Tseng Ping-Tao, Wang Hung-Yu, Cheng Yu-Shian, Shen Feng-Chih, Lin Pao-Yen, Wu Ching-Kuan
Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, Taiwan.
Division of Endocrinology and Metabolism, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2014 Nov;30(11):579-86. doi: 10.1016/j.kjms.2014.09.002. Epub 2014 Oct 11.
The prevalence rate of metabolic syndrome (MS) and coronary artery disease (CAD) has been found to be high in patients with chronic schizophrenia. Current evidence shows that CAD is underdiagnosed in this group. Our study evaluated the prevalence of MS and the risk of CAD in patients with chronic schizophrenia in a chronic care mental hospital in southern Taiwan. We included all patients with the diagnosis of schizophrenia or schizoaffective disorder. We collected all laboratory, physical examination, psychiatric interview, and chart review data. We also evaluated the risk of CAD in these patients using the Framingham point system. There was no significant age difference in the MS prevalence rate in these patients. The young patients with schizophrenia in our study tended to have a higher prevalence of MS than the general population. In addition, female patients had a higher prevalence rate of MS than males. Based on the Framingham point system, we found the 10-year risk of CAD to be higher among the patients with schizophrenia than in the general population. Our study highlights the importance of the high risk of MS in both younger and older patients with schizophrenia, without a significant relationship to the use of antipsychotics. More complete cohort studies are needed to confirm these findings. Psychiatrists may want to establish more specific and detailed clinical guidelines for patients with chronic schizophrenia with comorbid physical diseases, especially MS and CAD.
已发现慢性精神分裂症患者的代谢综合征(MS)和冠状动脉疾病(CAD)患病率较高。目前的证据表明,该群体中CAD的诊断不足。我们的研究评估了台湾南部一家慢性护理精神病院中慢性精神分裂症患者的MS患病率和CAD风险。我们纳入了所有诊断为精神分裂症或分裂情感性障碍的患者。我们收集了所有实验室检查、体格检查、精神科访谈和病历审查数据。我们还使用弗明汉评分系统评估了这些患者的CAD风险。这些患者的MS患病率在年龄上无显著差异。我们研究中的年轻精神分裂症患者的MS患病率往往高于一般人群。此外,女性患者的MS患病率高于男性。基于弗明汉评分系统,我们发现精神分裂症患者的10年CAD风险高于一般人群。我们的研究强调了MS在年轻和老年精神分裂症患者中高风险的重要性,且与抗精神病药物的使用无显著关系。需要更完整的队列研究来证实这些发现。精神科医生可能需要为患有合并躯体疾病(尤其是MS和CAD)的慢性精神分裂症患者制定更具体、详细的临床指南。