Metabolic syndrome, abdominal obesity and hyperuricemia in schizophrenia: Results from the FACE-SZ cohort

International audienceOBJECTIVE:Abdominal obesity was suggested to be a better predictor than Metabolic Syndrome (MetS) for cardiovascular mortality, however this is has not been extensively studied in schizophrenia. Hyperuricemia (HU) was also suggested to be both an independent risk factor for greater somatic comorbidity and a global metabolic stress marker in patients with schizophrenia. The aim of this study was to estimate the prevalence of MetS, abdominal obesity and HU, to examine the association between metabolic parameters with HU in a cohort of French patients with schizophrenia or schizo-affective disorder (SZ), and to estimate the prevalence rates of treatment of cardio-vascular risk factors.METHOD:240 SZ patients (age=31.4years, male gender 74.3%) were systematically included. Metabolic syndrome was defined according to the International Diabetes Federation and HU if serum uric acid level was above 360μmol/L.RESULTS:MetS, abdominal obesity and HU were found respectively in 24.2%, 21.3% and 19.6% of patients. In terms of risk factors, multiple logistic regression showed that after taking into account the potential confounders, the risk for HU was higher in males (OR=5.9, IC95 [1.7-21.4]) and in subjects with high waist circumference (OR=3.1, IC95 [1.1-8.3]) or hypertriglyceridemia (OR=4.9, IC95 [1.9-13]). No association with hypertension, low HDL cholesterol or high fasting glucose was observed. Only 10% of patients with hypertension received a specific treatment, 18% for high fasting glucose and 8% for dyslipidemia.CONCLUSIONS:The prevalence of MetS, abdominal obesity and hyperuricemia is elevated in French patients with schizophrenia, all of which are considerably under-diagnosed and undertreated. HU is strongly associated with abdominal obesity but not with psychiatric symptomatology

Medication and aggressiveness in real-world schizophrenia. Results from the FACE-SZ dataset

International audienceINTRODUCTION:The primary objective of this study was to determine if second-generation antipsychotic (SGA) administration was associated with lower aggressiveness scores compared to first-generation (FGA) in schizophrenia (SZ). The secondary objective was to determine if antidepressants, mood stabilizers, and benzodiazepines administration were respectively associated with lower aggressiveness scores compared to patients who were not administered these medications.METHODS:Three hundred thirty-one patients with schizophrenia (N = 255) or schizoaffective disorder (N = 76) (mean age = 32.5 years, 75.5 % male gender) were systematically included in the network of FondaMental Expert Center for Schizophrenia and assessed with the structured clinical interview for DSM-IV Axis I disorders and validated scales for psychotic symptomatology, insight, and compliance. Aggressiveness was measured by the Buss-Perry Aggression Questionnaire (BPAQ) score. Ongoing psychotropic treatment was recorded.RESULTS:Patients who received SGA had lower BPAQ scores than patients who did not (p = 0.01). More specifically, these patients had lower physical and verbal aggression scores. On the contrary, patients who received benzodiazepines had higher BPAQ scores than patients who did not (p = 0.04). No significant difference was found between BPAQ scores of patients respectively being administered mood stabilizers (including valproate), antidepressant, and the patients who were not. These results were found independently of socio-demographical variables, psychotic symptomatology, insight, compliance into treatment, daily-administered antipsychotic dose, the way of antipsychotic administration (oral vs long acting), current alcohol disorder, and daily cannabis consumption.CONCLUSION:The results of the present study are in favor of the choice of SGA in SZ patients with aggressiveness, but these results need further investigation in longitudinal studies. Given the potent side effects of benzodiazepines (especially dependency and cognitive impairment) and the results of the present study, their long-term prescription is not recommended in patients with schizophrenia and aggressive behavior

Peripheral sub-inflammation is associated with antidepressant ă consumption in schizophrenia. Results from the multi-center FACE-SZ data ă set

