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P.3.b.038 Prevalence of metabolic syndrome in psychotic patients treated with antipsychotics
P.3.b. Psychotic disorders and treatment − Psychotic disorders (clinical) Results: Incidence of convergence insufficiency was significantly higher in SZ group (14 of 32, 43.75%) than in HC (1 of 22, 1.82%, p = 0.001).Compared to HC, patients with schizophrenia also revealed significantly higher ICARS subscores: posture (p = 0.017), kinetic (p < 0.001), dysarthria (p < 0.01), oculomotor (p < 0.001) as well as total score (p < 0.001). SZ patients with symptom presented significantly higher oculomotor subscore (with symptom x = 2.50, without x = 1.27, p = 0.04) than SZ patients without the symptom. Conclusions: To our best knowledge, there has been no previous study concerning unilateral exophoria in schizophrenia. Observed symptom occurred significantly more often in SZ patients, and was accompanied with ataxia-related neurological deficits. Since only oculomotor subscore differences reached statistical significance, the specificity of this syndrome for SZ patients may be associated with widely described eye movement deficits in SZ, as the vergence and the smooth pursuit are considered to have a common biological background. This phenomenon may be explained by deterioration of the midbrain, cortico-pontocerebellar pathways including cerebellar nuclei (fastigal nucleus). Our findings seem to be coherent with Andreasen theory of cognitive dysmetria, where cerebellum and cerebello-cortical tracts dysfunctions are hypothesized to be involved in pathogenesis of schizophrenia. The limitation of our study was lack of neuroleptic naive group, however atypical antipsychotics were selected due to their minimal effect on motor performance of our patients. Assessment of this symptom is short and applicable in everyday practice and it could be used in order to differentiate patients with higher rate of eye movement deficits.
P.3.b.038 Prevalence of metabolic syndrome in psychotic patients treated with antipsychotics B. Ferreiro Fernandez1 ° , M.C. Garc´ıa Mah´ıa1 , M. Vidal Millares2 Universitario a Coru˜na, Psychiatry, La Coru˜na, Spain; 2 Hospital Universitario Santiago de Compostela, Psychiatry, Santiago de Compostela, Spain
S513
Patients were classified according to man diagnosis in four groups: schizophrenia, affective psychosis, paranoid disorders and other functional psychosis. Variables analyzed were age, sex, number of hospitalizations, main diagnose, type and dose of currently administered antipsychotics; use of concomitant medication; and diagnosis and treatment of diabetes, hypertension, and/or dyslipidemia. Data were analyzed with statistical package v. 19.0 for windows. Results: From the whole sample 58.9% were male and 41.1% were female, age average 31 years (standard deviation 7.9) years. Comparison of the mean disease duration of the men (15.3±6.9 years) and women (11.5±9.7 years) indicated that there was no significant difference between them. Among all subjects, 12.6% were found to have diabetes, 36.5% hypertension, 72.0% dyslipidemia, and 46.1% central obesity. The frequency of these disorders did not presented significant differences between female and male. However, central obesity rate was higher in women than in men and age influence was detected in diabetes. Schizophrenic group presented higher rate of metabolic syndrome than other groups analyzed, with statistical significance. Metabolic syndrome was more frequent in patients treated with two or more antipsychotics compared to patients with monotherapy and in patients treated with atypical antipsychotics compared to patients with classic antipsychotics. Psychotic patients treated with injectable long acting antipsychotics presented similar rates of metabolic syndrome in comparison to patients treated with oral formulations of antipsychotics. Conclusions: Patients with psychotic disorders have high prevalence of metabolic syndrome. Psychiatric treatment facilities should offer and promote healthy lifestyle intervention early in the course of disease aiming to prevent serious metabolic adverse effects. Awareness of these aspects should be increased among primary healthcare providers and specialists, and physical health problems should be incorporated into psycho-educational programs.
1 Hospital
Introduction: Previous studies show that patients with schizophrenia and bipolar disorders have high levels of medical comorbidity and cardiovascular risk factors. The presence of 3 or more specific factors is indicative of metabolic syndrome, which is a significant factor in future morbidity and mortality. Objectives: To examine the prevalence of metabolic syndrome and its risk factors in patients diagnosed of psychotic illness and included in Diagnostic Related Group (DRG) 430 that were treated with antipsychotics. Methods: Retrospective descriptive study of psychiatric patients with psychosis (N = 126). Patients included in this study were recruited from two clinical settings. One group was obtained from a randomized sample of patients hospitalized in a psychiatric hospital in Santiago de Compostela in a period of two years (n = 60) and another group (n = 66) from ambulatory care. Data were obtained from clinical records. Inclusion criteria were age 18−65 years, continuous use of antipsychotic agents for at least 2 years prior and up to study initiation, and diagnose of psychiatric disorders included in DRG 430. Exclusion criteria were pregnancy, female patients currently taking contraceptives, and female patients on hormone therapy for various reasons.
References [1] Goff DC et al, 2005 Medical morbidity and mortality in schizophrenia: guidelines for psychiatrists. J Clin Psychiatry 66:183−94.
