The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Schizophrenia Trial: Clinical comparison of subgroups with and without the metabolic syndrome

被引:176
作者
Meyer, JM
Nasrallah, HA
McEvoy, JP
Goff, DC
Davis, SM
Chakos, M
Patel, JK
Keefe, RSE
Stroup, TS
Lieberman, JA
机构
[1] VA San Diego Healthcare Syst, San Diego, CA USA
[2] Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA
[3] Univ Cincinnati, Cincinnati, OH 45267 USA
[4] Duke Univ, Dept Psychiat & Behav Sci, Med Ctr, Durham, NC 27706 USA
[5] John Umstead Hosp, Butner, NC 27509 USA
[6] Harvard Univ, Dept Psychiat, Cambridge, MA 02138 USA
[7] Lindemann Mental Hlth Ctr, Freedom Trail Clin, Boston, MA 02114 USA
[8] Quintiles Inc, Biostat, Morrisville, NC 27560 USA
[9] Suny Downstate Med Ctr, Brooklyn, NY 11203 USA
[10] Univ Massachusetts, Sch Med, Worcester, MA 01605 USA
[11] Univ N Carolina, Dept Psychiat, Chapel Hill, NC 27599 USA
[12] Columbia Univ, Inst Psychiat, Dept Psychiat, New York, NY 10032 USA
关键词
schizophrenia; metabolic syndrome; health; rating; comorbidity;
D O I
10.1016/j.schres.2005.07.015
中图分类号
R749 [精神病学];
学科分类号
100205 [精神病与精神卫生学];
摘要
The metabolic syndrome (MS) is highly prevalent among patients with schizophrenia (current estimates 35-40%), yet no data exist on the correlation of this diagnosis with illness severity, neurocognitive or quality of life measures in this population. Methods: Using baseline data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Schizophrenia Trial, assignment of MS status was performed using an updated definition derived from the National Cholesterol Education Program (NCEP) criteria. Those with and without MS were compared on the basis of primary and secondary variables of interest from baseline data encompassing psychiatric, neurocognitive and quality of life measures. Results: Of 1460 subjects enrolled at baseline, MS status could be reliably assigned for 1231 subjects, with a prevalence of 35.8% using the NCEP derived criteria. After adjustment for age, gender, race, ethnicity and site variance, those with MS rated themselves significantly lower on physical health by SF-12 (p <.001), and scored higher on somatic preoccupation (PANSS item G 1) (p =.03). There were no significant differences between the two cohorts on measures of symptom severity, depression, quality of life, neurocognition, or self-rated mental health. Neither years of antipsychotic exposure nor alcohol usage were significant predictors of MS status when adjusted for age, gender, race, and ethnicity. Conclusions: The metabolic syndrome is highly prevalent in this large cohort of schizophrenia patients and is strongly associated with a poor self-rating of physical health and increased somatic preoccupation. These results underscore the need for mental health practitioners to take an active role in the health monitoring of patients with schizophrenia to minimize the impact of medical comorbidity on long-term mortality and on daily functioning. Outcomes data from CATIE will provide important information on the metabolic and clinical impact of antipsychotic treatment for those subjects with MS and other medical comorbidities. (c) 2005 Elsevier B.V. All rights reserved.
引用
收藏
页码:9 / 18
页数:10
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