Abstract

BackgroundOne of the main causes of death in psychiatric patients is cardiovascular diseases which are closely related with lifestyle-related diseases. Psychiatric disorders include schizophrenia and mood disorders, whose symptoms and treatment medicines are different, suggesting that they might have different metabolic disorders. Thus, we studied the differences of lifestyle-related diseases between schizophrenia and mood disorders in Japan.MethodsThis cross-sectional study was performed from 2015 to 2017. Study participants were 189 Japanese hospitalized patients (144 schizophrenia group, 45 mood disorders group) in the department of psychiatry at Kohnodai hospital. We examined physical disorders, metabolic status of glucose and lipid, estimated glomerular filtration rate (eGFR) and brain magnetic resonance imaging. We compared these data between schizophrenia and mood disorders groups using analysis of covariance or logistic regression analysis. In comparisons between inpatients with schizophrenia or mood disorders group and the standard, we quoted ‘The National Health and Nutrition Survey in Japan 2015’ by Ministry of Health, Labor and Welfare as the standard.ResultseGFR and prevalence of smoking were significantly lower in patients with mood disorder group than those with schizophrenia group by adjustment for age. In comparisons between patients with schizophrenia group or mood disorders group and each standard, the ratio of silent brain infarction (SBI) and cerebral infarction were significantly high in both groups. Schizophrenia group showed significantly higher prevalence of diabetes, low high-density lipoprotein (HDL) cholesterolemia, metabolic syndrome and smoking than the standard. Mood disorders group had significantly high prevalence of low HDL-cholesterolemia compared with the standard. Fasting blood glucose and HbA1c were significantly higher in schizophrenia group and female mood disorders group than the standard. Female mood disorders group had significantly decreased eGFR with increased ratio of eGFR < 60 ml/min than the standard.ConclusionsParticipants of both groups had increased ratio of SBI and cerebral infarction, accompanied with glucose and lipid disorders. Compared with schizophrenia group, mood disorders group showed significantly low eGFR and prevalence of smoking.

Highlights

  • One of the main causes of death in psychiatric patients is cardiovascular diseases which are closely related with lifestyle-related diseases

  • There are many reports that schizophrenic patients have a high rate of diabetes, smoking, low high-density lipoprotein (HDL)-cholesterolemia, obesity and metabolic syndrome [6,7,8]

  • Our study has shown that psychiatric inpatients have increased silent brain infarction (SBI) and cerebral infarctions compared with Japanese healthy controls, accompanied with high prevalence of diabetes and low HDL-cholesterolemia [13]

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Summary

Introduction

One of the main causes of death in psychiatric patients is cardiovascular diseases which are closely related with lifestyle-related diseases. Crump et al [4] and Smith et al [5] reported that cardiovascular diseases and malignancy are the main causes of death in psychiatric patients, and cardiovascular diseases are likely to be underrecognized and undertreated in schizophrenic patients. These facts indicate that cardiovascular diseases are one of the most important causes of short life expectancy in psychiatric patients. Some atypical antipsychotics cause adverse effects on glucose and lipid metabolism and induce diabetes and dyslipidemia [10, 11] These side effects of antipsychotics increase the risks of cardiovascular diseases

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