Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-18T13:09:54.912Z Has data issue: false hasContentIssue false
  • English
  • Français

Management of physical health in patients with schizophrenia: practical recommendations

Published online by Cambridge University Press:  16 April 2020

A. Heald ,
A.L. Montejo ,
H. Millar ,
M. De Hert ,
J. McCrae  and
C.U. Correll
A. Heald*
Affiliation:
Leighton Hospital, Crewe, United-Kingdom
A.L. Montejo
Affiliation:
University Clinical Hospital, Salamanca, Spain
H. Millar
Affiliation:
Carseview Centre, Dundee, Scotland
M. De Hert
Affiliation:
University Psychiatric Centre, Catholic University, Kortenberg, Belgium
J. McCrae
Affiliation:
European Federation of Associations of Families of people with Mental Illness (EUFAMI), Leuven, Belgium
C.U. Correll
Affiliation:
Zucker Hillside Hospital, New York, New York, United-States
*
Correspondence. Tel.: +44 (0)1270 612353. E-mail address: [email protected]
Get access

Abstract

Improved physical health care is a pressing need for patients with schizophrenia. It can be achieved by means of a multidisciplinary team led by the psychiatrist. Key priorities should include: selection of antipsychotic therapy with a low risk of weight gain and metabolic adverse effects; routine assessment, recording and longitudinal tracking of key physical health parameters, ideally by electronic spreadsheets; and intervention to control CVD risk following the same principles as for the general population. A few simple tools to assess and record key physical parameters, combined with lifestyle intervention and pharmacological treatment as indicated, could significantly improve physical outcomes. Effective implementation of strategies to optimise physical health parameters in patients with severe enduring mental illness requires engagement and communication between psychiatrists and primary care in most health settings.

Keywords

Physical HealthSchizophreniaPractical RecommendationsAntipsychotic TherapyCardiovascular DiseaseMultidisciplinary Care
Type
Research Article
Information
European Psychiatry , Volume 25 , Issue S2: Physical health in patients with schizophrenia: current knowledge and practical recommendations , June 2010 , pp. S41 - S45
Copyright
Copyright © 2010 Elsevier Masson SAS

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.)

