Increased Risk of Diabetes Mellitus Among Persons With Psychotic Symptoms: Results From the WHO World Health Survey
Open accessAbstract
OBJECTIVE: To analyze with a symptom-based approach the relationship between psychosis and diabetes mellitus in the general population. METHOD: Nationally representative samples from the World Health Organization (WHO) World Health Survey, totaling 224,743 randomly selected adults 18 years and older from 52 countries worldwide, were interviewed to establish the presence of psychotic symptoms and diabetes mellitus. Presence of psychotic symptoms was established using questions pertaining to positive symptoms from the psychosis screening module of the Composite International Diagnostic Interview. Presence of diabetes was established with a response of "yes" to the question, "Have you ever been diagnosed with diabetes (high blood sugar)?" The World Health Survey was conducted between 2002 and 2004. RESULTS: An increasing number of psychotic symptoms was related to increasing likelihood of diabetes mellitus (OR = 1.27; 95% CI, 1.24-1.30). As compared to no symptoms, at least 1 psychotic symptom substantially elevated the risk (OR = 1.71; 95% CI, 1.61-1.81). In people with a lifetime diagnosis of schizophrenia or psychosis, the prevalence of diabetes was higher in those with current psychotic symptoms (7.3% vs 5.2%; OR = 1.65; 95% CI, 1.21-2.26), suggesting that the persistence of symptoms over time could play a central role. After controlling for different potential confounders, there was a clear increase in the probability of having diabetes as the number of psychotic symptoms increased. The relationship between psychotic symptoms and diabetes was tested with multiple mediation models and path analyses for categorical outcomes. Only body mass index appeared as a relevant mediator in a model with a good fit (ie, χ21 = 3.2, P = .0742; comparative fit index = 0.999). CONCLUSIONS: Psychotic symptoms are related to increased rates of diabetes mellitus in nonclinical samples, independent of several potential confounders-including a clinical diagnosis of psychosis or schizophrenia, previous antipsychotic treatment, depression, lifestyle, and individual or country socioeconomic status. The findings highlight the worldwide relevance of the problem and the importance of identifying the specific paths of this association.
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There are strong correlations between metabolic diseases (such as obesity and diabetes) and mental disorders such as schizophrenia, bipolar disorders and severe depression.
“there are strong correlations between metabolic diseases (such as obesity and diabetes) and mental disorders such as schizophrenia, bipolar disorders and severe depression [35].”
From Treatment of obesity and diabetes using oxytocin or analogs in patients and mouse models (2013) · cites this paper as [35]
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- Authors
- Nuevo, R., Chatterji, S., Fraguas, D., Verdes, E., Naidoo, N., Arango, C., & Ayuso-Mateos, J. L.
- Affiliations
- Instituto de Salud Carlos III (ES)
- World Health Organization (CH)
- Hospital General Universitario Gregorio Marañón (ES)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2011-12-15
- Volume
- 72
- Issue
- 12
- Pages
- 1592-1599
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W1973501742
- Cited by
- 48
- References
- 29
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 2 · 2022: 2 · 2021: 5 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 1 · 2016: 7 · 2015: 6 · 2014: 5 · 2013: 5 · 2012: 1
- FWCI
- 2.41
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Bristol Research (University of Bristol) (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Keywords
- psychotic symptoms, diabetes mellitus, schizophrenia, body mass index, mediation, non-clinical population, positive symptoms, antipsychotic drugs, depression, socioeconomic status
- MeSH terms
- Adolescent, Adult, Aged, Diabetes Mellitus, Female, Health Surveys, Humans, Interview, Psychological, Male, Middle Aged, Psychotic Disorders, Risk, Schizophrenia, Time Factors, World Health Organization, Comorbidity, Prevalence, Young Adult
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.
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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