Topics tagged with "Schizophrenia and weight management"

Cardiometabolic changes and weight gain

How are cardiometabolic or weight problems related to schizophrenia? Patient populations that are prescribed antipsychotic agents may experience cardio and metabolic side effects. What are the cardiometabolic side effects? Medicated patients versus population or healthy controls Moderate quality evidence suggests small to medium-sized increased risks of hypertension, low HDL cholesterol, hypertriglyceridemia, diabetes, metabolic syndrome, abdominal obesity and reduced heart rate variability in people with schizophrenia. People with first-episode psychosis and antipsychotic-naïve patients also show increased hypertension and reduced heart rate variability, but not other cardiometabolic indices. There is increased incidence of myocardial infarction in people with any lifetime use of…

Diet

How is diet related to schizophrenia? People with mental disorders may be at increased risk of nutritional deficiencies due to poor diet. Poor diet is a major and modifiable cause of comorbid conditions, including metabolic syndrome and obesity. During pregnancy, it also contributes to the risk of developmental problems in the foetus. What is the evidence regarding diet ? Moderate to low quality evidence finds poor dietary patterns in people with schizophrenia, including decreased fibre and fruit intake, and increased saturated fat intake compared to people without a mental disorder. People with schizophrenia may have high LDL and low HDL…

For weight gain

What are psychosocial treatments for weight gain? Weight gain is a well documented side effect of many antipsychotic medications. Weight management is important to ensure that the benefits of antipsychotic medications are not outweighed by the increased risk of physical disease. Excessive weight gain is a serious health concern, it is associated not only with reduced quality of life and social stigma, but can affect treatment adherence and increase morbidity (both physical and psychological) and mortality. Behavioural therapies are targeted at changing patterns of behaviour and actions that lead to an unfavourable consequence, while reinforcing favourable behaviours. Pharmacological strategies for…

Treatments for weight gain

How is weight gain relevant for people with schizophrenia?  Many antipsychotic medications are associated with weight gain, and various adjunctive pharmacological approaches have been investigated for this problem. Effective adjunctive pharmaceutical treatments for side effects such as weight gain increase adherence to antipsychotic medications and reduces the risk of psychotic relapse. What is the evidence for adjunctive pharmaceutical therapies for weight reduction? Moderate quality evidence finds a benefit of adjunctive metformin for reducing weight in people with schizophrenia. Moderate to low quality evidence finds more weight reduction with metformin plus lifestyle intervention than placebo (less 5.05kg), metaformin alone (less 1.5kg)…

Metabolic syndrome

How is metabolic syndrome related to schizophrenia? Metabolic syndrome is a risk factor for diabetes and cardiovascular diseases. It is defined as a clustering of at least three abnormalities including obesity, high blood pressure, high blood triglycerides, low levels of high-density lipoprotein (HDL) cholesterol and insulin resistance. What is the evidence for metabolic syndrome in people with schizophrenia? Moderate quality evidence finds an overall prevalence of metabolic syndrome in people with schizophrenia of around 32%. Compared to age and gender-matched population controls, there are increased rates of abdominal obesity, hypertension, hypertriglyceridemia, and low HDL cholesterol in people with schizophrenia, with…

Heart disease

How is heart disease related to schizophrenia? People with schizophrenia may show increased rates of co-occurring conditions, including heart disease. It is unclear if any increased risk is a consequence of the metabolic impact of antipsychotic administration or unhealthy lifestyle choices, or most likely, a combination of both. What is the evidence for comorbid heart disease? Moderate quality evidence finds small increases in rates of coronary heart disease and congestive heart failure in people with schizophrenia, with rates gained from both longitudinal and cross-sectional studies, and from data adjusted for potential confounding factors. Longitudinal studies with adjusted data also show…

Diabetes

How is diabetes related to schizophrenia? People with schizophrenia may show increased rates of unrelated co-occurring illnesses, one example is diabetes. Diabetes is a state of impaired insulin function, either as a result of reduced insulin production (type I diabetes) or reduced insulin responsiveness (type II diabetes). Insulin regulates blood glucose levels, and reduced insulin function effectively increases blood glucose levels (hyperglycaemia). This is a dangerous state in the long term, and can ultimately damage the retina, kidneys, nerves and blood vessels. Consequently, effective management of diabetes is crucial. It is unclear if any increased risk in people with schizophrenia…

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