The DOI matches its Crossref record; 605 of the 605 references it cites were found in a registry or an index; 3 of the 259 sources its claims cite were checked for support.
Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care
Open accessAbstract
The lifespan of people with severe mental illness (SMI) is shorter compared to the general population. This excess mortality is mainly due to physical illness. We report prevalence rates of different physical illnesses as well as important individual lifestyle choices, side effects of psychotropic treatment and disparities in health care access, utilization and provision that contribute to these poor physical health outcomes. We searched MEDLINE (1966 - August 2010) combining the MeSH terms of schizophrenia, bipolar disorder and major depressive disorder with the different MeSH terms of general physical disease categories to select pertinent reviews and additional relevant studies through cross-referencing to identify prevalence figures and factors contributing to the excess morbidity and mortality rates. Nutritional and metabolic diseases, cardiovascular diseases, viral diseases, respiratory tract diseases, musculoskeletal diseases, sexual dysfunction, pregnancy complications, stomatognathic diseases, and possibly obesity-related cancers are, compared to the general population, more prevalent among people with SMI. It seems that lifestyle as well as treatment specific factors account for much of the increased risk for most of these physical diseases. Moreover, there is sufficient evidence that people with SMI are less likely to receive standard levels of care for most of these diseases. Lifestyle factors, relatively easy to measure, are barely considered for screening; baseline testing of numerous important physical parameters is insufficiently performed. Besides modifiable lifestyle factors and side effects of psychotropic medications, access to and quality of health care remains to be improved for individuals with SMI.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
People with severe mental illness (SMI) have substantially elevated physical morbidity and mortality, with excess mortality two to three times that of the general population and a 13–30 year shortened life expectancy. This selective review reports higher prevalence of obesity, metabolic syndrome, diabetes, cardiovascular disease, viral infections, respiratory disease, osteoporosis, sexual dysfunction, pregnancy complications, and oral disease in SMI, alongside medication effects and health care disparities.
Key findings
- Excess mortality in SMI is two or three times as high as in the general population, translating to a 13–30 year shortened life expectancy; about 60% of this excess mortality is due to physical illness.
- Obesity is more common in SMI: people with schizophrenia have a 2.8–3.5 increased likelihood of being obese, with reported obesity rates of 42–60%; those with major depression or bipolar disorder have a 1.2–1.5 increased likelihood.
- Metabolic syndrome is highly prevalent in treated schizophrenia, with estimates between 19.4% and 68%; rates in bipolar disorder and schizoaffective disorder are reported as 22–30% and 42%, respectively. Diabetes prevalence is 2–3 fold higher in schizophrenia, bipolar disorder, and schizoaffective disorder, and 1.2–2.6 times higher with depression or depressive symptoms.
- Health care disparities are marked: baseline metabolic testing rates for patients starting novel antipsychotics vary between 8% and less than 30%, with follow-up assessments in only 8.8%; in CATIE, non-treatment rate for diabetes was 45.3%, and up to 88% of schizophrenia patients had untreated dyslipidemia and up to 62% untreated hypertension.
Methods
- Selective, rather than systematic, review of clinical data on physical health problems in people with SMI.
- Searched MEDLINE (1966–August 2010) combining MeSH terms for schizophrenia, bipolar disorder, and major depressive disorder with MeSH terms for major general physical disease categories; included pertinent reviews and cross-referenced additional relevant studies, sometimes using specific physical illnesses as search terms.
- Aimed to identify prevalence figures and factors contributing to excess morbidity and mortality, including lifestyle, psychotropic medication effects, and disparities in health care access, utilization, and provision.
Limitations
- Stated: the review is selective rather than systematic and did not include all physical diseases.
- Stated: there is a paucity of information and a lack of large, well-designed, prospective comparative studies during pregnancy; data on antidepressant-associated diabetes risk are sparse; cancer findings in SMI are conflicting.
- Evident: prevalence estimates vary widely by metabolic syndrome criteria, country or region, gender, ethnicity, age group, and antipsychotic treatment, limiting any single summary figure.
Model-written summary. Check it against the paper before relying on it.
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Verification
Claims the paper makes
183 Not checked yet · 21 No basis given · 18 Own interpretation · 1 Partly supported · 1 Own method · 1 Own result · accuracy not yet measured
None of the sources cited for this claim have been checked yet.
In the paper
“people with schizophrenia exhibit a higher MetS prevalence than their peers in the general population across the world”
§ WPA EDUCATIONAL MODULE > MetS in SMI patients
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“most children starting treatment with novel AP do not receive recommended glucose and lipid screening”
§ WPA EDUCATIONAL MODULE > Disparities in health care
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“The MetS is highly prevalent among treated patients with schizophrenia”
§ WPA EDUCATIONAL MODULE > MetS in SMI patients
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“there is sufficient evidence that people with SMI are less likely to receive standard levels of care for most of these diseases”
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“In patients with SMI, as in the general population, obesity is associated with lifestyle factors (e.g., lack of exercise, poor diet), but also with illness-related (negative, disorganized and depressive symptoms) and treatment-related factors, including weight liability of certain psychotropic agents”
§ WPA EDUCATIONAL MODULE > Obesity in SMI patients
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Even after FDA (Food and Drug Administration) and ADA (American Diabetes Association)/APA (American Psychiatric Association) recommendations for novel AP, the frequency of baseline glucose and lipid testing showed little change”
§ WPA EDUCATIONAL MODULE > Disparities in health care
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“It seems that lifestyle as well as treatment specific factors account for much of the increased risk for most of these physical diseases”
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Lifestyle factors, relatively easy to measure, are barely considered for screening”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“The risk of obesity in persons with SMI, however, varies by diagnosis”
§ WPA EDUCATIONAL MODULE > Obesity in SMI patients
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“The proportion of SMI patients not receiving tests for assessing metabolic risk factors, even for factors relatively simple and easy to measure, such as obesity and blood pressure, is high”
§ WPA EDUCATIONAL MODULE > Disparities in health care
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Probably not a substantial claim. 79
- It may state two separate claims as one. 75
- The quote only partly states this claim. 2
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Although there are relatively few systematic investigations concerning sexual disorders in schizophrenia (514), sexual dysfunction in schizophrenia is, compared to normal controls, estimated to be more frequent (515-519) and to affect 30-80% of women and 45-80% of men (512,515, 520-523).”
