title: [Comorbidity of metabolic syndrome, diabetes and schizophrenia: theoretical and practical considerations].
abstract: Schizophrenia is a psychiatric disorder characterized by heterogeneous symptoms, affecting 0.8-1% of the population worldwide. It usually begins in early adulthood and demonstrates a chronic course. In recent years research interest has turned to the increased burden of somatic illness in schizophrenia, with special emphasis on metabolic syndrome and diabetes. In this article I review the theoretical and practical aspects of the comorbidity of schizophrenia with metabolic syndrome and diabetes mellitus. Epidemiological studies demonstrate the occurrence of metabolic syndrome between 22% and 66%, while the prevalence of diabetes is at least threefold compared to the non-psychiatric population in all age groups. Etiologically it is not clear to what extent these alterations are caused by direct genetic and biological effects in contrast to environmental factors. Among the latter the role of atypical antipsychotics should be emphasized. Clinical management of prediabetic conditions and diabetes in schizophrenia warrants the close cooperation of professionals working in the areas of psychiatry and diabetology. This cooperation should include close metabolic monitoring, lifestyle and dietary training, moreover careful modification and in some cases switching of antipsychotic medication. Persisting metabolic symptoms or diabetes require treatment with oral antidiabetics, fibrates, and statins.
authors.affiliation: Semmelweis Egyetem, Általános Orvostudományi Kar Pszichiátriai és Pszichoterápiás Klinika Budapest Balassa u. 6. 1083. rethelyi@psych.sote.hu
authors.forename: János
authors.initials: J
authors.lastname: Réthelyi
authors.forename: Anna-Dalal
authors.initials: AD
authors.lastname: Sawalhe
mesh_terms: D017668:Age of Onset; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D002908:Chronic Disease; D015897:Comorbidity; D048909:Diabetes Complications / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D005247:Feeding Behavior; D058607:Fibric Acids / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D033183:Interdisciplinary Communication; D008055:Lipids / Q000097:blood; D024821:Metabolic Syndrome / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D040242:Risk Reduction Behavior; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D015430:Weight Gain / Q000187:drug effects
chemical_list: D014150:Antipsychotic Agents; D001786:Blood Glucose; D058607:Fibric Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D008055:Lipids