Conference paper

THE COMORBIDITY OF DIABETES MELLITUS AND PSYCHIATRIC DISORDERS

Vesna Medved ; University of Zagreb, School of Medicine and Clinical Hospital Centre Zagreb, Department of Psychiatry, Kišpatićeva 12, HR-10000 Zagreb, Croatia
Nikolina Jovanović ; University of Zagreb, School of Medicine and Clinical Hospital Centre Zagreb, Department of Psychiatry, Kišpatićeva 12, HR-10000 Zagreb, Croatia
V. Popović Knapić ; University of Zagreb, School of Medicine and Clinical Hospital Centre Zagreb, Department of Psychiatry, Kišpatićeva 12, HR-10000 Zagreb, Croatia

Abstract

Diabetes mellitus is a chronic disease affecting approximately 6% of the general population. Depression and schizophrenia are often comorbid with diabetes. There are two main ways to explain this phenomenon. Firstly, patients with diabetes mellitus have higher incidence of psychiatric disorders and secondly, antidepressants and antipsychotics may cause metabolic abnormalities.
Antidepressants with noradrenergic activity have the highest potential to cause metabolic abnormalities. In schizophrenia, the risk is highest with clozapine and olanzapine pose the highest risk, moderate for risperidone and quetiapine, while ziprasidone and sertindole have not been associated with diabetes. American
Diabetes Association and American Psychiatric Association suggested that optimal management of patients with schizophrenia should include baseline assessment on their weight, waist circumference, blood pressure, blood glucose level and lipidogram and family history on obesity, diabetes, dyslipidemia, hypertension and
cardiovascular illness. During the first three months, weight gain should be monitored on monthly basis, while biochemical analysis should be performed after the first three months, and then once a year. In patients with significant weight gain, increase of blood glucose level or dyslipidemia, the first intervention should be
switch to another antipsychotic. If necessary, a patient should be referred to an endocrinologist and advised on changing their life style.

Keywords

diabetes mellitus; depression; schizophrenia

Hrčak ID:

49637

URI

https://hrcak.srce.hr/49637

Publication date:

25.8.2009.

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