§ WPA EDUCATIONAL MODULE > Sexual dysfunction in SMI patients
What the sources say
- Partly supportedcites [515] sourceExperimental — accuracy not yet measured
The Men and Women results report more sexual dysfunction among patients with schizophrenia than among controls. However, the paper reports at least one dysfunction in 82% of men and 96% of women with schizophrenia, not the cited ranges of 45–80% and 30–80%, respectively. Page numbers are unavailable in our copy. (LLM, conf=0.90)
- Partly supportedcites [516] sourceExperimental — accuracy not yet measured
The Results report sexual dysfunction in 45% of patients taking antipsychotics versus 17% of normal controls. The introductory discussion gives estimates of 30–93% for women and 60% for men in neuroleptic-treated groups, not the cited ranges of 30–80% and 45–80% for schizophrenia generally. (LLM, conf=0.88)
- Not checked yetcites [517]
- Not checked yetcites [518] source
- Not checked yetcites [519] source
- Not checked yetcites [512] source
- Not checked yetcites [520] source
- Partly supportedcites [521] sourceExperimental — accuracy not yet measured
The Discussion reports that approximately one in two patients with schizophrenia experiences sexual dysfunction, and the Abstract says prevalence is high in both men and women. Those passages support the general prevalence claim, but the paper does not give the stated 30–80% and 45–80% ranges or compare patients with normal controls. (LLM, conf=0.85)
- Not checked yetcites [522] source
- Not checked yetcites [523] source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Partly supported
None of the sources cited for this claim have been checked yet.
In the paper
“persons with SMI are, compared to the general population, at increased risk for overweight (i.e., BMI =25-29.9,unless Asian: BMI =23-24.9),obesity (i.e., BMI ≥30, unless Asian: BMI ≥25) and abdominal obesity”
§ WPA EDUCATIONAL MODULE > Obesity in SMI patients
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Nutritional and metabolic diseases, cardiovascular diseases, viral diseases, respiratory tract diseases, musculoskeletal diseases, sexual dysfunction, pregnancy complications, stomatognathic diseases, and possibly obesity-related cancers are, compared to the general population, more prevalent among people with SMI”
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“At present, neither psychiatrists nor primary care physicians carefully screen or monitor patients receiving AP medication for metabolic risk factors”
§ WPA EDUCATIONAL MODULE > Disparities in health care
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“baseline testing of numerous important physical parameters is insufficiently performed”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The MetS remains, thus, widely underdiagnosed and undertreated among patients with SMI”
§ WPA EDUCATIONAL MODULE > Disparities in health care
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“people with schizophrenia are not being adequately screened and treated for dyslipidemia (up to 88% untreated) and hypertension (up to 62% untreated)”
§ WPA EDUCATIONAL MODULE > Disparities in health care
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“it is unclear whether or not specific AD themselves may increase the risk of DM”
§ WPA EDUCATIONAL MODULE > DM and psychotropic medications
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“People with SMI have significantly higher rates of several of the modifiable risk factors compared with controls.They are more likely to be overweight or obese, to have DM, hypertension, or dyslipidemia and to smoke”
§ WPA EDUCATIONAL MODULE > CVD in SMI patients
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“SMI patients have the highest CVD mortality but the least chance of receiving many specialized interventions or circulatory medications”
§ WPA EDUCATIONAL MODULE > Disparities in health care
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Patients with SMI are at increased risk for a variety of chronic viral infections, of which the most serious are the diseases associated with human immunodeficiency virus (HIV) and hepatitis C virus”
§ WPA EDUCATIONAL MODULE > Viral diseases
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Despite clear guidance and a high prevalence of undiagnosed DM, screening rates for metabolic abnormalities in people with SMI remain low, which may lead to prolonged periods of poor glycaemic control”
§ WPA EDUCATIONAL MODULE > Disparities in health care
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In the only study to date in first-episode patients, DM development was promoted in patients with schizophrenia by initial treatment with olanzapine (hazard ratio, HR=1.41) and mid-potency conventional AP (HR=1.60),as well as by current treatment with low-potency conventional AP (odds ratio, OR=1.52), olanzapine (OR= 1.44) and clozapine (OR=1.67)”
§ WPA EDUCATIONAL MODULE > DM and psychotropic medications
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Weight gain is greatest with clozapine and olanzapine (107,108), while quetiapine and risperidone have an intermediate risk.Aripiprazole, asenapine, amisulpride and ziprasidone have little effect on weight”
§ WPA EDUCATIONAL MODULE > Obesity and psychotropics
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“A recent large-scale pharmacoepidemiologic study (including 345,937 patients who purchased antipsychotics and 1,426,488 unexposed individuals) found low to moderate, but significantly increased rates of incident DM compared with the general population for clozapine (RR=1.45),olanzapine (RR=1.29)and risperidone (RR=1.23)”
§ WPA EDUCATIONAL MODULE > DM and psychotropic medications
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Studies of genetic predictors of weight gain under AP therapy have mainly but not exclusively (131) focused on HTR2C (132-135) and LEPR (135,136) gene polymorphisms”
