The British Journal of Psychiatry (2009) 194: 434-438. doi: 10.1192/bjp.bp.108.052605
© 2009 The Royal College of Psychiatrists
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Metabolic profile of antipsychotic-naive individuals with non-affective psychosis

Emilio Fernandez-Egea, MD

Schizophrenia Program, Department of Psychiatry, Neuroscience Institute, Hospital Clinic, Barcelona, Spain

Miguel Bernardo, MD, PhD

Schizophrenia Program, Department of Psychiatry, Neuroscience Institute, Hospital Clinic and Institute of Biomedical Research Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain

Thomas Donner, MD

Department of Internal Medicine, Division of Endocrinology, Diabetes and Nutrition, University of Maryland Baltimore, Baltimore, Maryland, USA

Ignacio Conget, MD, PhD

Endocrinology and Diabetes Section, Institute of Digestive and Metabolic Diseases, Hospital Clinic and Institute of Biomedical Research, Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain

Eduard Parellada, MD, PhD

Schizophrenia Program, Department of Psychiatry, Neuroscience Institute, Hospital Clinic and Institute of Biomedical Research Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain

Azucena Justicia, RN

Schizophrenia Program, Department of Psychiatry, Neuroscience Institute, Hospital Clinic, Barcelona, Spain

Enric Esmatjes, MD, PhD

Endocrinology and Diabetes Section, Institute of Digestive and Metabolic Diseases, Hospital Clinic and Institute of Biomedical Research, Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain

Clemente Garcia-Rizo, MD

Schizophrenia Program, Department of Psychiatry, Neuroscience Institute, Hospital Clinic, Barcelona, Spain

Brian Kirkpatrick, MD, MSPH

Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta, Georgia, USA

Correspondence: Brian Kirkpatrick, Department of Psychiatry and Health Behavior, Medical College of Georgia, 929 St. Sebastian Way, Augusta, GA 30912, USA. Email: bkirkpatrick2{at}aol.com

Declaration of interest

E.F.-E. received consulting fees and honoraria from Pfizer. T.D. received honoraria from Sanofi Aventis, Pfizer, Merck, Novartis and Amylin, and has received research grants from Eli Lilly. M.B. received consultant fees from Bristol-Myers Squibb and Wyeth, and honoraria from Janssen-Cilag, Eli Lilly, Pfizer, Synthelabo, GlaxoSmithKline and AstraZeneca. E.P. received research grants and consultant fees from Janssen-Cilag and GlaxoSmithKline, and served on the speakers/advisory boards for Janssen-Cilag. E.E. received consulting or speaking fees from Sanofi-Aventis, GlaxoSmithKline, Merck, Sharpe & Dohme, Servier, Bristol-Myers Squibb, Abbott and Novartis. I.C. received consulting or speaking fees from Sanofi-Aventis, GlaxoSmithKline, Merck, Sharpe & Dohme, Novartis, Bayer, Eli-Lilly. B.K. received consulting and/or speaking fees from Pfizer, Organon, AstraZeneca, Wyeth, Bristol-Myers Squibb, and Solvay.

Funding

Supported in part by grant RO1 DK069265 from the National Institute of Diabetes and Digestive and Kidney Diseases (B.K), NARSAD Young Investigator Award (E.F.-E.), and the Spanish Ministry of Health, Instituto de Salud Carlos III, CIBERSAM CB7/09/0005 and Catalonia Government DURSI 2005GR00223 (M.B.).

Background

Some studies suggest individuals with schizophrenia have an increased risk of diabetes prior to antipsychotic use. Small sample sizes and the potential for confounding by hypercortisolaemia have decreased confidence in those results.

Aims

To examine diabetes-related factors in newly diagnosed, antipsychotic-naive people with non-affective psychosis.

Method

Participants with psychosis (the psychosis group; n = 50) and matched controls (the control group; n = 50) were given a 2 h oral glucose tolerance test. Fasting concentrations were also determined for adiponectin, interleukin-6 and C-reactive protein.

Results

Compared with the control group, the psychosis group had significant increases in 2 h glucose and interleukin-6 concentrations, and in the prevalence of abnormal glucose tolerance (16% of psychosis group v. 0% of control group). Adiponectin and C-reactive protein concentrations did not differ significantly between the two groups. These findings could not be attributed to differences in cortisol concentrations, smoking, gender, neighbourhood of residence, body mass index, aerobic conditioning, ethnicity, socioeconomic status or age.

Conclusions

Individuals with non-affective psychosis appear to have an increased prevalence of abnormal glucose tolerance prior to antipsychotic treatment, as well as abnormalities in a related inflammatory molecule. These underlying problems may contribute to the metabolic side-effects of antipsychotic medications.


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Metabolic profile of antipsychotic-naive individuals with non-affective psychosis
Jeshoor Kumar Jebadurai, et al.
BJP Online, 3 Jun 2009 [Full text]