title: Metabolic disturbance in first-episode schizophrenia.
abstract: BACKGROUND
  Schizophrenia shortens life, e.g. through suicide and obesity-related diseases such as type 2 diabetes mellitus. It is assumed that medications play a major role, but most of the evidence for this comes from studies poorly controlled for variables such as lifestyle and medication status.
  
  
  OBJECTIVE
  To determine whether schizophrenia is associated (independently of medication) with the development of certain metabolic disturbances and whether these might be explained by stress axis dysfunction.
  
  
  METHODS
  Literature review.
  
  
  RESULTS
  Most studies did not control for confounding factors such as previous usage of medication, lifestyle, age and ethnicity. A few conducted in drug-naïve patients with first-episode schizophrenia appear to indicate that these patients have higher than expected rates of visceral obesity and impaired fasting glucose concentrations, which may be related to a subtle disturbance of the hypothalamic-pituitary-adrenal axis.
  
  
  CONCLUSIONS
  Schizophrenia is independently associated with physical illnesses that have a metabolic signature. Therefore, patients need to have a thorough physical assessment at diagnosis and at regular intervals thereafter. Metabolic disturbances have been found in drug-naïve patients with first-episode illness and may be an inherent part of the illness.
authors.affiliation: Senior Lecturer in Psychiatry, Royal College of Surgeons in Ireland, Dublin. jthakore@rcsi.ie
authors.forename: Jogin H
authors.initials: JH
authors.lastname: Thakore
mesh_terms: D044882:Glucose Metabolism Disorders / Q000209:etiology*; D006801:Humans; D009765:Obesity / Q000209:etiology; D012559:Schizophrenia / Q000150:complications*; D013315:Stress, Psychological / Q000209:etiology