References

Allison, D.B.Mentore, J.L.Heo, M.Chandler, L.P.Cappelleri, J.C.Infante, M.C., et al.Antipsychotic-induced weight gain: a comprehensive research synthesis. Am J Psychiatry 1999; 156: 1686–1696Google ScholarPubMed
Basson, R.Rees, P.Wang, R.X.Montejo, A.L.Incrocci, L.Sexual Function in Chronic Illness. J Sexual Medicine 2010; 7: 374–388CrossRefGoogle ScholarPubMed
Buckley, P.F.Miller, d.D.Singer, B.Arena, J.Stirewalt, E.M.Clinicians’ recognition of the metabolic adverse effects of antipsychotic medications. Schizophr Res 2005; 79: 281–288CrossRefGoogle ScholarPubMed
Casey, D.E.Carson, W.H.Saha, A.R.Liebeskind, A.Ali, M.W.Jody, D., et al.Switching patients to aripiprazole from other antipsychotic agents: a multicenter randomized study. Psychopharmacology (Berl) 2003; 166: 391–399CrossRefGoogle ScholarPubMed
Citrome, L.Yeomans, D.Do guidelines for severe mental illness promote physical health and well-being? J Psychopharmacol 2005; 19: 102–109CrossRefGoogle ScholarPubMed
Correll, C.U.From receptor pharmacology to improved outcomes: individualizing the selection, dosing and switching of antipsychotics. Eur Psychiatry 2010; 25: S12–21CrossRefGoogle Scholar
Correll, C.U.Frederickson, A.M.Kane, J.M.Manu, P.Does antipsychotic polypharmacy increase the risk for metabolic syndrome? Schizophr Res 2007; 89: 91–100CrossRefGoogle ScholarPubMed
De Hert, M.Dekker, J.M.Wood, D.Kahl, K.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
De Hert, M.van Winkel, R.Silic, A.Van Eyck, D.Peuskens, B.Physical health management in psychiatric settings. Eur Psychiatry 2010; 25: S22–S28CrossRefGoogle ScholarPubMed
Fleischhacker, W.W.Cetkovich-Bakmas, M.De Hert, M.Hennekens, C.H.Lambert, M.Leucht, S., et al.Comorbid somatic illnesses in patients with severe mental disorders: clinical, policy, and research challenges. J Clin Psychiatry 2008; 69: 514–519CrossRefGoogle ScholarPubMed
Gibney, J.Smith, T.P.McKenna, T.J.Clinical relevance of macroprolactin. Clin Endocrinol (Oxf) 2005; 62: 633–643CrossRefGoogle ScholarPubMed
Graham, I.Atar, D.Borch-Johnsen, K.Boysen, G.Burell, G.Cifkova, R., et al.European guidelines on cardiovascular disease prevention in clinical practice: executive summary. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur J Cardiovasc Prev Rehabil 2007; 14(Suppl. 2): E1–E40CrossRefGoogle Scholar
Haddad, P.M.Wieck, A.Antipsychotic-induced hyperprolactinaemia: mechanisms, clinical features and management. Drugs 2004; 64: 2291–2314CrossRefGoogle 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
Heald, A.Physical health in schizophrenia: a challenge for antipsychotic therapy. Eur Psychiatry 2010; 25: S6–S11CrossRefGoogle ScholarPubMed
Hoschl, C.Importance of physical health in patients with schizophrenia. Eur Psychiatry 2010; 25-S1-2CrossRefGoogle Scholar
Kinon, B.J.Kaiser, C.J.Ahmed, S.Rotelli, M.D.Kollack-Walker, S.Association between early and rapid weight gain and change in weight over one year of olanzapine therapy in patients with schizophrenia and related disorders. J Clin Psychopharmacol 2005; 25: 255–258CrossRefGoogle ScholarPubMed
L’Italien, G.J.Casey, D.E.Kan, H.J.Carson, W.H.Marcus, R.N.Comparison of metabolic syndrome incidence among schizophrenia patients treated with aripiprazole versus olanzapine or placebo. J Clin Psychiatry 2007; 68: 1510–1516CrossRefGoogle ScholarPubMed
Maguire, G.A.Prolactin elevation with antipsychotic medications: mechanisms of action and clinical consequences. J Clin Psychiatry 2002; 63(Suppl. 4): 56–62Google ScholarPubMed
Marder, S.R.McQuade, R.D.Stock, E.Kaplita, S.Marcus, R.Safferman, A.Z., et al.Aripiprazole in the treatment of schizophrenia: safety and tolerability in short-term, placebo-controlled trials. Schizophr Res 2003; 61: 123–136CrossRefGoogle ScholarPubMed
Millar, H.The development of a physical health screening clinic. Eur Psychiatry 2010; 25: S29–33CrossRefGoogle ScholarPubMed
Montejo, A.L.The need for routine physical healthcare in schizophrenia. Eur Psychiatry 2010; 25-S3-5CrossRefGoogle Scholar
Montejo, ALMajadas, SRico-Villademoros, FLlorca, GDe La Gándara, JFranco, MMartín-Carrasco, MAguera, LPrieto, N.; for the Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. Frequency of sexual dysfunction in patients with a psychotic disorder receiving antipsychotics. J Sexual Medicine 2010 [Epub ahead of print] PMID: 20214720.CrossRefGoogle Scholar
Montejo, A.L.Rico-Villademoros, F.Psychometric properties of the Psychotropic-Related Sexual Dysfunction Questionnaire (PRSexDQSALSEX) in patients with schizophrenia and other psychotic disorders. J Sex Marital Ther 2008; 34: 227–239CrossRefGoogle Scholar
Nasrallah, H.A.Meyer, J.M.Goff, D.C.McEvoy, J.P.Davis, S.M.Stroup, T.S., 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
Newcomer, J.W.Nasrallah, H.A.Loebel, A.D.The Atypical Antipsychotic Therapy and Metabolic Issues National Survey: practice patterns and knowledge of psychiatrists. J Clin Psychopharmacol 2004; 24(5 Suppl. 1): S1–S6CrossRefGoogle ScholarPubMed
Peveler, R.C.Branford, D.Citrome, L.Fitzgerald, P.Harvey, P.W.Holt, R.I., et al.Antipsychotics and hyperprolactinaemia: clinical recommendations. J Psychopharmacol 2008; 22: 98–103CrossRefGoogle ScholarPubMed
Schiettecatte, J.De Schepper, J.Velkeniers, B.Smitz, J.Van Steirteghem, A.Rapid detection of macroprolactin in the form of prolactinimmunoglobulin G complexes by immunoprecipitation with anti-human IgG-agarose. Clin Chem Lab Med 2001; 39: 1244–1248CrossRefGoogle Scholar
Straker, D.Correll, C.U.Kramer-Ginsberg, E.Abdulhamid, N.Koshy, F.Rubens, E., et al.Cost-effective screening for the metabolic syndrome in patients treated with second-generation antipsychotic medications. Am J Psychiatry 2005; 162: 1217–1221CrossRefGoogle ScholarPubMed
Turrone, P.Kapur, S.Seeman, M.V.Flint, A.J.Elevation of prolactin levels by atypical antipsychotics. Am J Psychiatry 2002; 159: 133–135CrossRefGoogle ScholarPubMed
Weiden, P.J.Simpson, G.M.Potkin, S.G.O'Sullivan, R.L.Effectiveness of switching to ziprasidone for stable but symptomatic outpatients with schizophrenia. J Clin Psychiatry 2003; 64: 580–588CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.