Vassilopoulou Emilia, Efthymiou Dimitris, Papatriantafyllou Evangelia, Markopoulou Maria, Sakellariou Efthymia-Maria, Popescu Alina Codruta
Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece.
Department of Psychiatry, Division of Neurosciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
J Pers Med. 2021 Nov 12;11(11):1189. doi: 10.3390/jpm11111189.
Mentally disordered offenders provided with forensic psychiatric care are often treated with second generation antipsychotic (SGA) medication and experience metabolic and inflammatory side effects.
In this paper, we monitored the three-year fluctuation of selected anthropometric, biochemical, and inflammatory indices in forensic psychiatric patients receiving antipsychotic (AP) medication for more than five years, according to the type of AP.
Thirty-five patients with psychotic disorders were classified into two groups based on the type of AP. Specifically: AP1, related to a lower risk, and AP2, related to an increased risk of weight gain (WG) and metabolic complications. Biochemical, hematological, anthropometric, blood pressure (BP), and medication data were retrieved from the individual medical files. Statistical analysis was performed with SPSS 23.
No significant differences in weight and glucose and cholesterol levels were observed, but patients taking AP2 more often needed drugs to control diabetes mellitus (DM), lipidemia, and cardiovascular disease (CVD). In those taking AP1, the mean HDL level decreased significantly over time ( < 0.05) and a higher proportion developed higher BP (52.9% of AP1 vs. 16.7% AP2). In the AP2 group the median level of C-reactive protein (CRP) ( < 0.001) and the white blood cell count (WBC) increased over the three years ( < 0.001).
The proposed sub-classification of SGAs into AP1 and AP2, depending on their potential for metabolic and inflammatory effects, might facilitate study of their long-term side-effects but also help in personalized prevention or treatment measures to counteract these side-effects.
接受法医精神病护理的精神错乱罪犯通常使用第二代抗精神病药物（SGA）进行治疗，并会出现代谢和炎症副作用。
在本文中，我们根据抗精神病药物（AP）的类型，监测了接受抗精神病药物治疗超过五年的法医精神病患者所选人体测量、生化和炎症指标的三年波动情况。
35名精神病患者根据AP类型分为两组。具体如下：AP1，与较低风险相关；AP2，与体重增加（WG）和代谢并发症风险增加相关。从个人医疗档案中检索生化、血液学、人体测量、血压（BP）和用药数据。使用SPSS 23进行统计分析。
在体重、血糖和胆固醇水平方面未观察到显著差异，但服用AP2的患者更常需要药物来控制糖尿病（DM）、血脂异常和心血管疾病（CVD）。在服用AP1的患者中，平均高密度脂蛋白（HDL）水平随时间显著下降（<0.05），且有更高比例患者血压升高（AP1组为52.9%，AP2组为16.7%）。在AP2组中，C反应蛋白（CRP）中位数水平（<0.001）和白细胞计数（WBC）在三年中有所增加（<0.001）。
根据SGA对代谢和炎症影响的潜力将其分为AP1和AP2的提议分类，可能有助于研究其长期副作用，也有助于采取个性化预防或治疗措施来对抗这些副作用。
