How should people with schizophrenia be screened for heart disease and diabetes?

Adverse health behaviors and medication side effects may place people with schizophrenia at elevated risk for cardiometabolic problems including diabetes, high blood pressure, and high cholesterol. Clinical practice guidelines recommend the following tests at baseline and annually thereafter: medical history; weight, waist circumference and body mass index; glucose/hemoglobin A1c; lipids; and lifestyle advice. These tests should also be conducted at 6 and 12 weeks after starting a new antipsychotic medication. Nonfasting lipid and glucose tests may be acceptable alternatives to fasting labs. Screenings can be performed at mental health or medical clinics; results should be provided to both primary care and mental health providers.

REFERENCES

De Hert, M., Vancampfort, D., Correll, C.U., Mercken, V., Peuskens, J., Sweers, K., van Winkel, R., Mitchell, A.J. (2011)
Guidelines for screening and monitoring of cardiometabolic risk in schizophrenia: systematic evaluation. Br J Psychiatry, 199(2), 99-105. doi: 10.1192/bjp.bp.110.084665.
https://www.ncbi.nlm.nih.gov/pubmed/21804146

Vanderlip, E.R., Chwastiak, L.A., McCarron, R.M. (2014). Nonfasting screening for cardiovascular risk among individuals taking second-generation antipsychotics. Psychiatr Serv, 65(5), 573-6. doi: 10.1176/appi.ps.201400015.
https://www.ncbi.nlm.nih.gov/pubmed/24788735

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