Metabolic Syndrome and Illness Severity Predict Relapse at 1-Year Follow-Up in Schizophrenia: The FACE-SZ Cohort

Marion Leboyer, MD, PhD; Laurent Boyer, MD, PhD; Christophe Lancon, MD, PhD; Pierre Vidailhet, MD, PhD; Caroline Dubertret, MD, PhD; Jean-Michel Dorey, MSc; Paul Roux, MD, PhD; David Misdrahi, MD; Delphine Capdevielle, MD, PhD; Bruno Aouizerate, MD, PhD; Fabrice Berna, MD, PhD; Isabelle Chereau, MD; Julien Dubreucq, MD; Jasmina Mallet, MD, PhD; Romain Rey, MD; Christine Passerieux, MD, PhD; Ophélia Godin, PhD; Dominique Costagliola, PhD; Frank Schürhoff, MD, PhD; Myrtille Andre, PhD; Meja Andrianarisoa, MD, PhD; Catherine Faget, MD; Sylvain Leignier, MSc; Guillaume Fond, MD, PhD

J Clin Psychiatry 2018;79(6):17m12007

Article Abstract

Objective: Predicting relapse is a major challenge in schizophrenia from a clinical and medico-economic point of view. During recent decades, major psychiatric disorders have been found to be extensively associated with metabolic disorders, even before the illness onset, with a prevalence estimated to be 35% in this population. However, no study to date has, to our knowledge, explored the potential impact of metabolic syndrome (MetS) on relapse.

Methods: From 2010 to 2016, 185 patients (mean age = 32 years) with a DSM-IV-TR diagnosis of schizophrenia were included in the FondaMental Academic Centers of Expertise for Schizophrenia (FACE-SZ) cohort and followed up for 1 year. Multivariable logistic regression was performed to estimate the adjusted odds ratio for relapse.

Results: Thirty-seven percent of stabilized outpatients with schizophrenia (mean illness duration = 11 years) experienced a relapse at least once during the 1 year of follow-up. MetS strongly predicted relapse at 1 year, independently of illness severity, insight into illness, and treatment characteristics (including medication compliance). Patients with MetS at baseline had a 3 times higher risk (95% CI, 1.1-8.4) of experiencing a new episode of psychosis during the 12 months of follow-up.

Conclusions: Further studies should determine if reducing or preventing MetS could help to protect subjects with schizophrenia from relapse.

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