P.3.b.039 Predictors of adherence to antipsychotic treatment in first episode schizophrenia − results of the Romanian cohort in the EUFEST study V. Matei1 ° , A.I. Mihailescu2 , R. Al-Bataineh3 1 University of Medicine and Pharmacy Carol Davila Bucharest, Psychiatry, Bucharest, Romania; 2 University of Medicine and Pharmacy Carol Davila Bucharest, Medical Psychology, Bucharest, Romania; 3 Hospital “Prof. Dr. Al. Obregia”, Department II, Bucharest, Romania Introduction: Adherence to treatment in schizophrenia is a permanent theme of research due to its great importance. Analyzing predictors of antipsychotic adherence could lead to identify potential non-adherent patients, to tailor interventions to improve adherence and to help patients with schizophrenia maintain a satisfactory functioning. Understanding early predictors of antipsychotic adherence could give us information on long term adherence [1] which is of tremendous importance.
P.3.b.038 Prevalence of metabolic syndrome in psychotic patients treated with antipsychotics B. Ferreiro Fernandez1 ° , M.C. Garc´ıa Mah´ıa1 , M. Vidal Millares2 Universitario a Coru˜na, Psychiatry, La Coru˜na, Spain; 2 Hospital Universitario Santiago de Compostela, Psychiatry, Santiago de Compostela, Spain
S513
Patients were classified according to man diagnosis in four groups: schizophrenia, affective psychosis, paranoid disorders and other functional psychosis. Variables analyzed were age, sex, number of hospitalizations, main diagnose, type and dose of currently administered antipsychotics; use of concomitant medication; and diagnosis and treatment of diabetes, hypertension, and/or dyslipidemia. Data were analyzed with statistical package v. 19.0 for windows. Results: From the whole sample 58.9% were male and 41.1% were female, age average 31 years (standard deviation 7.9) years. Comparison of the mean disease duration of the men (15.3±6.9 years) and women (11.5±9.7 years) indicated that there was no significant difference between them. Among all subjects, 12.6% were found to have diabetes, 36.5% hypertension, 72.0% dyslipidemia, and 46.1% central obesity. The frequency of these disorders did not presented significant differences between female and male. However, central obesity rate was higher in women than in men and age influence was detected in diabetes. Schizophrenic group presented higher rate of metabolic syndrome than other groups analyzed, with statistical significance. Metabolic syndrome was more frequent in patients treated with two or more antipsychotics compared to patients with monotherapy and in patients treated with atypical antipsychotics compared to patients with classic antipsychotics. Psychotic patients treated with injectable long acting antipsychotics presented similar rates of metabolic syndrome in comparison to patients treated with oral formulations of antipsychotics. Conclusions: Patients with psychotic disorders have high prevalence of metabolic syndrome. Psychiatric treatment facilities should offer and promote healthy lifestyle intervention early in the course of disease aiming to prevent serious metabolic adverse effects. Awareness of these aspects should be increased among primary healthcare providers and specialists, and physical health problems should be incorporated into psycho-educational programs.
1 Hospital
Introduction: Previous studies show that patients with schizophrenia and bipolar disorders have high levels of medical comorbidity and cardiovascular risk factors. The presence of 3 or more specific factors is indicative of metabolic syndrome, which is a significant factor in future morbidity and mortality. Objectives: To examine the prevalence of metabolic syndrome and its risk factors in patients diagnosed of psychotic illness and included in Diagnostic Related Group (DRG) 430 that were treated with antipsychotics. Methods: Retrospective descriptive study of psychiatric patients with psychosis (N = 126). Patients included in this study were recruited from two clinical settings. One group was obtained from a randomized sample of patients hospitalized in a psychiatric hospital in Santiago de Compostela in a period of two years (n = 60) and another group (n = 66) from ambulatory care. Data were obtained from clinical records. Inclusion criteria were age 18−65 years, continuous use of antipsychotic agents for at least 2 years prior and up to study initiation, and diagnose of psychiatric disorders included in DRG 430. Exclusion criteria were pregnancy, female patients currently taking contraceptives, and female patients on hormone therapy for various reasons.
References [1] Goff DC et al, 2005 Medical morbidity and mortality in schizophrenia: guidelines for psychiatrists. J Clin Psychiatry 66:183−94.
P.3.b.039 Predictors of adherence to antipsychotic treatment in first episode schizophrenia − results of the Romanian cohort in the EUFEST study V. Matei1 ° , A.I. Mihailescu2 , R. Al-Bataineh3 1 University of Medicine and Pharmacy Carol Davila Bucharest, Psychiatry, Bucharest, Romania; 2 University of Medicine and Pharmacy Carol Davila Bucharest, Medical Psychology, Bucharest, Romania; 3 Hospital “Prof. Dr. Al. Obregia”, Department II, Bucharest, Romania Introduction: Adherence to treatment in schizophrenia is a permanent theme of research due to its great importance. Analyzing predictors of antipsychotic adherence could lead to identify potential non-adherent patients, to tailor interventions to improve adherence and to help patients with schizophrenia maintain a satisfactory functioning. Understanding early predictors of antipsychotic adherence could give us information on long term adherence [1] which is of tremendous importance.