§ WPA EDUCATIONAL MODULE > Obesity and psychotropics
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“There is growing evidence for similar effects in patients with bipolar disorder”
§ WPA EDUCATIONAL MODULE > Obesity and psychotropics
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Of the atypical AP, specifically olanzapine (231-234) and clozapine (232,234,235) and, to a lesser extent, quetiapine (236) and risperidone (237), are associated with an increased risk of DM (80) in people who have schizophrenia or bipolar disorder”
§ WPA EDUCATIONAL MODULE > DM and psychotropic medications
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The high interindividual variability in medication-induced weight gain suggests that genetic factors influence the risk to gain weight”
§ WPA EDUCATIONAL MODULE > Obesity and psychotropics
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Weight gain during acute and maintenance treatment of patients with schizophrenia is a well established side effect of antipsychotics (AP), affecting between 15 and 72% of patients”
§ WPA EDUCATIONAL MODULE > Obesity and psychotropics
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The reason for the increased risk of DM in SMI patients is multifactorial and includes genetic and lifestyle factors as well as disease and treatment specific effects”
§ WPA EDUCATIONAL MODULE > DM in SMI patients
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Aripiprazole, amisulpride and quetiapine did not have a significantly increased rate”
§ WPA EDUCATIONAL MODULE > DM and psychotropic medications
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Equally, antidepressants (AD) such as paroxetine (116), and mood stabilizers, such as lithium and valproate (117-119), have been associated with weight gain”
§ WPA EDUCATIONAL MODULE > Obesity and psychotropics
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Atypical AP seem to have a stronger diabetogenic risk than conventional AP (96,228,229), the risk being 1.3 fold higher in people with schizophrenia taking atypical AP compared with those receiving conventional AP”
§ WPA EDUCATIONAL MODULE > DM and psychotropic medications
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“It seems that the somatic well being of people with a (severe) mental illness has been neglected for decades (15), and still is today”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“there is agreement that the major characteristics of the syndrome include central obesity, hypertension, dyslipidemia, glucose intolerance or insulin resistance”
§ WPA EDUCATIONAL MODULE > Obesity and psychotropics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“There is also evidence supporting the hypothesis that the MetS or components of the MetS may be important etiologic factors for certain cancers (e.g., colon cancer)”
§ WPA EDUCATIONAL MODULE > Obesity and psychotropics
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“There is a hierarchy for risk of weight gain with AP that has been confirmed in different studies and meta-analyses”
§ WPA EDUCATIONAL MODULE > Obesity and psychotropics
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“One large study found that the tenyear coronary heart disease risk was significantly elevated in male (9.4% vs. 7.0%) and female (6.3% vs. 4.2%) patients who have schizophrenia compared to controls (p=0.0001)”
§ WPA EDUCATIONAL MODULE > Coronary heart disease in SMI patients
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“The incidence of DKA is nearly (266) or more (267) than 10-fold greater in those with schizophrenia compared to the general population”
§ WPA EDUCATIONAL MODULE > diabetic ketoacidosis
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“The high frequency of substance abuse, sexual risk behaviors (e.g., sex without a condom, trading sex for money and drugs), and a reduced knowledge about HIV-related issues contribute to this high HIV prevalence (364,371-376).”
§ WPA EDUCATIONAL MODULE > HIV positivity
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The mortality of reported cases of DKA varies between 15.4% and 48% (233,235-237), which is up to ten times higher than the 4% rate in the general population”
§ WPA EDUCATIONAL MODULE > diabetic ketoacidosis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In patients with AP monotherapy, a similar dose-related increased risk of sudden cardiac death was found for both conventional and atypical AP, with adjusted RRs of 1.31 vs. 1.59 (low dose, chlorpromazine equivalents <100mg), 2.01 vs. 2.13 (moderate dose, chlorpromazine equivalents 100-299mg) and 2.42 vs. 2.86 (high dose, chlorpromazine equivalents ≥300mg), respectively”
§ WPA EDUCATIONAL MODULE > Sudden cardiac death and psychotropics
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The prevalence of CVD in people with schizophrenia and bipolar disorder is approximately 2-to 3-fold increased, particularly in younger individuals”
§ WPA EDUCATIONAL MODULE > CVD in SMI patients
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“the largest randomized study to date (n=18,154) did not find a statistically significant difference in the risk of sudden cardiac death between ziprasidone and olanzapine treated patients with schizophrenia”
§ WPA EDUCATIONAL MODULE > Sudden cardiac death and psychotropics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Cases of DKA have been reported with the atypical AP clozapine (235,268), olanzapine (233,269), quetiapine (236), risperidone (237), aripiprazole (270-272) and ziprasidone (242)”
§ WPA EDUCATIONAL MODULE > diabetic ketoacidosis
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The prevalence of HIV positivity in people with SMI is generally higher than in the general population, but varies substantially (1.3-23.9%)(347-370).”
