Metabolic Syndrome and Illness Severity Predict Relapse at 1-Year Follow-Up in Schizophrenia: The FACE-SZ Cohort.

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Metabolic Syndrome and Illness Severity Predict Relapse at 1-Year Follow-Up in Schizophrenia: The FACE-SZ Cohort.

J Clin Psychiatry. 2018 Sep 18;79(6):

Authors: Godin O, Leboyer M, Schürhoff F, Llorca PM, Boyer L, Andre M, Andrianarisoa M, Aouizerate B, Berna F, Capdevielle D, Chereau I, Dorey JM, Dubertret C, Dubreucq J, Faget C, Lancon C, Leignier S, Mallet J, Misdrahi D, Passerieux C, Rey R, Roux P, Vidailhet P, Costagliola D, Fond G, FACE-SZ (FondaMental Academic Centers of Expertise for Schizophrenia) Group

Abstract
OBJECTIVE: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: Further studies should determine if reducing or preventing MetS could help to protect subjects with schizophrenia from relapse.

PMID: 30257079 [PubMed - in process]