Behavioral Interventions to Improve Management of Overweight, Obesity, and Diabetes in Patients with Schizophreniaedit
The relationship between schizophrenia and diabetes mellitus has been recognized in case reports since the end of the nineteenth century (Holt, Bushe, & Citrome, 2005). More recent data suggest that diabetes, obesity, and the metabolic syndrome are 1.5–2 times more common in patients with schizophrenia than in the general population (American Diabetes Association, American Psychiatric Association, American Association of Clinical Endocrinologists, & North American Association for the Study of Obesity, 2004; Henderson, 2005). Although the mechanisms of this relationship are not clearly understood, a combination of genetic and environmental factors (e.g., sedentary lifestyle, poor diet, and side effects of antipsychotic medications) may play a role in the high prevalence of metabolic dysregulation in this population (Citrome, 2004; Cohn, Prud’homme, Streiner, Kameh, & Remington, 2004; Henderson, Cagliero et al., 2006; De Hert et al., 2006; Lamberti et al., 2004; McEvoy et al., 2005). While some increased risk may be attributed to standard risk patterns (i.e., 17–50% of people with schizophrenia have a family history of diabetes; Mukherjee, Schnur, & Reddy, 1989), the high rates of obesity in patients with schizophrenia (Marder et al., 2004) may also contribute to increased risk, due, in part, to the relative weight gain liabilities of second-generation antipsychotics (Newcomer, 2005).