Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-24T04:32:47.921Z Has data issue: false hasContentIssue false
  • English
  • Français

Diabetes, cardiovascular disease, and health care use in people with and without schizophrenia

Published online by Cambridge University Press:  16 April 2020

L.C. Bresee ,
S.R. Majumdar ,
S.B. Patten  and
J.A. Johnson
L.C. Bresee
Affiliation:
School of Public Health, University of Alberta, Edmonton, Alberta, Canada Institute of Health Economics, Edmonton, Alberta, Canada
S.R. Majumdar
Affiliation:
School of Public Health, University of Alberta, Edmonton, Alberta, Canada Institute of Health Economics, Edmonton, Alberta, Canada Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
S.B. Patten
Affiliation:
Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
J.A. Johnson*
Affiliation:
School of Public Health, University of Alberta, Edmonton, Alberta, Canada Institute of Health Economics, Edmonton, Alberta, Canada
*
*Corresponding author. Tel.: +1 780 248 1010; fax: +1 780 492 7455. E-mail address: [email protected] (J.A. Johnson).
Get access

Abstract

Purpose

To compare the prevalence of cardiovascular risk factors (CV-RF) and disease (CV-D) and health care use in people with and without schizophrenia.

Subjects/materials and methods

Data from the Canadian Community Health Survey (CCHS), cycle 3.1, were used. Prevalence of CV-RF, CV-D, and health care use were compared in those with and without schizophrenia using logistic regression analysis. Sampling weights and bootstrap variance estimates were used to account for survey design.

Results

A total of 399 (0.3%) people with schizophrenia were identified and compared to 120,044 (97.7%) people without. Individuals with schizophrenia were significantly more likely to be obese (34.8% vs. 15.6%) and report diabetes (11.9% vs. 5.3%). After accounting for sociodemographic variables, schizophrenia was not independently associated with diabetes (adjusted odds ratio [aOR]: 0.86; 0.49–1.51). Individuals with schizophrenia were more likely to be hospitalized (21.9% vs. 8.0%; aOR: 2.37; 95% CI: 1.51–3.74) but no more likely to visit their physician (86.7% vs. 85.7%; aOR: 1.23; 95% CI: 0.65–2.35).

Discussion/conclusion

Our findings suggest that people with schizophrenia access the primary health care system at least as frequently as someone without schizophrenia, and the opportunity for management of modifiable CV-RF exists in this vulnerable population.

Keywords

SchizophreniaEpidemiologyQuality of careMiscellaneous
Type
Original article
Information
European Psychiatry , Volume 26 , Issue 5 , August 2011 , pp. 327 - 332
Copyright
Copyright © Elsevier Masson SAS 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

1

2-040 Health Research Innovation Facility, University of Alberta, Edmonton, Alberta, Canada T6G 1K4.

2

2F1.24 WMC – 8440 112 Street, University of Alberta, Edmonton, Alberta, Canada T6G 2B7.

3

3330 Hospital Drive NW, University of Calgary, Calgary, Alberta, Canada T2N 4N1.

4

2-040 Health Research Innovation Facility, University of Alberta, Edmonton, Alberta, Canada T6G 1K4.

