title: Abnormal glycemic homeostasis at the onset of serious mental illnesses: A common pathway.
abstract: OBJECTIVE
  Patients with serious mental illnesses exhibit a reduced lifespan compared with the general population, a finding that can not solely rely on high suicide risk, low access to medical care and unhealthy lifestyle. The main causes of death are medical related pathologies such as type 2 diabetes mellitus and cardiovascular disease; however pharmacological treatment might play a role.
  
  
  METHODS
  We compared a two hour glucose load in naïve patients at the onset of a serious mental illness (N=102) (84 patients with a first episode of schizophrenia and related disorders, 6 with a first episode of bipolar I disorder and 12 with a first episode of major depression disorder) with another psychiatric diagnose, adjustment disorder (N=17) and matched controls (N=98).
  
  
  RESULTS
  Young patients with serious mental illness showed an increased two hour glucose load compared with adjustment disorder and the control group. Mean two hour glucose values [±standard deviation] were: for schizophrenia and related disorders 106.51mg/dL [±32.0], for bipolar disorder 118.33mg/dL [±34.3], for major depressive disorder 107.42mg/dL [±34.5], for adjustment disorder 79.06mg/dL[±24.4] and for the control group 82.11mg/dL [±23.3] (p<0.001).
  
  
  CONCLUSIONS
  Our results reflect an abnormal metabolic pathway at the onset of the disease before any pharmacological treatment or other confounding factors might have taken place. Our results suggest a similar glycemic pathway in serious mental illnesses and the subsequent need of primary and secondary prevention strategies.
authors.affiliation: Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic, Barcelona, Spain; Institute of Biomedical Research Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain. Electronic address: cgarcia3@clinic.ub.es.
authors.forename: Clemente
authors.initials: C
authors.lastname: Garcia-Rizo
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Nevada School of Medicine, Reno, NV, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Kirkpatrick
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, CB2 0QQ Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Huntingdon PE29 3RJ, UK.
authors.forename: Emilio
authors.initials: E
authors.lastname: Fernandez-Egea
authors.affiliation: Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic, Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Oliveira
authors.affiliation: Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic, Barcelona, Spain; Institute of Biomedical Research Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry and Clinical Psychobiology, University of Barcelona Barcelona, Spain.
authors.forename: Miquel
authors.initials: M
authors.lastname: Bernardo
mesh_terms: D000275:Adjustment Disorders / Q000097:blood*; D000328:Adult; D001714:Bipolar Disorder / Q000097:blood*; D001786:Blood Glucose; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000097:blood*; D005260:Female; D005951:Glucose Tolerance Test; D006706:Homeostasis; D006801:Humans; D008297:Male; D012559:Schizophrenia / Q000097:blood*; D055815:Young Adult
chemical_list: D001786:Blood Glucose
keywords: Bipolar disorder; Major depressive disorder; Mortality; Schizophrenia; Thrifty psychiatric phenotype; Type 2 diabetes mellitus