§ WPA EDUCATIONAL MODULE > HIV positivity
What the sources say
- Not checked yetcites 347-370
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Current aripiprazole treatment reduced DM risk (OR= 0.51)”
§ WPA EDUCATIONAL MODULE > DM and psychotropic medications
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Most AP and some AD may be associated with QTc prolongation”
§ WPA EDUCATIONAL MODULE > Sudden cardiac death and psychotropics
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Within the class of conventional AP, cases of DKA have been reported with chlorpromazine (274,275), but no such cases have been reported for other conventional AP”
§ WPA EDUCATIONAL MODULE > diabetic ketoacidosis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“certain mood stabilizers, especially valproate, have been associated with an elevated risk for the development of insulin resistance (252,253), conferring a risk for DM, which is possibly related to weight gain (254), and/or fatty liver infiltration (255), but also to valproate itself (256)”
§ WPA EDUCATIONAL MODULE > DM and psychotropic medications
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“This is a selective, rather than a systematic review of clinical data on physical health problems in people with SMI, as we did not include all physical diseases”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“There are no reported cases of lithium-induced torsade de pointes”
§ WPA EDUCATIONAL MODULE > Sudden cardiac death and psychotropics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Overall, SSRIs appear safe in cardiac populations, with few cardiac side effects”
§ WPA EDUCATIONAL MODULE > CVD and psychotropics
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“However, studies investigating HIV testing rates among individuals with a SMI indicate that fewer than half of these patients (percentages ranging from 17% to 47%) have been tested in the past year (378-394).”
§ WPA EDUCATIONAL MODULE > HIV positivity
What the sources say
- Not checked yetcites [378] source
- Not checked yetcites [379] source
- Not checked yetcites [380] source
- Not checked yetcites [381] source
- Not checked yetcites [382] source
- Not checked yetcites [383] source
- Not checked yetcites [384] source
- Not checked yetcites [385] source
- Not checked yetcites [386] source
- Not checked yetcites [387] source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“There is a consensus that QTc values >500 msec, or an absolute increase of 60 msec compared with drug-free baseline, puts a patient at significant risk of torsade de pointes, ventricular fibrillation and sudden cardiac death”
§ WPA EDUCATIONAL MODULE > Sudden cardiac death and psychotropics
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Obesity, DM, CVD as well as depressive symptoms are recognized as risk factors for cerebrovascular accident”
§ WPA EDUCATIONAL MODULE > Cerebrovascular disease in SMI patients
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“AP associated with a greater risk of QTc prolongation include pimozide, thioridazine and mesoridazine among the conventional AP (94,335,336) and sertindole and ziprasidone among the atypical AP”
§ WPA EDUCATIONAL MODULE > Sudden cardiac death and psychotropics
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“One study (n=76,799), examining the impact of mental illness on DM management, found the unadjusted OR to be 1.24 (1.22-1.27)for no hemoglobin A(1c) testing, 1.25 (1.23-1.28)for no low-density lipoprotein cholesterol testing, 1.05 (1.03-1.07)for no eye examination, 1.32 (1.30-1.35)for poor glycemic control, and 1.17 (1.15-1.20)for poor lipaemic control”
§ WPA EDUCATIONAL MODULE > Disparities in health care
plaincorrelationaln = 76,799- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These large randomized studies, which focused on a low incidence serious side effect, suffer from the problem that they did not enrich samples for cardiac risk, so that they lack power and, possibly, generalizability”
§ WPA EDUCATIONAL MODULE > Sudden cardiac death and psychotropics
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Patients with schizophrenia have been reported to be three times as likely to experience sudden cardiac death as individuals from the general population”
§ WPA EDUCATIONAL MODULE > Sudden cardiac death and psychotropics
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Tricyclic AD commonly increase heart rate by over 10%, induce orthostatic hypotension, slow cardiac conduction, and increase the risk of arrhythmias”
§ WPA EDUCATIONAL MODULE > CVD and psychotropics
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Although SSRIs have been associated with QTc prolongation, no cases of torsade de pointes have been reported with the use of these agents”
§ WPA EDUCATIONAL MODULE > Sudden cardiac death and psychotropics
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“another large randomized study (n=9,858) observed no significant differences between sertindole and risperidone recipients in cardiac events, including arrhythmias, requiring hospitalization”
§ WPA EDUCATIONAL MODULE > Sudden cardiac death and psychotropics
plainn = 9,858- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“An analysis of the FDA's DM-related adverse events database (ranging from new-onset hyperglycemia to life-threatening ketoacidosis), found the following adjusted reporting ratios for DM relative to all drugs and events: olanzapine 9.6 (9.2-10.0);risperidone 3.8 (3.5-4.1);quetiapine 3.5 (3.2-3.9);clozapine 3.1 (2.9-3.3);ziprasidone 2.4 (2.0-2.9);aripiprazole 2.4 (1.9-2.9);haloperidol 2.0 (1.7-2.3)”
§ WPA EDUCATIONAL MODULE > DM and psychotropic medications
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“in general, lithium can be safely used in cardiac patients”
§ WPA EDUCATIONAL MODULE > CVD and psychotropics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“higher incidence rates for clozapine and olanzapine can be due to reporting and detection biases”
§ WPA EDUCATIONAL MODULE > diabetic ketoacidosis
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The aetiology of this excess CVD is multifactorial and likely includes genetic and lifestyle factors as well as disease specific and treatment effects”
§ WPA EDUCATIONAL MODULE > CVD in SMI patients
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“a systematic review of 22 prospective, randomized, controlled trials found no difference in the incidence of glycaemic abnormalities between placebo cohorts and AP medication cohorts, as well as no significant difference between any of the AP medications studied in terms of their association with glycaemic abnormalities”
§ WPA EDUCATIONAL MODULE > DM and psychotropic medications
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The largest study to date found prevalence rates of hepatitis B virus (23.4%) and hepatitis C virus (19.6%) in SMI patients to be approximately 5 and 11 times the overall estimated population rates for these infections.”
