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Cited by 208Schizophrenia research and treatmentDiabetes, Cardiovascular Risks, and LipoproteinsCardiac Health and Mental Health

Relative risk of diabetes, dyslipidaemia, hypertension and the metabolic syndrome in people with severe mental illnesses: Systematic review and metaanalysis

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Osborn, David PJ, Wright, Christine A, Levy, Gus, King, Michael B, Deo, Raman, Nazareth, Irwin·2008·BMC Psychiatry
DOI 10.1186/1471-244x-8-84PMC PMC2570660
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Abstract

BACKGROUND: Severe mental illnesses (SMI) may be independently associated with cardiovascular risk factors and the metabolic syndrome. We aimed to systematically assess studies that compared diabetes, dyslipidaemia, hypertension and metabolic syndrome in people with and without SMI. METHODS: We systematically searched MEDLINE, EMBASE, CINAHL & PsycINFO. We hand searched reference lists of key articles. We employed three search main themes: SMI, cardiovascular disease, and each cardiovascular risk factor. We selected cross-sectional, case control, cohort or intervention studies comparing one or more risk factor in both SMI and a reference group. We excluded studies without any reference group. We extracted data on: study design, cardiovascular risk factor(s) and their measurement, diagnosis of SMI, study setting, sampling method, nature of comparison group and data on key risk factors. RESULTS: Of 14592 citations, 134 papers met criteria and 36 were finally included. 26 reported on diabetes, 12 hypertension, 11 dyslipidaemia, and 4 metabolic syndrome. Most studies were cross sectional, small and several lacked comparison data suitable for extraction. Meta-analysis was possible for diabetes, cholesterol and hypertension; revealing a pooled risk ratio of 1.70 (1.21 to 2.37) for diabetes and 1.11 (0.91 to 1.35) of hypertension. Restricting SMI to schizophreniform illnesses yielded a pooled risk ratio for diabetes of 1.87 (1.68 to 2.09). Total cholesterol was not higher in people with SMI (Standardized Mean Difference -0.10 (-0.55 to 0.36)) and there were inconsistent data on HDL, LDL and triglycerides with some, but not all, reporting lower levels of HDL cholesterol and raised triglyceride levels. Metabolic syndrome appeared more common in SMI. CONCLUSION: Diabetes (but not hypertension) is more common in SMI. Data on other risk factors were limited by poor quality or inconsistent research findings, but a small number of studies show greater prevalence of the metabolic syndrome in SMI.

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  • Underdiagnosis of somatic disorders in schizophrenic patients has been described in many studies.

    “Underdiagnosis of somatic disorders in schizophrenic patients has been described in many other studies (Frayne et al. 2005, Laursen et al. 2009, Osborn et al. 2008).”

    From Excess early mortality in schizophrenia. (2014) · cites this paper as Osborn et al. 2008

    The Discussion (Quality and variability of published studies; page unavailable) says people with severe mental illness may previously have been less likely to receive diabetes screening, which could underestimate recorded diabetes prevalence. That supports a possible detection gap, but not the broader claim that many studies have described underdiagnosis of somatic disorders specifically in patients with schizophrenia. (LLM, conf=0.84)

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Cited by

Sorted by citations

Authors
Osborn, D. P., Wright, C. A., Levy, G., King, M. B., Deo, R., & Nazareth, I.
Affiliations
The Royal Free Hospital (GB)
Corresponding author
Osborn, David PJ
ORCID
Venue
BMC Psychiatry
Publisher
Springer Science and Business Media LLC
Published
2008-09-25
Volume
8
Issue
1
Pages
84-84
ISSN
1471-244X (ISSN-L)
DOI
10.1186/1471-244x-8-84
PMC
PMC2570660
OpenAlex
W1971287303
Cited by
208
References
2
Citations by year
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FWCI
0.91
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Funders
Medical Research Council
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Keywords
severe mental illness, diabetes mellitus, dyslipidemia, hypertension, metabolic syndrome, cardiovascular risk factors, schizophrenia, total cholesterol, HDL cholesterol, triglycerides, LDL cholesterol, relative risk
MeSH terms
Mental Disorders, Diabetes Mellitus, Humans, Hypertension, Risk Factors, Comorbidity, Prevalence, Metabolic Syndrome, Dyslipidemias

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