Investigation of the Relationship of Sociodemographic and Clinical Characteristics with Cardiovascular Risk Scores in Patients with Schizophrenia Living in Nursing Homes

Year 2023, , 124 - 131, 16.03.2023

Rümeysa Taşdelen , Batuhan Ayık , Hatice Kaya

https://doi.org/10.31832/smj.1228002

Abstract

Objective: Cardiovascular risk increases in patients with schizophrenia. In our study, it was aimed to predict the 10-year risk of developing cardiovascular disease using the Framingham risk score in schizophrenia patients living in nursing homes
Materials and Methods: In our study, the sociodemographic and clinical characteristics of schizophrenia patients living in nursing homes, such as age, gender, educational status, duration of disease, and treatments used, and Framingham risk scoring which included age, gender total cholesterol, HDL, smoking status, systolic blood pressure, and presence of diabetes mellitus. were used in the calculation of cardiovascular risk. Also, the results of the General Assessment of Functioning and Clinical Global Impression disease severity scale were recorded in order to determine the functionality and severity of the disease.
Results: 51 patients with schizophrenia were included, and the Framingham risk score of the patients was calculated as 4.65±4.63. While Framingham risk scores were significantly correlated with disease duration (r=0.284, p=0.044), age (r=0363, p=0.01) and length of stay in nursing home (r=0.538, p<0.001)), No relationship was found between risk scores and the number of psychotropic drugs. disease severity or functionality.
Conclusİon: Our results showed that factors such as advanced age, male gender and length of nursing home stay were associated with an increased cardiovascular disease risk. Further studies including schizophrenia patients who do not stay in nursing homes are essential to determine the effects of nursing home conditions on cardiovascular disease risk

Keywords

Schizophrenia, Nursing home, Cardiovascular risk, Framingham risk score

Bakımevinde yaşayan Şizofreni Hastalarında Sosyodemografik ve Klinik Özelliklerin Kardiyovasküler Risk Skorları ile İlişkisinin İncelenmesi

Abstract

Amaç: Şizofreni hastalarında kardiyovasküler riskin arttığı bilinmektedir. Çalışmamızda bakımevinde yaşayan şizofreni tanılı hastalarda Framingham risk skorlaması kullanılarak 10 yıllık kardiyovasküler hastalık gelişme riskini yordamak amaçlanmıştır.
Gereç ve Yöntemler: Çalışmamızda bakımevinde yaşayan şizofreni hastalarının yaş, cinsiyet, eğitim durumu, hastalık süresi, kullanılan tedaviler gibi sosyodemografik ve klinik özellikleri yanında işlevsellikleri ve hastalık şiddetini saptamak üzere İşlevsellik Genel Değerlendirmesi ve Klinik Global İzlenim hastalık şiddeti ölçeği sonuçları kaydedilmiş, kardiyovasküler riskin hesaplanmasında yaş, cinsiyet, toplam kolesterol, HDL, sigara içme durumu, sistolik kan basıncı ve diabetes mellitus varlığını içeren Framingham risk skorlaması kullanılmıştır.
Bulgular: 51 şizofreni hastası dahil edilmiş, hastaların Framingham risk skoru 4.65±4.63 olarak hesaplanmıştır. Framingham risk skorlarının hastalığın süresi (r=0.284, p=0.044), yaş (r=0363, p=0.01) ve bakımevinde kalış süresi (r=0. 538, p<0.001)) ile anlamlı ilişki bulunurken hastalık şiddeti, işlevsellik ve psikotropik ilaç sayıları arasında ilişki bulunamamıştır
Sonuç: Sonuçlarımız ileri yaş, erkek cinsiyet ve bakımevinde kalış süresi gibi faktörlerin artmış kardiyovasküler hastalık riski ile ilişkili olduğunu göstermiştir. Bakımevi koşullarının kardiyovasküler hastalık riski üzerindeki etkilerini saptamak için bakımevinde kalmayan şizofreni hastalarını da içeren yeni çalışmalara ihtiyaç vardır.

