Artikel
Long term impact of second generation antipsychotics, physical activity, and waist size on objective and subjective physical health in patients with schizophrenia (ELAN-Study)
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Veröffentlicht: | 12. Oktober 2011 |
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Background: Background: Increased body weight, visceral adiposity and lack of physical activity/fitness are common in psychotic disorders and may be related to or even predict physical well being. The relationships between different antipsychotic treatments and physical-well being, prevalence of hypertonia and hyperlipidemia, metabolic and anthropometric changes, and physical activity/ fitness of patients with psychotic disorders was evaluated under real-world treatment conditions over 24 months.
Materials and methods: 374 patients with schizophrenia or schizoaffective disorders were followed at 0, 6, 12, 18 and 24 months after discharge from inpatient treatment. A cut-off for the waist circumference at risk for the Framginham coronary heart disease risk index (CHDRI, Ardern et al., Obesity 2004) was adapted for BMI and sex.
Results: Results: At discharge, 31% of patients were obese (BMI > 30 kg/m²), 59% out of 363 patients had a waist at risk for CHDRI and 27.5 % had arterial hypertension, 13.2% of those patients with normal waist and 37% of patients beyond the risk waist. 3.9% of the patients had insulin dependent diabetes mellitus. Physical fitness after 6 months (ability to climb 3 stairs without sweating) was a protective factor for subjective general and physical well-being at that time point: OR 2.5 (CI 1.6–3.9, n=316). The choice of second generation antipsychotics (quetiapine, risperidone or olanzapine) had no impact on physical well-being, as statements about physical exercise, BMI, waist circumference, age or sex had also no significant impact on physical well-being at the same point in time or at the end of study. Physical fitness at 6 months, however, predicted subjective physical well being at 24 months (n=272, OR 1.7 CI 1.1–2.8).
Conclusions: In this study, subjective well-being from physical health and objective metabolic health was mainly related to physical fitness and lack of visceral adiposity, but was unaffected by different second generation antipsychotic treatments. Attractive exercise programs and daily physical activities should be offered to psychotic patients.
Acknowledgement: The ELAN study was funded as an investigator-initiated research project by a grant fromAstraZeneca Deutschland to the University of Tübingen.