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Minimising metabolic and cardiovascular risk in schizophrenia: diabetes, obesity and dyslipidaemia

Birmingham Heartlands Hospital, Birmingham, UK

P. Mackin

School of Neurology, Neurobiology and Psychology, Department of Psychiatry, Royal Victoria Infirmary, Newcastle upon Tyne, UK

I. Chaudhry

Early Intervention Service, Blackburn, UK

A. Farooqi

East Leicester Medical Practice, Leicester, UK

R. Gadsby

University of Warwick, Coventry, UK

A. Heald

Leighton Hospital, Crewe, UK

J. Hill

Community Diabetes Team, Eastern Birmingham PCT, Alum Rock, Birmingham, UK

H. Millar

Carseview Centre, Dundee, UK.

R. Peveler

Clinical Neurosciences Division, University of Southampton, Royal South Hants Hospital, Southampton, UK

A. Rees

University Hospital of Wales, Heath Park, Cardiff, UK

V. Singh

Handsworth and Ladywood Home Treatment Team, Handsworth, Birmingham, UK

D. TayLor

The Maudsley Hospital, Pharmacy Department, London, UK

J. Vora

Royal Liverpool University Hospital, Liverpool, UK

P.B. Jones

Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK, pbj21{at}cam.ac.uk

People with schizophrenia are at greater risk of obesity, Type 2 diabetes, dyslipidaemia and hypertension than the general population. This results in an increased incidence of cardiovascuLar disease (CVD) and reduced Life expectancy, over and above that imposed by their mentaL illness through suicide. Several Levels of evidence from data Linkage analyses to clinical trials demonstrate that treatment-related metabolic disturbances are commonplace in this patient group, and that the use of certain second-generation antipsychotics may compound the risk of developing the metabolic syndrome and CVD. In addition, smoking, poor diet, reduced physical activity and alcohol or drug abuse are prevalent in people with schizophrenia and contribute to the overall CVD risk. Management and minimization of metaboLic risk factors are pertinent when providing optimal care to patients with schizophrenia. This review recommends a framework for the assessment, monitoring and management of patients with schizophrenia in the UK clinical setting.

Key Words: antipsychotic • cardiovascuLar disease • diabetes • dysLipidaemia • hypertension • metaboLic syndrome • obesity • schizophrenia

Journal of Psychopharmacology, Vol. 21, No. 4, 357-373 (2007)
DOI: 10.1177/0269881107075509


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