. Psychother Psychosom. 2019;88(6):327-332. DOI http://dx.doi.org/10.1159/000503835 .
De Hert M, Detraux J, Vancampfort D. The intriguing relationship between coronary heart disease and mental disorders. Dialogues Clin Neurosci. 2018;20(1):31-40. DOI http://dx.doi.org/10.31887/DCNS.2018.20.1/mdehert
Kohen D. Diabetes mellitus and schizophrenia: historical perspective. BJP 2004; 184: 64–66.
Allison D, Fontaine K, Moonseong H et al. The distribution of body mass index among individuals with and without schizophrenia. J Clin Psychiatry 1999; 60: 215- 220.
Freyberg Z, Aslanoglou D, Shah R, Ballon JS. Intrinsic and Antipsychotic Drug-Induced Metabolic Dysfunction in Schizophrenia. Front Neurosci. 2017;11:432. DOI http://dx.doi.org/10.3389/fnins.2017.00432
Vancampfort D, Wampers M, Mitchell AJ, et al. A meta-analysis of cardio-metabolic abnormalities in drug naïve, first-episode and multi-episode patients with schizophrenia versus general population controls. World Psychiatry. 2013;12(3):240-250. DOI http://dx.doi.org/10.1002/wps.20069
Chen J, Tan L, Long Z, Wang L, Hu L, Yang D. Drug-naive patients with schizophrenia have metabolic disorders that are not associated with polymorphisms in the LEP (-2548G/A) and 5-HTR2C (-759C/T) genes. Int J Clin Exp Pathol. 2018;11(12):5969-5980.
Maina G, Salvi V, Vitalucci A. Prevalence and correlates of overweight in drug-naïve patients with bipolar disorder. J Affect Disord. 2008;110:149–155.
Lin CH, Chen CC, Wong J, McIntyre RS. Both body weight and BMI predicts improvement in symptom and functioning for patients with major depressive disorder. J Affect Disord. 2014;161:123-6. DOI http://dx.doi.org/10.1016/j.jad.2014.02.039 .
Roberts RE, Deleger S, Strawbridge WJ, Kaplan GA. Prospective association between obesity and depression: evidence from the Alameda County Study. Int J Obes Relat Metab Disord. 2003; 27(4):514-21. DOI http://dx.doi.org/10.1038/sj.ijo.0802204 .
Marmorstein NR, Iacono WG, Legrand L. Obesity and depression in adolescence and beyond: reciprocal risks. Int J Obes (Lond). 2014; 38(7):906-11. DOI http://dx.doi.org/10.1038/ijo.2014.19 .
Every-Palmer S, Huthwaite MA, Elmslie JL, Grant E, Romans SE. Long-term psychiatric inpatients' perspectives on weight gain, body satisfaction, diet and physical activity: a mixed methods study. BMC Psychiatry. 2018;18(1):300. DOI http://dx.doi.org/10.1186/s12888-018-1878-5
Bradshaw T, Mairs H. Obesity and Serious Mental Ill Health: A Critical Review of the Literature. Healthcare (Basel). 2014;2(2):166-182. DOI http://dx.doi.org/10.3390/healthcare2020166
Jessica Tyrrell, Anwar Mulugeta, Andrew R Wood, Ang Zhou, Robin N Beaumont, et al. Using genetics to understand the causal influence of higher BMI on depression, International Journal of Epidemiology, 2019; 48(3): 834–848,. DOI https://doi.org/10.1093/ije/dyy223
Ibrahim MA, Asuka E, Jialal I. Hypercholesterolemia. [Updated 2020 Aug 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459188/ (acces 22.10.2020)
Lee Y, Siddiqui WJ. Cholesterol Levels. [Updated 2020 Jul 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542294/ (access 22.10.2020)
Llorente ML, Urrutia V, Diabetes, Psychiatric Disorders, and the Metabolic Effects of Antipsychotic Medications, Clinical Diabetes. 2006; 24(1): 18-24. DOI http://dx.doi.org/10.2337/diaclin.24.1.18
Wirshing DA, Boyd JA, Meng LR, Ballon JS, Marder SR, Wirshing WC. The effects of novel antipsychotics on glucose and lipid levels. J Clin Psychiatry. 2002; 63(10):856-65. DOI http://dx.doi.org/10.4088/jcp.v63n1002 .
Vanderlip ER, Fiedorowicz JG, Haynes WG. Screening, diagnosis, and treatment of dyslipidemia among persons with persistent mental illness: a literature review. Psychiatr Serv. 2012; 63(7):693-701. DOI http://dx.doi.org/10.1176/appi.ps.201100475 .
Nasrallah HA, Meyer JM, Goff DC, McEvoy JP, Davis SM, Stroup TS, Lieberman JA. Low rates of treatment for hypertension, dyslipidemia and diabetes in schizophrenia: data from the CATIE schizophrenia trial sample at baseline. Schizophr Res. 2006;86(1-3):15-22. DOI http://dx.doi.org/10.1016/j.schres.2006.06.026 .
Canadian Diabetes Association Clinical Practice Guidelines Expert Committee, Robinson DJ, Luthra M, Vallis M. Diabetes and mental health. Can J Diabetes. 2013; 37 Suppl 1:S87-92. DOI http://dx.doi.org/10.1016/j.jcjd.2013.01.026 .
Srihari VH, Tek C. Glucose metabolism dysregulation at the onset of mental illness is not limited to first episode psychosis: A systematic review and meta-analysis. Early Interv Psychiatry. 2019 Oct;13(5):1021-1031. DOI http://dx.doi.org/10.1111/eip.12749 .