References

Allison, D.B.Fontaine, K.R.Heo, M., et al.The distribution of body mass index among individuals with and without schizophrenia. J Clin Psychiatry 1999; 60: 215–220CrossRefGoogle ScholarPubMed
Balf, G.Stewart, T.D.Whitehead, R.Baker, R.A.Metabolic adverse events in patients with mental illness treated with antipsychotics: a primary care perspective. Prim Care Companion J Clin Psychiatry 2008; 10: 15–24CrossRefGoogle ScholarPubMed
Baliunas, D.O.Taylor, B.J.Irving, H., et al.Alcohol as a risk factor for type 2 diabetes: a systematic review and meta-analysis. Diabetes Care 2009; 32: 2123–2132CrossRefGoogle ScholarPubMed
Bresee, L.C.Majumdar, S.R.Patten, S.B.Johnson, J.A.Burden of cardiovascular risk factors and disease in people with schizophrenia: a population-based study. Schizophr Res 2010; 117: 75–82CrossRefGoogle Scholar
Bushe, C.Prevalence of diabetes and impaired glucose tolerance in patients with schizophrenia. Br J Psychiatry 2004; 184: S67–S71CrossRefGoogle Scholar
Canadian Council on Social Development: Available at: http://www.ccsd.ca/factsheets/fs_lico05_bt.htm. [Accessed February 24, 2010].Google Scholar
Canadian Psychiatric Association Working Group. Clinical Practice Guidelines: treatment of Schizophrenia. Can J Psychiatry 2005;50(Suppl. 1):1S–56S.Google Scholar
Citrome, L.L.Jaffe, A.B.Relationship of atypical antipsychotics with development of diabetes mellitus. Ann Pharmacother 2003; 37: 1849–1857CrossRefGoogle ScholarPubMed
Cohn, T.Prud’homme, D.Streiner, D.Kameh, H.Remington, G.Characterizing coronary heart disease risk in chronic schizophrenia: high prevalence of the metabolic syndrome. Can J Psychiatry 2004; 49: 753–760CrossRefGoogle ScholarPubMed
Curkendall, S.M.Mo, J.Glasser, D.B.Stang, M.R.Jones, J.K.Cardiovascular disease in patients with schizophrenia in Saskatchewan, Canada. J Clin Psychiatry 2004; 65: 715–720CrossRefGoogle ScholarPubMed
De Hert, M.Dekker, J.M.Wood, D.Kahl, K.G.Holt, R.I.G.Moller, H.J.Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC). Eur Psychiatry 2009; 24: 412–424CrossRefGoogle Scholar
Delgado-Rodriguez, M.Bias, L.J.J Epidemiol Community Health 2004; 58: 635–641CrossRefGoogle Scholar
Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New Engl J Med 2002;346:393–403.CrossRefGoogle Scholar
Dixon, L.Weiden, P.Delahanty, J., et al.Prevalence and correlates of diabetes in national schizophrenia samples. Schizophr Bull 2000; 26: 903–912CrossRefGoogle ScholarPubMed
Druss, B.G.Bradford, D.Rosenheck, R.A.Radford, M.J.Krumholz, H.M.Quality of medical care and excess mortality in older patients with mental disorders. Arch Gen Psychiatry 2001; 58: 565–572CrossRefGoogle ScholarPubMed
Eaker, E.D.Sullivan, L.M.Kelly-Hayes, M.D’Agostino, R.B.Benjamin, E.J.Marital status, marital strain, and risk of coronary heart disease or total mortality: the Framingham Offspring Study. Psychosom Med 2007; 69: 509–513CrossRefGoogle ScholarPubMed
Field, A.E.Coakley, E.H.Must, A., et al.Impact of overweight on the risk of developing chronic diseases during a 10-year period. Arch Intern Med 2001; 161: 1581–1586CrossRefGoogle ScholarPubMed
Gianfrancesco, F.White, R.Wang, R.H.Nasrallah, H.A.Antipsychotic-induced type 2 diabetes: evidence from a large health plan database. J Clin Psychopharmacol 2003; 23: 328–335CrossRefGoogle ScholarPubMed
Goldner, E.M.Hsu, L.Waraich, P.Somers, J.M.Prevalence and incidence studies of schizophrenic disorders: a systematic review of the literature. Can J Psychiatry 2002; 47: 833–843CrossRefGoogle ScholarPubMed
Haupt, D.W.Rosenblatt, L.C.Kim, E.Baker, R.A.Whitehead, R.Newcomer, J.W.Prevalence and predictors of lipid and glucose monitoring in commercially insured patients treated with second-generation antipsychotic agents. Am J Psychiatry 2009; 166: 345–353CrossRefGoogle ScholarPubMed
Health Canada. Canadian Guidelines for Body Weight Classification in Adults. Ottawa, ON: Health Canada; 2003. Publication H49-179/2003E. Available at: http://www.hc-sc.gc.ca/fn-an/alt_formats/hpfb-dgpsa/pdf/nutrition/weight_book-livres_des_poids-eng.pdf. [Accessed February 24, 2010].Google Scholar
