Physical health problems, specifically glucose/lipid metabolism and cardiovascular comorbidity, in schizophrenic patients have become a major focus in both clinical care and research in recent years. The association of schizophrenia with metabolic and other cardiovascular disease risk factors is a complex interplay between environmental (including lifestyle, diet and substance use), genetic and illness-related (such as specific symptoms) factors, as well as the effects of treatment. Both past and more recent studies have confirmed the high rate of premature mortality due to cardiovascular disease in people with schizophrenia. Moreover, antipsychotic medication per se may induce cardiovascular and metabolic abnormalities (such as obesity, hyperglycemia, dyslipidemia and the metabolic syndrome) that are associated with increased risks of type 2 diabetes mellitus and cardiovascular disease. Controversy remains about the contribution of individual antipsychotic drugs to this increased risk and whether they cause sudden cardiac death through prolongation of the corrected QT interval.
The need for screening, monitoring and prevention of metabolic and other cardiovascular disease risk factors has been acknowledged in the psychiatric literature. However, the evaluation of screening practices by clinicians has consistently shown that they are suboptimal.
In our facilities, we monitor the physical risks induced by novel antipsychotics by performing comprehensive examination for metabolic syndrome-related side effects and QT interval abnormality, and continue to follow the health of patients with schizophrenia. In this report, we introduce the results of research in our facilities, which is based on evidence reported in overseas countries, and attempt to show the preventive measures for each physical risk associated with novel antipsychotics.