Reduced prevalence of cardiovascular disease and metabolic syndrome-related disorders among Japanese long-term inpatients with schizophrenia

• Published in: Clinical Neuropsychopharmacology and Therapeutics Vol. 6; pp. 16 - 27
• Main Authors: Saitou, Kenichi, Tani, Masayuki, Kato, Nobumasa, Iwanami, Akira, Yamada, Hiroki, Nakamura, Dan, Takashio, Osamu, Ikeda, Ayumi, Tamura, Toshiyuki, Umezawa, Kaori, Hirata, Yosihito, Morita, Tepei, Inamoto, Atsuko
• Format: Journal Article
• Language: English
• Published: The Japanese Society of Clinical Neuropsychopharmacology 2015
• Subjects: antipsychotic drugs; cardiovascular disease; metabolic syndrome-related disorders; nursing care; schizophrenia
• ISSN: 1884-8826; 1884-8826
• DOI: 10.5234/cnpt.6.16

Purpose: Individuals with schizophrenia have a vastly reduced lifespan compared with the general population; comorbid cardiovascular disease (CVD) is the leading cause of death for them. Furthermore, these individuals are more likely to have metabolic syndrome-related disorders (MSDs), which increase CVD risk. We examined the medical records of long-term inpatients with schizophrenia to identify methods for preventing CVD and MSDs. Method: A retrospective survey was conducted on 56 inpatients with schizophrenia. The prevalence rates of CVD and MSDs among inpatients with schizophrenia were compared with Japanese general population data from the 2010 National Health and Nutrition Examination Survey. Then, we compared the variables influencing CVD and MSDs between first- and second-generation antipsychotic drug groups. Results: The prevalences of hyperlipidemia, diabetes mellitus, hypertension, myocardial infarction, and cerebral hemorrhage among individuals with schizophrenia were lower than those among the Japanese general population. This effect is likely attributable to the nursing care offered to individuals with schizophrenia, which includes dietary advice, moderate exercise support, and body weight and blood pressure measurement. Medication did not correlate with CVD or MSD prevalence. Discussion: Long-term hospitalization appeared to be particularly useful in preventing CVD and MSDs; thus, nursing care equivalent to that provided in hospitals can reduce the prevalence of CVD and MSDs among patients with schizophrenia. Antipsychotic drugs might have only a minor influence on CVD and MSD prevalence with reliable nursing care. Japanese psychiatric personnel should attend to outpatients with schizophrenia, as this population is increasing and receives less care than do inpatients.