§ WPA EDUCATIONAL MODULE > Hepatitis
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Since many patients with SMI are exposed to atypical AP, which have been associated with metabolic abnormalities, and since patients infected with HIV and on highly active antiretroviral therapy may also develop metabolic abnormalities, this group of patients is at particularly high risk for developing MetS and ultimately CVD (395).”
§ WPA EDUCATIONAL MODULE > HIV positivity
What the sources say
- Not checked yetcites [395] source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A recent study showed that the assignment of people with SMI to the “STIRR” (Screening, Testing, Immunization, Risk reduction counseling, medical treatment Referral) intervention had high levels (over 80%) of participation and acceptance of core services (testing for hepatitis C, immunization against hepatitis, knowledge about hepatitis) (407).”
§ WPA EDUCATIONAL MODULE > Hepatitis
What the sources say
- Not checked yetcites [407] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Studies consistently show a higher incidence of tuberculosis among patients with schizophrenia compared with the general population (422-426).”
§ WPA EDUCATIONAL MODULE > Tuberculosis
What the sources say
- Not checked yetcites [422]
- Not checked yetcites [423] source
- Not checked yetcites [424]
- Not checked yetcites [425]
- Not checked yetcites [426]
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Filik et al (414) found that people with SMI have a higher prevalence of angina and respiratory symptoms and impaired lung function when compared with the general population.”
§ WPA EDUCATIONAL MODULE > Pneumonia
What the sources say
- Not checked yetcites [414] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In a study of 200 outpatients in the US, 15% of those with schizophrenia and 25% of those with bipolar disorder had chronic bronchitis, and 16% of people with schizophrenia and 19% of people with bipolar disorder had asthma.”
§ WPA EDUCATIONAL MODULE > Chronic obstructive pulmonary disease
What the sources say
- Not checked yetcites [430] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Although the association remains unclear, a higher incidence of chronic obstructive pulmonary disease in the past two decades has been associated with the side effects of phenothiazine conventional AP (434).”
§ WPA EDUCATIONAL MODULE > Chronic obstructive pulmonary disease
What the sources say
- Not checked yetcites [434]
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“On the other hand, other studies found an increased (9,21,28,(449)(450)(451) or no different (292,419,452,453) overall risk of cancer in patients with schizophrenia compared to the general population.”
§ WPA EDUCATIONAL MODULE > Cancer risk in SMI patients
What the sources say
- Not checked yetcites [9] source
- Not checked yetcites [21] source
- Not checked yetcites [28] source
- Not checked yetcites [449] source
- Not checked yetcites [450] source
- Not checked yetcites [451] source
- Not checked yetcites [292] source
- Not checked yetcites [419] source
- Not checked yetcites [452] source
- Not checked yetcites [453] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This discrep-ancy of results may be a result of various confounding factors that could artificially lower the rates of diagnosed and reported cancer in SMI populations.”
§ WPA EDUCATIONAL MODULE > Cancer risk in SMI patients
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Nevertheless, a problem with most of the existing data base analyses is that etiologically disparate cancer types were lumped together.”
§ WPA EDUCATIONAL MODULE > Cancer risk in SMI patients
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“Furthermore, patients with SMI have a shorter life expectancy, so they may die from cardiovascular reasons before reaching the expected age of death from cancer (30).”
§ WPA EDUCATIONAL MODULE > Cancer risk in SMI patients
What the sources say
- Not checked yetcites [30] source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“An important analysis of cause-specific excess deaths associated with underweight, overweight, and obesity in the general population found that obesity was associated with an increased mortality from cancers considered obesity-related but not with mortality from other cancers (463).”
§ WPA EDUCATIONAL MODULE > Cancer risk in SMI patients
What the sources say
- Not checked yetcites [463] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In the population of bipolar spectrum disorders, deaths from cancer are not higher (8,288,416,417,454-456) or only slightly elevated (417,418,456) compared with the general population, despite the higher number of risk factors for cancer (such as obesity) in this population.”
§ WPA EDUCATIONAL MODULE > Cancer risk in SMI patients
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“On the one hand, this is because of the disease itself, on the other hand, because of risk factors related to their lifestyle (e.g., smoking, reduced physical activity, alcohol abuse, vitamin D and calcium deficiency, polydipsia) (470-476).”
§ WPA EDUCATIONAL MODULE > Osteoporosis in SMI patients
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The majority of the studies in which the risk of breast cancer has been investigated in patients treated with conventional AP (465-468) did not uncover an increased risk of breast cancer, an exception being the cohort study by Wang et al (469).”
§ WPA EDUCATIONAL MODULE > Cancer risk and psychotropics
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“The current study database on AP and breast cancer risk is very limited (464).”
