Bennett Catherine W, Gensler Lauren, Goldsmith David R
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Drive, Suite 331K, Atlanta, GA, 30329, USA.
Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Community Ment Health J. 2023 May;59(4):641-653. doi: 10.1007/s10597-022-01045-2. Epub 2022 Nov 10.
Patients with psychotic disorders have increased rates of medical comorbidities. In this cross-sectional study, we investigated the relationship between antipsychotics and medical comorbidities among patients with psychotic disorders in an urban psychiatry clinic in Atlanta, Georgia (n = 860). Each antipsychotic group was compared to a group of patients from the same sample who were not on any antipsychotic, and logistic regression models were constructed for each comorbidity. Ziprasidone was associated with diabetes (aOR 2.56, 95% CI 1.03-6.38) and obesity (aOR 3.19, 95% CI 1.37-7.41). Aripiprazole was associated with obesity (aOR 2.39, 95% CI 1.27-4.51). Clozapine was associated with GERD (aOR 3.59, 95% CI 1.11-11.61), movement disorders (aOR 4.44, 95% CI 1.02-19.32), and arrythmias (4.89, 95% CI 1.44-16.64). Two antipsychotics that are considered weight neutral, ziprasidone and aripiprazole, were associated with cardiometabolic comorbidities. This study suggests that research is warranted to study the association between antipsychotics, medical comorbidity, and psychotic symptom burden.
患有精神障碍的患者合并其他疾病的几率更高。在这项横断面研究中，我们调查了佐治亚州亚特兰大市一家城市精神病诊所中患有精神障碍的患者使用抗精神病药物与合并其他疾病之间的关系（n = 860）。将每个抗精神病药物组与同一样本中未使用任何抗精神病药物的患者组进行比较，并针对每种合并症构建逻辑回归模型。齐拉西酮与糖尿病（调整后比值比2.56，95%置信区间1.03 - 6.38）和肥胖症（调整后比值比3.19，95%置信区间1.37 - 7.41）相关。阿立哌唑与肥胖症（调整后比值比2.39，95%置信区间1.27 - 4.51）相关。氯氮平与胃食管反流病（调整后比值比3.59，95%置信区间1.11 - 11.61）、运动障碍（调整后比值比4.44，95%置信区间1.02 - 19.32）和心律失常（调整后比值比4.89，95%置信区间1.44 - 16.64）相关。两种被认为对体重无影响的抗精神病药物，齐拉西酮和阿立哌唑，与心脏代谢合并症相关。这项研究表明，有必要开展研究以探讨抗精神病药物、合并其他疾病和精神症状负担之间的关联。
