Skip to main content
NCBI home page
International Journal of Methods in Psychiatric Research logoLink to International Journal of Methods in Psychiatric Research
. 2010 Nov 25;19(4):195–210. doi: 10.1002/mpr.322

The METEOR study of diabetes and other metabolic disorders in patients with schizophrenia treated with antipsychotic drugs. I. Methodology

Marc De Hert 1,✉, Mauro Mauri 2, Ken Shaw 3, Tilman Wetterling 4, Adam Doble 5, Agnès Giudicelli 6, Bruno Falissard 7
PMCID: PMC6878539  PMID: 20683849

Abstract

Patients with schizophrenia present a two‐ to three‐fold higher prevalence of diabetes, of metabolic syndrome and of cardiovascular morbidity. The reason for this increased prevalence may involve intrinsic vulnerability, lifestyle factors and iatrogenic effects of antipsychotic drugs. The objective of this multinational, cross‐sectional, pharmacoepidemiological study was to determine the prevalence of diabetes, lipid disorders, obesity, hypertension and the metabolic syndrome in patients with schizophrenia treated with antipsychotic drugs. Particular attention was taken to acquire data on a wide a range as possible of demographic, clinical and lifestyle variables that may influence the risk of metabolic disorders, which were taken into account in the calculation of prevalence data by propensity scoring. The study included 2270 subjects from 16 European countries, predominantly from Central and Eastern Europe. The proportion of subjects presenting the pathologies of interest was relatively high, ranging from 28% for glycaemic disorders to 70% for lipid disorders. Copyright © 2010 John Wiley & Sons, Ltd.

Keywords: schizophrenia, antipsychotics, prevalence, diabetes, metabolic disorders

Full Text

The Full Text of this article is available as a PDF (526.6 KB).