§ WPA EDUCATIONAL MODULE > Cancer risk and psychotropics
What the sources say
- Not checked yetcites [464] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Two recent meta-analyses confirmed that depression is associated with low BMD and should be considered as an important risk factor for osteoporosis, although this increased risk may be mediated by AD (484,485).”
§ WPA EDUCATIONAL MODULE > Osteoporosis in SMI patients
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Some studies (490-493) found a relationship between the use of prolactin-raising medication and low BMD in patients with chronic schizophrenia, while others (474,489,494-498) failed to find a relationship between prolactin, AP and osteoporosis.”
§ WPA EDUCATIONAL MODULE > Osteoporosis and psychotropics
What the sources say
- Not checked yetcites [490] source
- Not checked yetcites [491] source
- Not checked yetcites [492] source
- Not checked yetcites [493] source
- Not checked yetcites [474]
- Not checked yetcites [489] source
- Not checked yetcites [494] source
- Not checked yetcites [495] source
- Not checked yetcites [496] source
- Not checked yetcites [497] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Although the association between depression and loss of BMD has been reported inconsistently, most studies have found low BMD in patients with depressive symptoms or major depressive disorder (477-483).”
§ WPA EDUCATIONAL MODULE > Osteoporosis in SMI patients
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Data describing the epidemiology of osteoporotic fracture and psychotropics in patients with SMI are limited.”
§ WPA EDUCATIONAL MODULE > Osteoporosis and psychotropics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Although lithium has a potentially negative impact on bone metabolism (470), it is associated with lower fracture risk (OR=0.6)and, thus, seems to be protective against fractures (504,505).”
§ WPA EDUCATIONAL MODULE > Osteoporosis and psychotropics
What the sources say
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A metaanalysis showed a 33% increased risk of fractures with SSRIs compared to non-SSRI AD.The RR of fractures in this metaanalysis was 1.60 for AD and 1.59 for AP (511).”
§ WPA EDUCATIONAL MODULE > Osteoporosis and psychotropics
What the sources say
- Not checked yetcites [511] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Sexual dysfunction in SMI patients has received little attention from clinicians (512,513).”
§ WPA EDUCATIONAL MODULE > Sexual dysfunction in SMI patients
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“This low awareness has a significant negative impact on patients' satisfaction with treatment, adherence, quality of life and partner relationships (450).”
§ WPA EDUCATIONAL MODULE > Sexual dysfunction in SMI patients
What the sources say
- Not checked yetcites [450] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Sexual dysfunction is also a common symptom of depression (526-530).”
§ WPA EDUCATIONAL MODULE > Sexual dysfunction in SMI patients
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Approximately 25% of patients with major depression may experience problems with erection or lubrication (531).”
§ WPA EDUCATIONAL MODULE > Sexual dysfunction in SMI patients
What the sources say
- Not checked yetcites [531] source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Conventional AP cause less sexual dysfunction than risperidone but more than the other novel AP (520,522).”
§ WPA EDUCATIONAL MODULE > Sexual dysfunction and psychotropics
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Up to 70% of patients with depression may have sexual dysfunction (466).”
§ WPA EDUCATIONAL MODULE > Sexual dysfunction in SMI patients
What the sources say
- Not checked yetcites [466]
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“To date, only few studies (534-547) have directly compared the sexual functioning associated with different atypical AP.”
§ WPA EDUCATIONAL MODULE > Sexual dysfunction and psychotropics
What the sources say
- Not checked yetcites [534] source
- Not checked yetcites [535] source
- Not checked yetcites [536] source
- Not checked yetcites [537] source
- Not checked yetcites [538] source
- Not checked yetcites [539] source
- Not checked yetcites [540] source
- Not checked yetcites [541] source
- Not checked yetcites [542] source
- Not checked yetcites [543] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“However, findings suggest that sexual health education for these people tends to produce a reduction in sexual risk behavior (532).”
§ WPA EDUCATIONAL MODULE > Sexual dysfunction in SMI patients
What the sources say
- Not checked yetcites [532] source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“This dysfunction can be secondary to the disease itself and to comorbid physical disorders, or be an adverse event of AP (520,524,525).”
§ WPA EDUCATIONAL MODULE > Sexual dysfunction in SMI patients
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“These studies suggest that the relative impact of AP on sexual dysfunction can be summarized as: paliperidone = risperidone > haloperidol > olanzapine ≥ ziprasidone > clozapine ≥ quetiapine > aripiprazole (503,520,536).”
§ WPA EDUCATIONAL MODULE > Sexual dysfunction and psychotropics
What the sources say
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“AD therapy (except for mirtazapine, nefazodone and bupropion) frequently induces or exacerbates sexual dysfunction, which occurs in approximately 50% of patients (548).”
§ WPA EDUCATIONAL MODULE > Sexual dysfunction and psychotropics
What the sources say
- Not checked yetcites [548] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Psychotropic drugs are associated with sexual dysfunction (514).”
§ WPA EDUCATIONAL MODULE > Sexual dysfunction and psychotropics
What the sources say
- Not checked yetcites [514]
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Although sexual dysfunction has been reported with all classes of AD (549), SSRIs are associated with higher rates (550-552).”
§ WPA EDUCATIONAL MODULE > Sexual dysfunction and psychotropics
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“There is an extensive literature reporting an increased occurrence of obstetric complications among women who have schizophrenia (15).”
