입원 치료 중인 조현병 환자의 비만도와 정신병리
Obesity and Psychopathology of Inpatients with Schizophrenia
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Objectives ZZThe aims of this study were to examine the relationship between obesity and psychopathology of inpatients with schizophrenia. MethodsZZEighty four inpatients with schizophrenia and 81 control subjects were recruited. Height and weight were measured for calculation of body mass index (BMI). Symptom severity scales [Positive and Negative Syndrome Scale (PANSS), Brief Psychiatric Rating Scale] and Global Assessment of Functioning Scale (GAF) were conducted in all patients. Comorbid medical conditions, years of education, smoking status, age of onset, duration of illness, and medication history were collected. ResultsZZPatients with schizophrenia had significantly higher BMI and ratio of obesity than control subjects. Among patients, obese patients scored lower on symptom severity scales and better on functional assessment than not obese patients. Multiple regression analysis revealed an association of late onset and being obese with lower PANSS total score and better GAF score in patients. Late onset and being female were inversely related with negative symptom score. The type and dose of antipsychotics showed no association with obesity. ConclusionZZThe results of this study indicate that patients with schizophrenia are likely to be more obese. Some characteristics of patients with less severe psychopathology, such as late onset, being obese, were coincident with the result of previous studies. In addition, the result showing that the heavier the weight of patients, the lower severity of symptoms was repeatedly reported in previous studies. The type and dose of antipsychotics were not associated with obesity. These results prompt further investigation of the relationship among schizophrenia, antipsychotics, and weight gain.
Abstract
Objectives ZZThe aims of this study were to examine the relationship between obesity and psychopathology of inpatients with schizophrenia. MethodsZZEighty four inpatients with schizophrenia and 81 control subjects were recruited. Height and weight were measured for calculation of body mass index (BMI). Symptom severity scales [Positive and Negative Syndrome Scale (PANSS), Brief Psychiatric Rating Scale] and Global Assessment of Functioning Scale (GAF) were conducted in all patients. Comorbid medical conditions, years of education, smoking status, age of onset, duration of illness, and medication history were collected. ResultsZZPatients with schizophrenia had significantly higher BMI and ratio of obesity than control subjects. Among patients, obese patients scored lower on symptom severity scales and better on functional assessment than not obese patients. Multiple regression analysis revealed an association of late onset and being obese with lower PANSS total score and better GAF score in patients. Late onset and being female were inversely related with negative symptom score. The type and dose of antipsychotics showed no association with obesity. ConclusionZZThe results of this study indicate that patients with schizophrenia are likely to be more obese. Some characteristics of patients with less severe psychopathology, such as late onset, being obese, were coincident with the result of previous studies. In addition, the result showing that the heavier the weight of patients, the lower severity of symptoms was repeatedly reported in previous studies. The type and dose of antipsychotics were not associated with obesity. These results prompt further investigation of the relationship among schizophrenia, antipsychotics, and weight gain.
참고문헌 (50)
- Hsiao CC, "Obesity in schizophrenic outpatients receiving antipsychotics in Taiwan", Psychiatry Clin Neurosci, 58, pp.403~409 (2004)
- Subramaniam M, "Body mass index, obesity, and psychopathology in patients with schizophrenia", J Clin Psychopharmacol, 34, pp.40~46 (2014)
- Must A, "The disease burden associated with overweight and obesity", JAMA, 282, pp.1523~1529 (1999)
- DeFronzo RA, "Insulin resistance. A multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease", Diabetes Care, 14, pp.173~194 (1991)
- Isomaa B, "Cardiovascular morbidity and mortality associated with the metabolic syndrome", Diabetes Care, 24, pp.683~689 (2001)
- Heiskanen T, "Metabolic syndrome in patients with schizophrenia", J Clin Psychiatry, 64, pp.575~579 (2003)
- Cohn T, "Characterizing coronary heart disease risk in chronic schizophrenia: high prevalence of the metabolic syndrome", Can J Psychiatry, 49, pp.753~760 (2004)
- Kato MM, "Prevalence of Metabolic Syndrome in Hispanic and Non-Hispanic Patients with Schizophrenia", Prim Care Companion J Clin Psychiatry, 6, pp.74~77 (2004)
- Vancampfort D, "Metabolic syndrome and metabolic abnormalities in bipolar disorder: a meta-analysis of prevalence rates and moderators", Am J Psychiatry, 170, pp.265~274 (2013)
- Heiskanen TH, "Metabolic syndrome and depression:a cross-sectional analysis", J Clin Psychiatry, 67, pp.1422~1427 (2006)
- Henderson DC, "Weight gain with atypical antipsychotics: evidence and insights", J Clin Psychiatry, 68(Suppl 12), pp.18~26 (2007)
- Meyer JM, "The metabolic syndrome and schizophrenia", Acta Psychiatr Scand, 119, pp.4~14 (2009)
- Vancampfort D, "Relationships between obesity, functional exercise capacity, physical activity participation and physical self-perception in people with schizophrenia", Acta Psychiatr Scand, 123, pp.423~430 (2011)
