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Forum Discussion: Addressing Cardiovascular Risk Factors in Schizophrenia Patients

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In our Forum discussion “journal club” series, the editors of Schizophrenia Bulletin or Schizophrenia Research provide access to the full text of a recent article. A short introduction by a journal editor gets us started, and then it's up to our readers to share their ideas and insights, questions, and reactions to the selected paper. So read on…

Nasrallah HA, Meyer JM, Goff DC, McEvoy JP, Davis SM, Stroup TS, Lieberman JA. Low rates of treatment for hypertension, dyslipidemia and diabetes in schizophrenia: data from the CATIE schizophrenia trial sample at baseline. Schizophr Res. 2006 Sep;86(1-3):15-22. Epub 2006 Aug 1.

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by Henry Nasrallah, University of Cincinnati College of Medicine, and Editor, Schizophrenia Research

A number of recent studies have highlighted the fact that people with schizophrenia have higher rates of cardiovascular and metabolic disorders (see SRF related news story), compounded by the fact that these patients are a medically underserved population in general. Recent studies report that persons with schizophrenia lose a mean of 32 years of life! (See Miller et al., 2006). This may be due to a dangerous combination of high rate of medical morbidity coupled with a high rate of non-treatment.

Using baseline data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) (see SRF related news story), we now report that although the non-treatment rate for diabetes in schizophrenia patients (30.2 percent) is comparable to that of the general population, non-treatment rates of hypertension (62.4 percent) and dyslipidemia (88.0 percent) are significantly higher.

One obvious barrier to remedying these disparities is the inadequacy of most health and social care systems to anticipate, identify, and treat metabolic dysfunction in psychiatric patients. Another is the failure of psychiatrists to intervene in these areas, as revealed by several recent studies (Newcomer et al., 2004; Buckley et al., 2005).

We invite you to offer novel, practical, and achievable solutions to these problems.