Keywords

Şizofreni, Bakımevi, Kardiyovasküler risk, Framingham risk skoru, Schizophrenia, Nursing home, Cardiovascular risk, Framingham risk score

Supporting Institution

YOK

References

• 1. Tandon R, Gaebel W, Barch DM, Bustillo J, Gur RE, Hecker S, et al. Definition and description of schizophrenia in the DSM-5. Schizophrenia Research, 2013; 150(1), 3–10.
• 2. Walker E, McGee RE, Druss BG. Mortality in mental disorders and global disease burden implications: A systematic review and meta-analysis. JAMA Psychiat. 2015; 72(4):334–41
• 3. Ösby U, Westman J, Hällgren J, Gissler M. Mortality trends in cardiovascular causes in schizophrenia, bipolar and unipolar mood disorder in Sweden 1987-2010. Eur J Public Health. 2016;26(5):867-871.
• 4. Correll CU, Solmi M, Veronese N, Bortolato B, Rosson S, Santonastaso P, et al. Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: a large‐scale meta‐analysis of 3,211,768 patients and 113,383,368 controls. World Psychiatry. 2017;16(2):163‐180.
• 5. Fan Z, Wu Y, Shen J, Ji T, Zhan R. Schizophrenia and the risk of cardiovascular diseases: A meta-analysis of thirteen cohort studies. Journal of Psychiatric Research 2013; 47(11).1549–1556
• 6. Mortality in Mental Disorders and Global Disease Burden Implications: JAMA Psychiatry. 2015 April ; 72(4): 334–341.
• 7. Kılıç AK, Yılmaz S. Türkiye’de ruhsal hastalığı olan bireylere yönelik kurum bakım hizmetleri ve bu hizmetlerde sosyal hizmet uygulamaları. Pamukkale Journal of Eurasian Socioeconomic Studies 2018; 5(1):1-14.
• 8. Ersan EE, Yıldız M. Bakımevinde yaşayan ve psikotik bozukluğu olan bireylerde antipsikotik ilaç kullanma örüntüsü. Arch Neuropsychiatr 2015; 52:145-150.
• 9. Aydın M, Altınbaş K, Odabaş Nal Ş, Kırcı Ercan S, Gıynaş Ayhan M, Usta A, et al. Toplum ruh sağlığı merkezlerine devam eden şizofreni hastalarının bakımevinde veya evlerinde yaşama durumlarına göre karşılaştırılması. Anadolu Psikiyatri Dergisi 2020; 21(1): 14 - 22.
• 10. D'Agostino RB Sr, Grundy S, Sullivan LM, Wilson P; CHD Risk Prediction Group. Validation of the Framingham coronary heart disease prediction scores: results of a multiple ethnic groups investigation. JAMA 2001;286(2):180-187
• 11. Kilicaslan EE, Merve Karakilic M, Almila Erol A. The Relationship between 10 Years Risk of Cardiovascular Disease and Schizophrenia Symptoms: Preliminary Results Psychiatry Investig 2019;16(12):933-939
• 12. Vancampfort D, Firth J, Correll CU, Solmi M, Siskind D, DeHert M,et al. The impact of pharmacological and non-pharmacological interventions to improve physical health outcomes in people with schizophrenia: a meta-review of meta-analyses of randomized controlled trials. World Psychiatry 2019;18:53–66.
• 13. American Psychiatric Association. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders Fifth Edition. Arlington. 2013.
• 14. Guy, W. Clinical Global Impressions, ECDEU Assessment Manual for Psychopharmacology, revised (DHEW Publ. No. ADM 76-338). National Institute of Mental Health, Rockville, 1976: 218-222.
• 15. Framingham Heart Study. Risk score profiles. Available from: http://www.framinghamheartstudy.org/risk.
• 16. Westman J, Eriksson SV, Gissler M. Increased cardiovascular mortality in people with schizophrenia: a 24-year national register study. Epidemiol Psychiatr Sci. 2018;27(5):519- 527.