- McCreadie RG, "Diet, smoking and cardiovascular risk in people with schizophrenia: descriptive study", Br J Psychiatry, 183, pp.534~539 (2003)
- Nasrallah HA, "Atypical antipsychotic-induced metabolic side effects:insights from receptor-binding profiles", Mol Psychiatry, 13, pp.27~35 (2008)
- American Diabetes Association, "Consensus development conference on antipsychotic drugs and obesity and diabetes", Diabetes Care, 27, pp.596~601 (2004)
- Yang Y, "Association between ghrelin gene (GHRL) polymorphisms and clinical response to atypical antipsychotic drugs in Han Chinese schizophrenia patients", Behav Brain Funct, 8, pp.11~ (2012)
- Wofford MR, "Drug-induced metabolic syndrome", J Clin Hypertens (Greenwich), 8, pp.114~119 (2006)
- Hermes E, "The association between weight change and symptom reduction in the CATIE schizophrenia trial", Schizophr Res, 128, pp.166~170 (2011)
- Ganesan Venkatasubramanian, "A Longitudinal Study of Relation between Side-effects and Clinical Improvement in Schizophrenia: Is There a Neuro-metabolic Threshold for Second Generation Antipsychotics?", Clinical Psychopharmacology and Neuroscience, 11(1), pp.24~27 (2013), 대한정신약물학회
- Bai YM, "Association of initial antipsychotic response to clozapine and long-term weight gain", Am J Psychiatry, 163, pp.1276~1279 (2006)
- Meltzer HY, "Clozapine-induced weight gain predicts improvement in psychopathology", Schizophr Res, 59, pp.19~27 (2003)
- Czobor P, "Antipsychotic-induced weight gain and therapeutic response:a differential association", J Clin Psychopharmacol, 22, pp.244~251 (2002)
- Basson BR, "Factors influencing acute weight change in patients with schizophrenia treated with olanzapine, haloperidol, or risperidone", J Clin Psychiatry, 62, pp.231~238 (2001)
- Sharma E, "Association between antipsychotic-induced metabolic side-effects and clinical improvement:a review on the Evidence for “metabolic threshold”", Asian J Psychiatr, 8, pp.12~21 (2014)
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders: DSM-IV-TR" (2000), American Psychiatric Association
- Lee JS, "Effect of Weight Reduction on Obesity-specific Quality of Life (QOL) in Obese Subjects", Korean J Obes, 15, pp.106~113 (2006)
- Kay SR, "The positive and negative syndrome scale (PANSS) for schizophrenia", Schizophr Bull, 13, pp.261~276 (1987)
- Overall JE, "The brief psychiatric rating scale", Psychol Rep, 10, pp.799~812 (1962)
- Endicott J, "The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance", Arch Gen Psychiatry, 33, pp.766~771 (1976)
- Patel MX, "How to compare doses of different antipsychotics: a systematic review of methods", Schizophr Res, 149, pp.141~148 (2013)
- Yang J, "Efficacy and tolerability of Blonanserin in the patients with schizophrenia: a randomized, double-blind, risperidone-compared trial", Clin Neuropharmacol, 33, pp.169~175 (2010)
- Woods SW, "Chlorpromazine equivalent doses for the newer atypical antipsychotics", J Clin Psychiatry, 64, pp.663~667 (2003)
- Musil R, "Weight gain and antipsychotics:a drug safety review", Expert Opin Drug Saf, 14, pp.73~96 (2015)
- Melkersson K, "Association between body mass index and insulin receptor substrate-4 (IRS-4) gene polymorphisms in patients with schizophrenia", Neuro Endocrinol Lett, 32, pp.634~640 (2011)
- National Health Insurance Service, "2012 National Health Screening Statistical Yearbook", National Health Insurance Service, ~ (2013)
- Venkatasubramanian G, "Insulin and insulin-like growth factor-1 abnormalities in antipsychotic-naive schizophrenia", Am J Psychiatry, 164, pp.1557~1560 (2007)
- Girgis RR, "Antipsychotic drug mechanisms:links between therapeutic effects, metabolic side effects and the insulin signaling pathway", Mol Psychiatry, 13, pp.918~929 (2008)
- Sentissi O, "Leptin and ghrelin levels in patients with schizophrenia during different antipsychotics treatment: a review", Schizophr Bull, 34, pp.1189~1199 (2008)
- Venkatasubramanian G, "A longitudinal study on the impact of antipsychotic treatment on serum leptin in schizophrenia", Clin Neuropharmacol, 33, pp.288~292 (2010)
- Vancampfort D, "The functional exercise capacity is correlated with global functioning in patients with schizophrenia", Acta Psychiatr Scand, 125, pp.382~387 (2012)
- Newcomer JW, "Second-generation (atypical) antipsychotics and metabolic effects: a comprehensive literature review", CNS Drugs, 19(Suppl 1), pp.1~93 (2005)
- Salokangas RK, "Body mass index and functioning in long-term schizophrenia. Results of the DSP project", Eur Psychiatry, 22, pp.313~318 (2007)
- Aichhorn W, "Differences between men and women in side effects of secondgeneration antipsychotics", Nervenarzt, 78, pp.45~52 (2007)
- Aichhorn W, "Second-generation antipsychotics: is there evidence for sex differences in pharmacokinetic and adverse effect profiles?", Drug Saf, 29, pp.587~598 (2006)
- 노재우, "정신분열병 입원 환자에서의 대사 증후군 유병률 연구", 생물정신의학, 18(1), pp.46~54 (2011), 대한생물정신의학회
- Arai H, "Prevalence of metabolic syndrome in the general Japanese population in 2000", J Atheroscler Thromb, 13, pp.202~208 (2006)
- Sugawara N, "Body mass index and quality of life among outpatients with schizophrenia in Japan", BMC Psychiatry, 13, pp.108~ (2013)
- Pérez-Iglesias R, "Course of weight gain and metabolic abnormalities in first treated episode of psychosis:the first year is a critical period for development of cardiovascular risk factors", Int J Neuropsychopharmacol, 17, pp.41~51 (2014)
- Kang SH, "Crosssectional prevalence of metabolic syndrome in Korean patients with schizophrenia", Schizophr Res, 128, pp.179~181 (2011)
