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Metabolic issues in patients with severe mental illness
Leslie Citrome1, Lawrence Blonde, Cristina Damatarca
1New York University School of Medicine, Department of Psychiatry, and the Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA. citrome@nki.rfmh.org
Southern Medical Journal
|August 20, 2005
Summary
Patients with severe mental illness on antipsychotics face higher risks of weight gain and type 2 diabetes. Monitoring and collaborative care are crucial for managing these metabolic side effects.
Area of Science:
- Psychiatry
- Endocrinology
- Public Health
Background:
- Severe mental illness (SMI) is associated with significant health challenges.
- Antipsychotic medications, while crucial for SMI treatment, can lead to adverse metabolic effects.
- Weight gain and diabetes mellitus are prevalent comorbidities in this population.
Purpose of the Study:
- To review the epidemiology of weight gain and diabetes mellitus in the general population and specifically in patients with SMI.
- To identify predictors of weight gain associated with antipsychotic use.
- To discuss management strategies, including monitoring and collaborative care.
Main Methods:
- Literature review of epidemiological data on weight gain and diabetes.
- Enumeration of predictors for antipsychotic-induced weight gain.
- Analysis of risks associated with type 2 diabetes and dyslipidemias.
- Review of consensus panel recommendations and treatment guidelines.
Main Results:
- Patients with SMI, particularly those on antipsychotics, exhibit increased risk for weight gain and type 2 diabetes.
- Body mass index (BMI) is a key indicator, with specific predictors identified for medication-induced weight gain.
- Metabolic syndrome, including dyslipidemias, is a significant concern.
Conclusions:
- Close monitoring for metabolic changes is essential in patients with SMI on antipsychotics.
- Balancing the risks and benefits of antipsychotic medication is critical when metabolic disorders develop.
- Collaborative treatment involving psychiatrists, endocrinologists, and primary care physicians is recommended.
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