§ WPA EDUCATIONAL MODULE > Pregnancy complications, SMI and psychotropics
What the sources say
- Not checked yetcites [15] source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Current evidence seems to suggest that Fallot's tetralogy is not considerably elevated with lithium compared to the rate in the general population (560).”
§ WPA EDUCATIONAL MODULE > Pregnancy complications, SMI and psychotropics
What the sources say
- Not checked yetcites [560] source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Dental health has been consistently found to be poor in people with SMI (562-573).”
§ WPA EDUCATIONAL MODULE > Oral health in SMI patients
What the sources say
- Not checked yetcites [562]
- Not checked yetcites [563] source
- Not checked yetcites [564] source
- Not checked yetcites [565]
- Not checked yetcites [566] source
- Not checked yetcites [567]
- Not checked yetcites [568] source
- Not checked yetcites [569] source
- Not checked yetcites [570] source
- Not checked yetcites [571] source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Most women with a SMI cannot stop taking their medication, as this would interfere with their activities of daily living, especially taking care of an infant (555).”
§ WPA EDUCATIONAL MODULE > Pregnancy complications, SMI and psychotropics
What the sources say
- Not checked yetcites [555] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Among AD, SSRIs and, possibly, serotonin and noradrenaline reuptake inhibitors (SNRIs) have been associated with preterm labor, respiratory distress, serotonin rebound syndrome, pulmonary hypertension and feeding problems in the neonate (557-559).”
§ WPA EDUCATIONAL MODULE > Pregnancy complications, SMI and psychotropics
What the sources say
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Published studies suggest that between 30% and 60% of SSRI-treated patients may experience some form of treatment-induced sexual dysfunction (553,554).”
§ WPA EDUCATIONAL MODULE > Sexual dysfunction and psychotropics
What the sources say
- Not checked yetcites [553]
- Not checked yetcites [554] source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In one large study (n=4,769), 34.1% of the patients with SMI reported that oral health problems made it difficult for them to eat (572).”
§ WPA EDUCATIONAL MODULE > Oral health in SMI patients
What the sources say
- Not checked yetcites [572] source
plaindirectn = 4,769- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This poor dental health leads to functional difficulties.”
§ WPA EDUCATIONAL MODULE > Oral health in SMI patients
plaindirectn = 4,769- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Oral health status is a frequently disregarded health issue among SMI patients (498), with low rates of dental examination within the past 12 months (569,577-579).”
§ WPA EDUCATIONAL MODULE > Disparities in health care
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“AP, AD and mood stabilizers all cause xerostomia (575).”
§ WPA EDUCATIONAL MODULE > Oral health and psychotropics
What the sources say
- Not checked yetcites [575] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“According to another study, only 42% of patients with schizophrenia brush their teeth regularly (at least twice a day) (573).”
§ WPA EDUCATIONAL MODULE > Oral health in SMI patients
What the sources say
- Not checked yetcites [573] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“A study using an overall dental status index (DMF-T) in chronically hospitalized patients with mental disorders (mostly schizophrenia) found a mean score of 26.74 (out of a possible 32), one of the highest reported in the literature (571).”
§ WPA EDUCATIONAL MODULE > Oral health in SMI patients
What the sources say
- Not checked yetcites [571] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“This reduction in salivary flow changes the oral environment and leads to caries, gingivitis and periodontal disease (576).”
§ WPA EDUCATIONAL MODULE > Oral health and psychotropics
What the sources say
- Not checked yetcites [576] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Factors which influence oral health include: type, severity, and stage of mental illness; mood, motivation and selfesteem; lack of perception of oral health problems; habits, lifestyle (e.g., smoking), and ability to sustain self-care and dental attendance; socio-economic factors; effects of medication (dry mouth, carbohydrate craving); and attitudes and knowledge of dental health teams concerning”
§ WPA EDUCATIONAL MODULE > Oral health in SMI patients
What the sources say
- Not checked yetcites [569] source
- Not checked yetcites [574]
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Some physical conditions, although important, are rarely studied, underreported and not systematically assessed.”
§ WPA EDUCATIONAL MODULE > other physical health conditions in people with sMI
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Clozapine (approximately 0.8%) and phenothiazines (chlorpromazine approximately 0.13%) are the most common causes of drug-related neutropenia/agranulocytosis.”
§ WPA EDUCATIONAL MODULE > other physical health conditions in people with sMI
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Moreover, improving dental health status and care are relevant, as poor dental status is associated with endocarditis and reduces social and work opportunities.”
§ WPA EDUCATIONAL MODULE > Disparities in health care
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In addition to modifiable lifestyle factors and psychotropic medication side effects, poorer access to and quality of received health care remain addressable problems for patients with SMI.”
§ WPA EDUCATIONAL MODULE > conclUsIons
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Although a common side effect of AP that can be severe and lead to serious consequences and even death, constipation has been given relatively little attention.”
§ WPA EDUCATIONAL MODULE > other physical health conditions in people with sMI
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Constipation has most widely been reported for clozapine, although it can be associated with other AP as well.”
§ WPA EDUCATIONAL MODULE > other physical health conditions in people with sMI
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Prevalence of constipation in randomized controlled trials for different AP is: zotepine 39.6%, clozapine 21.3%, haloperidol 14.6% and risperidone 12% (583).”