• 17. Yazici MK, Anil Yagcioglu AE, Ertugrul A, Eni N, Karahan S, Karaagaoglu E, et al. The prevalence and clinical correlates of metabolic syndromein patients with schizophrenia: findings from a cohort in Turkey. Eur Arch Psychiatry Clin Neurosci 2011;261:69-78
• 18. Mitchell AJ, Lawrence D. Revascularisation and mortality rates following acute coronary syndromes in people with severe mental illness: comparative meta- analysis. The British Journal of Psychiatry 2011;198:434e41.
• 19. Engelli Bireylere Yönelik Özel Bakım Merkezleri Yönetmeliği 4 Kasım 2016 CUMA: Resmî Gazete Sayı : 29878 https://www.resmigazete.gov.tr/eskiler/2016/11/20161104-2.htm
• 20. Deenik J, Tenback DE, Tak ECPM, Rutters F, Hendriksen IJM, van Harten PN. Changes in physical and psychiatric health after a multidisciplinary lifestyle enhancing treatment for inpatients with severe mental illness: The MULTI study I. Schizophr Res. 2019;204:360-367.
• 21. De Hert M, Schreurs V, Sweers K, Van Eyck D, Hanssens L, Sinko S et al. Typical and atypical antipsychotics differentially affect long-term incidence rates of the metabolic syndrome in first- episode patients with schizophrenia: A retrospective chart review. Schizophr Res 2008;101:295-303
• 22. Shulman M, Miller A, Misher J, Tentler A. Managing cardiovascular disease risk in patients treated with antipsychotics: a multidisciplinary approach. J Multidiscip Healthc. 2014;7:489–50
• 23. Taipale H, Mittendorfer-Rutz E, Alexanderson K, Majak M, Mehtälä J, Hoti F,et al. JedeniusAntipsychotics and mortality in a nationwide cohort of 29,823 patients with schizophrenia. Schizophr Res. 2018;197:274- 280
• 24. Torniainen M, Mittendorfer-Rutz E, Tanskanen A, Björkenstam C, Suvisaari J, Alexanderson K, et al. Antipsychotic Treatment and Mortality in Schizophrenia. Schizophr Bull. 2015;41(3):656-63.
• 25. Goff DC, Sullivan LM, McEvoy JP, Meyer JM, Nasrallah HA, Daumit GL, et al. A comparison of ten-year cardiac risk estimates in schizophrenia patients from the CATIE study and matched controls. Schizophr Res. 2005;80(1):45-53.
• 26. Bobes J, Arango C, Aranda P, Carmena R, Garcia-Garcia M ,Rejas J. Cardiovascular and metabolic risk in outpatients with schizophrenia treated with antipsychotics: results of the CLAMORS Study. Schizophr Res. 2007;90(1):162-73
• 27. Savji N, Rockman CB, Skolnick AH, Guo Y, Adelman MA, Riles T, et al. Association between advanced age and vascular disease in different arterial territories: a population data base of over 3.6 million subjects. J Am Coll Cardiol. 2013; 61: 1736-43.
• 28. Dickerson F, Stallings C, Origoni A, Schroeder J, Khushalani S, Yolken R. Mortality in schizophrenia: clinical and serological predictors. Schizophr Bull. 2014;40(4):796-803
• 29. Chung KH, Chen PH, Kuo CJ, Tsai SY, Huang SH, Wu WC. Risk factors for early circulatory mortality in patients with schizophrenia. Psychiatry Res. 2018;267:7-11
• 30. Arangoa C, Bobes J, Kirkpatrick B, Garcia-Garcia M, Rejas J. Psychopathology, coronary heart disease and metabolic syndrome in schizo- phrenia spectrum patients with deficit versus non-deficit schizophrenia: Findings from the CLAMORS study. Eur Neuropsychopharmacol 2011;21:867-875.