The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Schizophrenia Trial: Clinical comparison of subgroups with and without the metabolic syndrome

Jonathan M. Meyer, Henry A. Nasrallah, Joseph Patrick McEvoy, Donald C. Goff, Sonia M. Davis, Miranda Chakos, Jayendra K. Patel, Richard S.E. Keefe, T. Scott Stroup, Jeffrey A. Lieberman

Research output: Contribution to journalArticle

154 Citations (Scopus)

Abstract

The metabolic syndrome (MS) is highly prevalent among patients with schizophrenia (current estimates 35-40%), yet no data exist on the correlation of this diagnosis with illness severity, neurocognitive or quality of life measures in this population. Methods: Using baseline data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Schizophrenia Trial, assignment of MS status was performed using an updated definition derived from the National Cholesterol Education Program (NCEP) criteria. Those with and without MS were compared on the basis of primary and secondary variables of interest from baseline data encompassing psychiatric, neurocognitive and quality of life measures. Results: Of 1460 subjects enrolled at baseline, MS status could be reliably assigned for 1231 subjects, with a prevalence of 35.8% using the NCEP derived criteria. After adjustment for age, gender, race, ethnicity and site variance, those with MS rated themselves significantly lower on physical health by SF-12 (p < .001), and scored higher on somatic preoccupation (PANSS item G1) (p = .03). There were no significant differences between the two cohorts on measures of symptom severity, depression, quality of life, neurocognition, or self-rated mental health. Neither years of antipsychotic exposure nor alcohol usage were significant predictors of MS status when adjusted for age, gender, race, and ethnicity. Conclusions: The metabolic syndrome is highly prevalent in this large cohort of schizophrenia patients and is strongly associated with a poor self-rating of physical health and increased somatic preoccupation. These results underscore the need for mental health practitioners to take an active role in the health monitoring of patients with schizophrenia to minimize the impact of medical comorbidity on long-term mortality and on daily functioning. Outcomes data from CATIE will provide important information on the metabolic and clinical impact of antipsychotic treatment for those subjects with MS and other medical comorbidities.

Original languageEnglish (US)
Pages (from-to)9-18
Number of pages10
JournalSchizophrenia Research
Volume80
Issue number1
DOIs
StatePublished - Dec 1 2005

Fingerprint

Antipsychotic Agents
Schizophrenia
Clinical Trials
Quality of Life
Comorbidity
Mental Health
Health
Cholesterol
Education
Physiologic Monitoring
Psychiatry
Alcohols
Depression
Mortality
Population

Keywords

  • Comorbidity
  • Health
  • Metabolic syndrome
  • Rating
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Schizophrenia Trial : Clinical comparison of subgroups with and without the metabolic syndrome. / Meyer, Jonathan M.; Nasrallah, Henry A.; McEvoy, Joseph Patrick; Goff, Donald C.; Davis, Sonia M.; Chakos, Miranda; Patel, Jayendra K.; Keefe, Richard S.E.; Stroup, T. Scott; Lieberman, Jeffrey A.

In: Schizophrenia Research, Vol. 80, No. 1, 01.12.2005, p. 9-18.

Research output: Contribution to journalArticle

Meyer, Jonathan M. ; Nasrallah, Henry A. ; McEvoy, Joseph Patrick ; Goff, Donald C. ; Davis, Sonia M. ; Chakos, Miranda ; Patel, Jayendra K. ; Keefe, Richard S.E. ; Stroup, T. Scott ; Lieberman, Jeffrey A. / The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Schizophrenia Trial : Clinical comparison of subgroups with and without the metabolic syndrome. In: Schizophrenia Research. 2005 ; Vol. 80, No. 1. pp. 9-18.
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abstract = "The metabolic syndrome (MS) is highly prevalent among patients with schizophrenia (current estimates 35-40{\%}), yet no data exist on the correlation of this diagnosis with illness severity, neurocognitive or quality of life measures in this population. Methods: Using baseline data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Schizophrenia Trial, assignment of MS status was performed using an updated definition derived from the National Cholesterol Education Program (NCEP) criteria. Those with and without MS were compared on the basis of primary and secondary variables of interest from baseline data encompassing psychiatric, neurocognitive and quality of life measures. Results: Of 1460 subjects enrolled at baseline, MS status could be reliably assigned for 1231 subjects, with a prevalence of 35.8{\%} using the NCEP derived criteria. After adjustment for age, gender, race, ethnicity and site variance, those with MS rated themselves significantly lower on physical health by SF-12 (p < .001), and scored higher on somatic preoccupation (PANSS item G1) (p = .03). There were no significant differences between the two cohorts on measures of symptom severity, depression, quality of life, neurocognition, or self-rated mental health. Neither years of antipsychotic exposure nor alcohol usage were significant predictors of MS status when adjusted for age, gender, race, and ethnicity. Conclusions: The metabolic syndrome is highly prevalent in this large cohort of schizophrenia patients and is strongly associated with a poor self-rating of physical health and increased somatic preoccupation. These results underscore the need for mental health practitioners to take an active role in the health monitoring of patients with schizophrenia to minimize the impact of medical comorbidity on long-term mortality and on daily functioning. Outcomes data from CATIE will provide important information on the metabolic and clinical impact of antipsychotic treatment for those subjects with MS and other medical comorbidities.",
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