Hosmer, D.W.Lemeshow S, Applied Logistic Regression. 2nd ed.Hoboken, NJ: John Wiley & Sons, Inc; 2000.CrossRefGoogle Scholar
Hsu, C.Ried, L.D.Bengtson, M.A.Garman, P.M.McConkey, J.R.Rahnavard, F.Metabolic monitoring in veterans with schizophrenia-related disorders and treated with second-generation antipsychotics: findings from a Veterans Affairs-based population. J Am Pharm Assoc 2008; 48: 393–400CrossRefGoogle ScholarPubMed
Johnson, J.A.Vermeulen, S.U.Epidemiological trends of diabetes in Alberta.. In: Alberta Diabetes Atlas 2007 Edmon, Alberta: Institute of Health Economics; 2007.11–24Google Scholar
Kaplan, G.A.Keil, J.E.Socioeconomic factors and cardiovascular disease: a review of the literature. Circulation 1993; 88: 1973–1998CrossRefGoogle ScholarPubMed
Kisely, S.Smith, M.Lawrence, D.Cox, M.Campbell, L.A.Maaten, S.Inequitable access for mentally ill patients to some medically necessary procedures. CMAJ 2007; 176: 779–784CrossRefGoogle ScholarPubMed
Lambert, B.L.Cunningham, F.E.Miller, D.R.Dalack, G.W.Hur, K.Diabetes risk associated with use of olanzapine, quetiapine, and risperidone in Veterans Health Administration patients with schizophrenia. Am J Epidemiol 2006; 164: 672–681CrossRefGoogle ScholarPubMed
Maddigan, S.L.Feeny, D.H.Majumdar, S.R.Farris, K.B.Johnson, J.A.Health Utilities Index mark 3 demonstrated construct validity in a population-based sample with type 2 diabetes. J Clin Epidemiol 2006; 59: 472–477CrossRefGoogle Scholar
McEvoy, J.P.Meyer, J.M.Goff, D.C., et al.Prevalence of the metabolic syndrome in patients with schizophrenia: baseline results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III. Schizophr Res 2005; 80: 19–32CrossRefGoogle ScholarPubMed
Morrato, E.H.Newcomer, J.W.Allen, R.R.Valuck, R.J.Prevalence of baseline serum glucose and lipid testing in users of second-generation antipsychotic drugs: a retrospective, population-based study of Medicaid claims data. J Clin Psychiatry 2008; 69: 316–322CrossRefGoogle ScholarPubMed
Nasrallah, H.A.Meyer, J.M.Goff, D.C., et al.Low rates of treatment for hypertension, dyslipidemia, and diabetes in schizophrenia: data from the CATIE schizophrenia trial sample at baseline. Schizophr Res 2006; 86: 15–22CrossRefGoogle ScholarPubMed
Osborn, D.P.J.Levy, G.Nazareth, I.Petersen, I.Islam, A.King, M.B.Relative risk of cardiovascular and cancer mortality in people with severe mental illness from the United Kingdom's General Practice Research Database. Arch Gen Psychiatry 2007; 64: 242–249CrossRefGoogle Scholar
Statistics Canada. Canadian Community Health Survey (CCHS) cycle 3.1. Available at: http://www.statcan.gc.ca/cgi-bin/imdb/p2SV.pl?Function=getSurvey&SurvId=3226&SurvVer=0&InstaId=15282&InstaVer=3&SDDS=3226&lang=en&db=imdb&adm=8&dis=2. [Accessed February 24, 2010].Google Scholar
Statistics Canada. Canadian Community Health Survey (CCHS) response rates. Available at: http://www.statcan.gc.ca/imdb-bmdi/document/3226_D19_T9_V1_B.pdf. [Accessed February 24, 2010].Google Scholar
Statistics Canada. Canadian Community Health Survey (CCHS) cycle 3.1: Integrated derived variable (DV) and grouped variable specifications. Available at: http://webapps6.ucalgary.ca/∽landru/adc/cchs/2005/derive.pdf. [Accessed May 12, 2010].Google Scholar
Supina, A.L.Patten, S.B.Self-reported diagnoses of schizophrenia and psychotic disorders may be valuable for monitoring and surveillance. Can J Psychiatry 2006; 51: 256–259CrossRefGoogle ScholarPubMed
Voruganti, L.P.Punthakee, Z.Van Lieshout, R.J.MacCrimmon, D.Parker, G.Awad, A.G., et al.Dysglycemia in a community sample of people treated for schizophrenia: the Diabetes in Schizophrenia in Central-south Ontario (DiSCO) study. Schizophr Res 2007; 96: 215–222CrossRefGoogle Scholar
Willi, C.Bodenmann, P.Ghali, W.A.Faris, P.D.Cornuz, J.Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis. JAMA 2007; 298: 2654–2664CrossRefGoogle ScholarPubMed
Yusuf, S.Hawken, S.Ounpuu, S., et al.Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004; 364: 937–952CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.