O Godin, M Leboyer, F Schürhoff, PM Llorca, L Boyer, M Andre, M Andrianarisoa, B Aouizerate, F Berna, D Capdevielle, I Chereau, JM Dorey, C Dubertret, J Dubreucq, C Faget, C Lancon, S Leignier, J Mallet, D Misdrahi, C Passerieux, R Rey, P Roux, P Vidailhet, D Costagliola and G Fond,
The Journal of clinical psychiatry, Sep 2018 18
Predicting relapse is a major challenge in schizophrenia from a clinical and medico-economic point of view. During recent decades, major psychiatric disorders have been found to be extensively associated with metabolic disorders, even before the illness onset, with a prevalence estimated to be 35% in this population. However, no study to date has, to our knowledge, explored the potential impact of metabolic syndrome (MetS) on relapse.From 2010 to 2016, 185 patients (mean age = 32 years) with a DSM-IV-TR diagnosis of schizophrenia were included in the FondaMental Academic Centers of Expertise for Schizophrenia (FACE-SZ) cohort and followed up for 1 year. Multivariable logistic regression was performed to estimate the adjusted odds ratio for relapse.Thirty-seven percent of stabilized outpatients with schizophrenia (mean illness duration = 11 years) experienced a relapse at least once during the 1 year of follow-up. MetS strongly predicted relapse at 1 year, independently of illness severity, insight into illness, and treatment characteristics (including medication compliance). Patients with MetS at baseline had a 3 times higher risk (95% CI, 1.1-8.4) of experiencing a new episode of psychosis during the 12 months of follow-up.Further studies should determine if reducing or preventing MetS could help to protect subjects with schizophrenia from relapse.