Abstract
BackgroundAgainst a background of interest in rates of diabetes in schizophrenia and related psychoses and claims that data from historical periods demonstrate a link that antedates modern antipsychotics, we sought to establish the rate of diabetes in first onset psychosis and subsequent prevalence in historical and contemporary cohorts.MethodsAnalysis of two epidemiologically complete databases of individuals admitted for mental illness. 3170 individuals admitted to the North Wales Asylum between 1875–1924 and tracked over 18,486 patient years and 394 North West Wales first admissions for schizophrenia and related psychoses between 1994 and 2006 and tracked after treatment.ResultsThe prevalence of Type 2 diabetes among patients with psychoses at time of first admission in both historical and contemporary samples was 0%. The incidence of diabetes remained 0% in the historical sample throughout 15 years of follow-up but rose in the contemporary sample after 3, 5 and 6 years of treatment with an incidence rate double the expected population rate so that the 15 year prevalence is likely to be over 8%.ConclusionNo association was found between diabetes and serious mental illness, but there may be an association between diabetes and treatment.
Highlights
Against a background of interest in rates of diabetes in schizophrenia and related psychoses and claims that data from historical periods demonstrate a link that antedates modern antipsychotics, we sought to establish the rate of diabetes in first onset psychosis and subsequent prevalence in historical and contemporary cohorts
If estimates that patients with serious mental illness are 2 to 4 times more likely to have diabetes than the rest of the population apply to an untreated population, while taking into account that diabetes has hugely increased in prevalence, we might expect a substantial number of those admitted to an asylum in the pre-antipsychotic era to have had manifestations of diabetes
In North West Wales, we have historical and contemporary databases for serious mental illnesses that allow us to shed some light on these issues
Summary
Against a background of interest in rates of diabetes in schizophrenia and related psychoses and claims that data from historical periods demonstrate a link that antedates modern antipsychotics, we sought to establish the rate of diabetes in first onset psychosis and subsequent prevalence in historical and contemporary cohorts. A series of recent studies have uniformly shown a prevalence of diabetes in patients with schizophrenia 2 to 4 times greater than is found in the rest of the population [1,2,3,4]. If estimates that patients with serious mental illness are 2 to 4 times more likely to have diabetes than the rest of the population apply to an untreated population, while taking into account that diabetes has hugely increased in prevalence, we might expect a substantial number of those admitted to an asylum in the pre-antipsychotic era to have had manifestations of diabetes. In North West Wales, we have historical and contemporary databases for serious mental illnesses that allow us to shed some light on these issues
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