从个人到群体--一个慢性精神分裂症患者的病史解剖..pptVIP

* * * * * * * * Cardiovascular Disease (CVD) Risk Factors1 There is growing evidence that patients with major mental disorders have a higher prevalence of key cardiovascular risk factors; this may explain the observation of higher rates of cardiovascular disease in mental health populations. The estimated prevalences of several modifiable risk factors for cardiovascular disease, including obesity, smoking, diabetes, hypertension, and dyslipidemia, are shown here. These risks factors represent a target for intervention. Reference: Newcomer JW. Medical Risk in Patients With Bipolar Disorder and Schizophrenia. J Clin Psychiatry 2006;67 (suppl 9):25-30. * * 除了肥胖，精神分裂症患者比正常人还更多出现代谢综合征，而且随着病程越长，代谢综合征发病率越高。 根据国际糖尿病联盟规定的代谢综合征标准，35-45岁及45-55岁的精神分裂症患者中有1/3-1/2的患有代谢综合征；当精神分裂症患者的病程长达20年以上时，代谢综合征的发生率已高达一半。 * * * One-Year Weight Gain: Mean Change From Baseline Weight For the most part, antipsychotics are not used as short-term therapies. They are used as chronic therapies, principally for psychotic disorders and bipolar disorders. This graph depicts 1-year data for mean changes from baseline weight in long-term clinical trials; kilograms are on the left and the corresponding pounds are on the right of the graph.1,2 Note at the bottom of the slide that the drugs ziprasidone and aripiprazole, which produced relatively minimal short-term weight gain, produced about the same amount of weight gain long-term, or an ~1-kg mean weight gain at 52 weeks.1 Amisulpride, risperidone, and quetiapine produced an approximately 2.3-kg, 2.5-kg, and 3.6-kg weight gain, respectively, over a year.1,2 There are 2 lines for olanzapine; the first is pooling together all doses of olanzapine, from 2.5 mg up to 17.5 mg, from the pooled clinical trial data sets, resulting in a mean increase in weight at 1 year of about 6 kg or about 13 lb. For most antipsychotic therapy, 2.5 mg of olanzapine is not used. In other analyses of these data, the mean increase exceeded 22 lb, or more than 10 kg at 52 w