International audienceObjectives: The relation between C-Reactive Protein (CRP), depression ă and antidepressant consumption has been well explored in major ă depressive disorders but not in schizophrenia, which has a high rate of ă depression comorbidity. The objectives of this study were: (i) to ă determine the prevalence of abnormal CRP levels, depression and ă antidepressant consumption in a multicenter community-dwelling sample of ă subjects with schizophrenia (ii) to determine the association between ă abnormal CRP levels, depression and antidepressant consumption in ă schizophrenia. ă Method: 219 stable patients with schizophrenia (mean age=31.6 years, ă 75.3% male gender) were systematically included in the multicentre ă network of FondaMental Expert Center for schizophrenia (FACESZ) and ă assessed with a dedicated electronic medical record including the ă Structured Clinical Interview for DSM-IV Axis I Disorders and Calgary ă Depression Scale for depression. High sensitivity CRP (hs-CRP) was ă measured with an assay using nephelometry (Dade Behring). Abnormal CRP ă level was defined by levels > 3 mg/L. Current medication was recorded. ă Results: Overall, 63 subjects (28.8%) were found to have abnormal CRP ă levels, 43 (20.1%) received a diagnosis of comorbid current depression, ă and 51 (31.9%) had ongoing antidepressant treatment. In univariate ă analysis, abnormal CRP levels were found to be significantly associated ă with body mass index (BMI) (p 0.05). ă In a multivariate model, abnormal CRP was associated with antidepressant ă consumption independently of other confounding variables (adjusted Odds ă Ratio =2.8, 95% confidence interval 1.226.62). Metabolic syndrome was ă also independently associated with abnormal CRP (adjusted Odds Ratio = ă 2.6, 95% confidence interval 1.01-6.71). ă Conclusion: Abnormal CRP levels in schizophrenia were found to be ă associated with antidepressant consumption, but not with depression. The ă potential mechanisms were discussed. Antidepressant consumption should ă be systematically recorded in future studies exploring inflammation in ă schizophrenia. Future clinical trials of interventions directed at ă lowering the level of CRP and other inflammatory markers are discussed. ă (c) 2015 Elsevier BY. All rights reserved

Differential effects of childhood trauma and cannabis use disorders in ă patients suffering from schizophrenia

International audienceBackground: Childhood trauma (CT) and cannabis use are both ă environmental and modifier risk factors for schizophrenia. However, ă little is known about how they interact in schizophrenia. We examined ă the main effect of each of these two environmental factors on the ă clinical expression of the disease using a large set of variables, and ă we tested whether and how cannabis and CT interact to influence the ă course and the presentation of the illness. ă Methods: A sample of 366 patients who met the DSM-IV-TR criteria for ă schizophrenia was recruited through the FACE-SCZ (Fondamental Advanced ă Centre of Expertise - Schizophrenia) network. Patients completed a large ă standardized clinical evaluation including Structured Clinical Interview ă for DSM Disorders-I (SCID-I), Positive and Negative Symptoms Scale ă (PANSS), Columbia-Suicide Severity Rating Scale (C-SSRS), Global ă Assessment of Functioning (GAF), Short-Quality of Life-18 (S-QoL-18), ă and Medication Adherence Rating Scale (MARS). We assessed CT with the ă Childhood Trauma Questionnaire and cannabis status with SCID-I. ă Results: CT significantly predicted the number of hospitalizations, GAF, ă and S-QoL-18 scores, as well as the PANSS total, positive, excitement, ă and emotional distress scores. Cannabis use disorders significantly ă predicted age of onset, and MARS. There was no significant interaction ă between CT and cannabis use disorders. However, we found evidence of a ă correlation between these two risk factors. ă Conclusions: CT and cannabis both have differential deleterious effects ă on clinical and functional outcomes in patients with schizophrenia. Our ă results highlight the need to systematically assess the presence of ă these risk factors and adopt suitable therapeutic interventions. (C) ă 2016 Elsevier B.V. All rights reserved

Birth by cesarean section and schizophrenia: results from the multicenter FACE-SZ data-set

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