title: Pathophysiological mechanisms of increased cardiometabolic risk in people with schizophrenia and other severe mental illnesses.
abstract: Patients with schizophrenia have increased mortality and morbidity compared with the general population. These patients have a 20-year shorter lifespan than peers without schizophrenia, mainly due to premature cardiovascular disease, suicide, and cancer. Patients with severe mental illness are at increased risk for cardiovascular disease related to increased incidence of diabetes, hypertension, smoking, poor diet, obesity, dyslipidaemia, metabolic syndrome, low physical activity, and side-effects of antipsychotic drugs. Some second-generation antipsychotics (eg, clozapine, olanzapine, quetiapine, and risperidone) are associated with an increased risk of weight gain and obesity, impaired glucose tolerance and new-onset diabetes, hyperlipidaemia, and cardiovascular disease. The mechanisms by which schizophrenia and patients with severe mental illness are susceptible to cardiometabolic disorders are complex and include lifestyle risks and direct and indirect effects of antipsychotic drugs. An understanding of these risks might lead to effective interventions for prevention and treatment of cardiometabolic disorders in schizophrenia and severe mental illness.
authors.affiliation: Schizophrenia Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry and Epidemiology, Harvard Medical School, Harvard School of Public Health, Boston, MA, USA; Department of Medicine, Harvard Medical School, Harvard School of Public Health, Boston, MA, USA. Electronic address: dchenderson@mgh.harvard.edu.
authors.forename: David C
authors.initials: DC
authors.lastname: Henderson
authors.affiliation: Schizophrenia Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Brenda
authors.initials: B
authors.lastname: Vincenzi
authors.affiliation: Schizophrenia Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Nicolas V
authors.initials: NV
authors.lastname: Andrea
authors.affiliation: Schizophrenia Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Ulloa
authors.affiliation: Endocrine Unit, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Copeland
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology*; D006801:Humans; D001523:Mental Disorders / Q000503:physiopathology*; D012307:Risk Factors; D012559:Schizophrenia / Q000503:physiopathology*; D012720:Severity of Illness Index