§ WPA EDUCATIONAL MODULE > other physical health conditions in people with sMI
What the sources say
- Not checked yetcites [583] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In the latter study, non-adherence to annual dental visits was predicted by substance abuse diagnosis, involuntary legal status, living in an institution, admission to a psychiatric facility for a minimum of 30 days, and male gender, whereas clozapine treatment, novel AP treatment, at least monthly outpatient visits, and age > 50 years were associated with a lower risk for inappropriate dental”
§ WPA EDUCATIONAL MODULE > Disparities in health care
What the sources say
- Not checked yetcites [577]
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The most reported complications of this physical condition are paralytic ileus, faecal impaction, bowel obstruction and intestine/bowel perforations.”
§ WPA EDUCATIONAL MODULE > other physical health conditions in people with sMI
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Haematological diseases, which may in themselves be primary problems in patients with SMI, have frequently been described in the literature as potential serious complications of psychotropic medications.”
§ WPA EDUCATIONAL MODULE > other physical health conditions in people with sMI
boostedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“With appropriate management, the mortality from drug-induced agranulocytosis in Western countries is 5-10% (before the use of antibiotics this percentage was 80%) (582).”
§ WPA EDUCATIONAL MODULE > other physical health conditions in people with sMI
What the sources say
- Not checked yetcites [582] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In one study of a mixed psychiatric population, 15% had not been to a dentist in the last 2 years (579), while in another only 31% of schizophrenia patients had visited a dentist during a three year period (577).”
§ WPA EDUCATIONAL MODULE > Disparities in health care
What the sources say
- Not checked yetcites [579] source
- Not checked yetcites [577]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Greater individual and system level attention to these physical disorders that can worsen psychiatric stability, treatment adherence, and life expectancy as well as quality of life will improve outcomes of these generally disadvantaged populations worldwide.”
§ WPA EDUCATIONAL MODULE > conclUsIons
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“AP (e.g., clozapine, haloperidol, olanzapine, phenothiazines, quetiapine, risperidone, ziprasidone), AD (e.g., amitriptyline, clomipramine, imipramine) as well as lithium are associated with blood dyscrasias.”
§ WPA EDUCATIONAL MODULE > other physical health conditions in people with sMI
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“This has significant clinical implications considering that cardiovascular disease is the leading cause of mortality in people with mental illness [52, 294, 295].”
From Infraslow closed-loop brain training for anxiety and depression (ISAD): a protocol for a randomized, double-blind, sham-controlled pilot trial in adult females with internalizing disorders (2022) · cites this paper as [295]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“People with severe mental illness (schizophrenia, bipolar disorder or major depressive disorder) have higher levels of somatic comorbidities and premature mortality than the general population 1-3 .”
In the citing paper
“Major risk factors include antipsychotic medication use and an unhealthy lifestyle 7”
From Diabetes mellitus in people with schizophrenia, bipolar disorder and major depressive disorder: a systematic review and large scale meta‐analysis (2016) · cites this paper as [7]
In the citing paper
“Factors predisposing people with SMI to CVD include antipsychotic medication and unhealthy lifestyles (7) as well as their reduced likelihood to receive standard levels of medical care (8)(9)(10)(11)(12).”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“The mortality of reported cases of DKA varies between 15.4% and 48% (233,235-237), which is up to ten times higher than the 4% rate in the general population (276).”
§ WPA EDUCATIONAL MODULE > diabetic ketoacidosis
Reported 10 · recomputed 12
Citations
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Metadata
- Authors
- DE HERT, M., CORRELL, C. U., BOBES, J., CETKOVICH‐BAKMAS, M., COHEN, D., ASAI, I., DETRAUX, J., GAUTAM, S., MÖLLER, H., NDETEI, D. M., NEWCOMER, J. W., UWAKWE, R., & LEUCHT, S.
- Affiliations
- Albert Einstein College of Medicine (US)
- Universidad de Oviedo (ES)
- University of Groningen (NL)
- KU Leuven (BE)
- SMS Medical College (IN)
- University of Nairobi (KE)
- Washington University in St. Louis (US)
- Nnamdi Azikiwe University (NG)
- Technical University of Munich (DE)
- ORCID
- Venue
- World Psychiatry
- Publisher
- Wiley
- Published
- 2011-02
- Volume
- 10
- Issue
- 1
- Pages
- 52-77
- ISSN
- 1723-8617 (ISSN-L)
- 2051-5545
- PMC
- PMC3048500
- OpenAlex
- W2116251861
- Semantic Scholar
- 611c371ce31e6dedc3d58ef6f711b7a21edbc450
- Cited by
- 2,488
- References
- 605
- Citations by year
- 2026: 119 · 2025: 142 · 2024: 159 · 2023: 174 · 2022: 209 · 2021: 190 · 2020: 224 · 2019: 181 · 2018: 171 · 2017: 162 · 2016: 186 · 2015: 147 · 2014: 112 · 2013: 216 · 2012: 68
- FWCI
- 93.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- World Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- University of Nairobi Research Archive (University of Nairobi) (submittedVersion)
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- mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Funders
- American Heart Association
- Bristol-Myers Squibb
- Pfizer
- Società Italiana di Psichiatria Biologica
- National Heart, Lung, and Blood Institute
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- severe mental illness, physical illness, comorbidities, excess mortality, psychotropic medication side effects, health care disparities, lifestyle factors, cardiovascular disease, obesity, sexual dysfunction, screening, schizophrenia, bipolar disorder, major depressive disorder
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-10, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-10 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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