References

  1. American Psychiatric Association . (2000) Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, American Psychiatric Association. [Google Scholar]
  2. Andrews E.A., Avorn J., Bortnichak E.A., Chen R., Dai W.S., Dieck G.S., Edlavitch S., Freiman J., Mitchell A.A., Nelson R.C., Neutel C.I., Stergachis A., Strom B.L., Walker A.M. (1996) Guidelines for Good Epidemiology Practices for drug, device, and vaccine research in the United States. Pharmacoepidemiology and Drug Safety, 5, 333–338. [DOI] [PubMed] [Google Scholar]
  3. Brown S., Inskip H., Barraclough B. (2000) Causes of the excess mortality of schizophrenia. British Journal of Psychiatry, 177, 212–217. [DOI] [PubMed] [Google Scholar]
  4. Byrne M., Agerbo E., Mortensen P.B. (2002) Family history of psychiatric disorders and age at first contact in schizophrenia: an epidemiological study. British Journal of Psychiatry Supplement, 43, s19–s25. [DOI] [PubMed] [Google Scholar]
  5. Casadebaig F., Philippe A., Guillaud‐Bataille J.M., Gausset M.F., Quemada N., Terra J.L. (1997) Schizophrenic patients: physical health and access to somatic care. European Psychiatry, 12, 289–293. [DOI] [PubMed] [Google Scholar]
  6. Conroy R.M., Pyorala K., Fitzgerald A.P., Sans S., Menotti A., De Backer G., De Bacquer D., Ducimetiere P., Jousilahti P., Keil U., Njolstad I., Oganov R.G., Thomsen T., Tunstall‐Pedoe H., Tverdal A., Wedel H., Whincup P., Wilhelmsen L., Graham I.M. (2003) Estimation of ten‐year risk of fatal cardiovascular disease in Europe: the SCORE project. European Heart Journal, 24, 987–1003. [DOI] [PubMed] [Google Scholar]
  7. Correll C.U. (2007) Balancing efficacy and safety in treatment with antipsychotics. CNS Spectrums, 12, 12–20, 35. [DOI] [PubMed] [Google Scholar]
  8. De Hert M., van Winkel R., Van Eyck D., Hanssens L., Wampers M., Scheen A., Peuskens J. (2006) Prevalence of diabetes, metabolic syndrome and metabolic abnormalities in schizophrenia over the course of the illness: a cross‐sectional study. Clinical Practice and Epidemiology in Mental Health, 2, 14. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. De Hert M., Schreurs V., Vancampfort D., van Winkel R. (2009) Metabolic syndrome in people with schizophrenia: a review. World Psychiatry, 8, 15–22. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Dixon L., Weiden P., Delahanty J., Goldberg R., Postrado L., Lucksted A., Lehman A. (2000) Prevalence and correlates of diabetes in national schizophrenia samples. Schizophrenia Bulletin, 26, 903–912. [DOI] [PubMed] [Google Scholar]
  11. Fleischhacker W.W., Cetkovich‐Bakmas M., De Hert M., Hennekens C.H., Lambert M., Leucht S., Maj M., McIntyre R.S., Naber D., Newcomer J.W., Olfson M., Osby U., Sartorius N., Lieberman J.A. (2008) Comorbid somatic illnesses in patients with severe mental disorders: clinical, policy, and research challenges. Journal of Clinical Psychiatry, 69, 514–519. [DOI] [PubMed] [Google Scholar]
  12. Gasquet I., Gury C., Tcherny‐Lessenot S., Quesnot A., Gaudebout P. (2005) Patterns of prescription of four major antipsychotics: a retrospective study based on medical records of psychiatric inpatients. Pharmacoepidemiology and Drug Safety, 14, 805–811. [DOI] [PubMed] [Google Scholar]
  13. Goff D.C., Sullivan L.M., McEvoy J.P., Meyer J.M., Nasrallah H.A., Daumit G.L., Lamberti S., D'Agostino R.B., Stroup T.S., Davis S., Lieberman J.A. (2005) A comparison of ten‐year cardiac risk estimates in schizophrenia patients from the CATIE study and matched controls. Schizophrenia Research, 80, 45–53. [DOI] [PubMed] [Google Scholar]
  14. Gottesman I.I. (1991) Schizophrenia Genesis. The Origins of Madness, W.H. Freeman. [Google Scholar]
  15. Grundy S.M., Cleeman J.I., Daniels S.R., Donato K.A., Eckel R.H., Franklin B.A., Gordon D.J., Krauss R.M., Savage P.J., Smith S.C. Jr, Spertus J.A., Costa F. (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation, 112, 2735–2752. [DOI] [PubMed] [Google Scholar]
  16. Hanssens L., De Hert M., Wampers M., Reginster J.Y., Peuskens J. (2006) Pharmacological treatment of ambulatory schizophrenic patients in Belgium. Clinical Practice and Epidemiology in Mental Health, 2, 11. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Henderson D.C. (2005) Schizophrenia and comorbid metabolic disorders. Journal of Clinical Psychiatry Supplement, 66(6), 11–20. [PubMed] [Google Scholar]
  18. IMS Health . (2006) http://www.imshealth.com [20 July 2010]
  19. Lamberti J.S., Crilly J.F., Maharaj K., Olson D., Wiener K., Dvorin S., Costea G.O., Bushey M.P., Dietz M.B. (2004) Prevalence of diabetes mellitus among outpatients with severe mental disorders receiving atypical antipsychotic drugs. Journal of Clinical Psychiatry, 65, 702–706. [DOI] [PubMed] [Google Scholar]
  20. Mortensen P.B., Pedersen C.B., Westergaard T., Wohlfahrt J., Ewald H., Mors O., Andersen P.K., Melbye M. (1999) Effects of family history and place and season of birth on the risk of schizophrenia. New England Journal of Medicine, 340, 603–608. [DOI] [PubMed] [Google Scholar]
  21. Mukherjee S., Decina P., Bocola V., Saraceni F., Scapicchio P.L. (1996) Diabetes mellitus in schizophrenic patients. Comprehensive Psychiatry, 37, 68–73. [DOI] [PubMed] [Google Scholar]
  22. Nasrallah H.A., Meyer J.M., Goff D.C., McEvoy J.P., Davis S.M., Stroup T.S., Lieberman J.A. (2006) Low rates of treatment for hypertension, dyslipidemia and diabetes in schizophrenia: data from the CATIE schizophrenia trial sample at baseline. Schizophrenia Research, 86, 15–22. [DOI] [PubMed] [Google Scholar]
  23. Newcomer J.W. (2005) Second‐generation (atypical) antipsychotics and metabolic effects: a comprehensive literature review. CNS Drugs Supplement, 19(1), 1–93. [DOI] [PubMed] [Google Scholar]
  24. Osby U., Correia N., Brandt L., Ekbom A., Sparen P. (2000) Mortality and causes of death in schizophrenia in Stockholm county, Sweden. Schizophrenia Research, 45, 21–28. [DOI] [PubMed] [Google Scholar]
  25. Ren X.S., Kazis L.E., Lee A.F., Hamed A., Huang Y.H., Cunningham F., Miller D.R. (2002) Patient characteristics and prescription patterns of atypical antipsychotics among patients with schizophrenia. Journal of Clinical Pharmacy and Therapeutics, 27, 441–451. [DOI] [PubMed] [Google Scholar]
  26. Rosenbaum P., Rubin D. (1983) The central role of the propensity score in observational studies for causal effect. Biometrika, 70, 41–55. [Google Scholar]
  27. Scheen A.J., De Hert M.A. (2007) Abnormal glucose metabolism in patients treated with antipsychotics. Diabetes & Metabolism, 33, 169–175. [DOI] [PubMed] [Google Scholar]
  28. Smith M., Hopkins D., Peveler R.C., Holt R.I., Woodward M., Ismail K. (2008) First‐ v. second‐generation antipsychotics and risk for diabetes in schizophrenia: systematic review and meta‐analysis. British Journal of Psychiatry, 192, 406–411. [DOI] [PubMed] [Google Scholar]
  29. Tschoner A., Engl J., Laimer M., Kaser S., Rettenbacher M., Fleischhacker W.W., Patsch J.R., Ebenbichler C.F. (2007) Metabolic side effects of antipsychotic medication. International Journal of Clinical Practice, 61, 1356–1370. [DOI] [PubMed] [Google Scholar]
  30. Wilson P.W., D'Agostino R.B., Levy D., Belanger A.M., Silbershatz H., Kannel W.B. (1998) Prediction of coronary heart disease using risk factor categories. Circulation, 97, 1837–1847. [DOI] [PubMed] [Google Scholar]

Articles from International Journal of Methods in Psychiatric Research are provided here courtesy of Wiley

RESOURCES