Kooy FH. Hyperglycemia in mental disorders. Brain 1919; 42: 214-289.
Kohen D. Diabetes mellitus and schizophrenia: historical perspective, BJP 2004, 184: 64-66. DOI: https://doi.org/10.1192/bjp.184.47.s64
Turner T. Chlorpromazine: unlocking psychosis. BMJ. 2007; 334 Suppl 1: 7. DOI http://dx.doi.org/10.1136/bmj.39034.609074.94 .
Dobkin, A.B., Fisher, L.M. & Wyant, G.M. The effect of chlorpromazine on haemostasis. Can. Anaes. Soc. J. 4, 352 (1957). DOI https://doi.org/10.1007/BF03021121
Whicher CA, Price HC, Holt RIG. Mechanisms in endocrinology: Antipsychotic medication and type 2 diabetes and impaired glucose regulation. Eur J Endocrinol. 2018; 178(6):R245-R258. DOI http://dx.doi.org/10.1530/EJE-18-0022 .
Gough SC, O'Donovan MC. Clustering of metabolic comorbidity in schizophrenia: a genetic contribution? J Psychopharmacol. 2005; 19(6 Suppl):47-55. DOI http://dx.doi.org/10.1177/0269881105058380 .
Suvisaari J, Perälä J, Saarni SI, Härkänen T, Pirkola S, Joukamaa M, Koskinen S, Lönnqvist J, Reunanen A. Type 2 diabetes among persons with schizophrenia and other psychotic disorders in a general population survey. Eur Arch Psychiatry Clin Neurosci. 2008; 258(3):129-36. DOI http://dx.doi.org/10.1007/s00406-007-0762-y .
Hackinger, S., Prins, B., Mamakou, V. et al. Evidence for genetic contribution to the increased risk of type 2 diabetes in schizophrenia. Transl Psychiatry 8, 252 (2018). DOI https://doi.org/10.1038/s41398-018-0304-6
Calkin CV, Gardner DM, Ransom T, Alda M. The relationship between bipolar disorder and type 2 diabetes: more than just co-morbid disorders. Ann Med. 2013; 45(2):171-81. DOI http://dx.doi.org/10.3109/07853890.2012.687835 .
Carnethon MR, Biggs ML, Barzilay JI, Smith NL, Vaccarino V, Bertoni AG, Arnold A, Siscovick D. Longitudinal association between depressive symptoms and incident type 2 diabetes mellitus in older adults: the cardiovascular health study. Arch Intern Med. 2007; 167(8):802-7. DOI http://dx.doi.org/10.1001/archinte.167.8.802 .
Webb M, Davies M, Ashra N, et al. The association between depressive symptoms and insulin resistance, inflammation and adiposity in men and women. PLoS One. 2017; 12(11):e0187448 . DOI http://dx.doi.org/10.1371/journal.pone.0187448
Mulugeta A, Zhou A, Power C, Hyppönen E. Obesity and depressive symptoms in mid-life: a population-based cohort study. BMC Psychiatry. 2018;18(1):297. DOI http://dx.doi.org/10.1186/s12888-018-1877-6
Penninx BWJH, Lange SMM. Metabolic syndrome in psychiatric patients: overview, mechanisms, and implications. Dialogues Clin Neurosci. 2018; 20(1): 63-73. DOI http://dx.doi.org/10.31887/DCNS.2018.20.1/bpenninx
Padmavati R. Metabolic syndrome, serious mental illnesses & lifestyle. Indian J Med Res. 2016;143(4):395-397. DOI http://dx.doi.org/10.4103/0971-5916.184280
Kamkar MZ, Sanagoo A, Zargarani F, Jouybari L, Marjani A. Metabolic syndrome in patients with severe mental illness in Gorgan. J Nat Sci Biol Med. 2016;7(1):62-67. DOI http://dx.doi.org/10.4103/0976-9668.175073
Carrà G, Bartoli F, Carretta D, Crocamo C, Bozzetti A, Clerici M, Bebbington PE. The prevalence of metabolic syndrome in people with severe mental illness: a mediation analysis. Soc Psychiatry Psychiatr Epidemiol. 2014; 49(11):1739-46. DOI http://dx.doi.org/10.1007/s00127-014-0835-y .
Łopuszańska UJ, Skorzyńska-Dziduszko K, Lupa-Zatwarnicka K, Makara-Studzińska M. Mental illness and metabolic syndrome--a literature review. Ann Agric Environ Med. 2014;21(4):815-21. DOI http://dx.doi.org/10.5604/12321966.1129939
De Hert M, Dekker JM, Wood D, Kahl KG, Holt RI, Möller HJ. Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC). Eur Psychiatry. 2009;24(6):412-24. DOI http://dx.doi.org/10.1016/j.eurpsy.2009.01.005
Malhotra N, Grover S, Chakrabarti S, Kulhara P. Metabolic syndrome in schizophrenia. Indian J Psychol Med. 2013; 35(3):227-40. DOI http://dx.doi.org/10.4103/0253-7176.119471
Grover S, Malhotra N, Chakrabarti S, Kulhara P. Metabolic syndrome in bipolar disorders. Indian J Psychol Med. 2012; 34(2): 110-118. DOI http://dx.doi.org/10.4103/0253-7176.101767
Kahl KG, Greggersen W, Schweiger U, Cordes J, Balijepalli C, Lösch C, Moebus S. Prevalence of the metabolic syndrome in unipolar major depression. Eur Arch Psychiatry Clin Neurosci. 2012; 262(4):313-20. DOI http://dx.doi.org/10.1007/s00406-011-0277-4
Downloads
Published
How to Cite
Issue
Section
License
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 702
Number of citations: 0
