Metabolic Syndrome And Psychiatric Illness

Metabolic syndrome is a set of risk factors that includes: abdominal obesity, a decreased ability to process glucose (insulin resistance), dyslipidemia (unhealthy lipid levels), and hypertension. Patients who have this syndrome have been shown to be at an increased risk of developing cardiovascular disease and/or type 2 diabetes. Metabolic syndrome is a common condition that goes by many names (dysmetabolic syndrome, syndrome X, insulin resistance syndrome, obesity syndrome, and Reaven's syndrome). This is the first book to fully explain the relationships between psychiatric illness, Metabolic Syndrome, diet, sleep, exercise, medications, and lifestyle choices. Metabolic Syndrome is a major risk factor in Major Depression, Alzheimer's Disease, Sleep Disorders, Sexual Dysfunction, Fibromyalgia, and several other illnesses of psychiatric significance. Conversely, some psychiatric illnesses tend to predispose patients to Metabolic Syndrome. Of further interest is the fact that some of the medications used in the treatment of psychiatric illnesses have been found to cause or exacerbate Metabolic Syndrome. The author here provides basic information about what genetic predispositions, medical conditions, and lifestyle choices make Metabolic Syndrome more likely to occur. Among the contributing factors that are discussed are genetics, habitual intake of high glycemic index carbohydrates, fructose, saturated fats, trans fatty acids, vitamins, micronutrients, obesity, smoking, and lack of exercise. The author describes the actual mechanisms by which Metabolic Syndrome progresses and causes damage in the body, including the action of insulin and the pathophysiology of insulin resistance. Details are provided on what occurs in the liver, pancreas, muscle, fat cells, and immune system as Metabolic Syndrome progresses. New findings are presented on fat cells, including the fact that they are beginning to be considered as endocrine cells. There is a substantive discussion of leptin, which is one of the important adipocytokines. Also carbohydrate, 'bad fats', inflammation, oxidative damage, over-stimulation of the 'fight or flight' system, and high levels of the stress hormone cortisol can actually cause the manifestations of Metabolic Syndrome. These explanations set the stage for an explanation of the inter-relationships between Metabolic Syndrome, psychiatric illness, dementia and effects of not only diet and life choices, but also the effects of psychiatric medications. Finally, there is an important and unique section on the relationship between Metabolic Syndrome and various psychiatric illnesses, and how they exacerbate each other. The significance of Metabolic Syndrome in Major Depression, Bipolar Affective Disorder, Schizophrenia, fibromyalgia and Polycystic Ovary Disease is vast and it is important to realise the effects of psychiatric medications on Metabolic Syndrome. The author discusses antidepressants, mood stabilizers and the new atypical antipsychotics. There are dramatic differences among medications in the way they affect Metabolic Syndrome and pharmaceutical companies will want to promote patient awareness with this book.

Patients with mental and substance use disorders have shown higher rates of morbidity and mortality from medical illnesses than the general population, and physicians are also increasingly aware of adverse effects of psychiatric medications on metabolic and cardiovascular health. In light of these problems, this book addresses an important unmet need of patients with mental disorders -- namely, the lack of integration of general medical care with psychiatric care and the related problem of barriers to collaboration and communication among health care providers. Managing Metabolic Abnormalities in the Psychiatrically Ill is the first book to provide a current review of the relationships among psychiatric illnesses, metabolic abnormalities, and treatment, focusing on how clinicians can tailor care to those doubly-afflicted patients. The book integrates research findings into practical clinical guidelines that spell out what psychiatrists need to know when their patients with mental illness suffer from -- or are at risk of developing -- obesity, diabetes, cardiovascular disease, or the metabolic syndrome. The contributors address those risks that need to be considered in the overall context of treatment, background risks of medical illnesses associated with specific psychiatric disorders themselves, and the means of applying these data to treatment recommendations, monitoring, and clinical practice. Among the specific topics addressed are: Potential effects of psychotropics on appetite, body weight, and metabolic parameters in obese patients, and the potential effects of anti-obesity agents on psychotic, manic, and depressive syndromes Increased risk of type 2 diabetes among individuals with psychotic and mood disorders due to neurobiological changes and behavioral effects associated with these disorders Greater risk for cardiovascular disease among the mentally ill, stressing the importance of mental health providers understanding cardiovascular risk classification and modification strategies An association between dysregulation of glucose and lipid metabolism and the related risk of type 2 diabetes during treatment with any of the eight second-generation antipsychotics currently available in the United States Guidance in choice of medications and appropriate monitoring strategies for hyperlipidemia, along with recognition of which antipsychotics pose the greatest risk and an understanding of the common dyslipidemia patterns seen with their use Chapters include key clinical concepts, quick-reference tables, and extensive references, and a final chapter provides an assessment tool for evaluating patients' metabolic risk. Together, the chapters in this book constitute an authoritative clinical guide that enables psychiatrists to better integrate the treatment of patients' mental disorders with their metabolic conditions.

Major depression and bipolar disorder are chronic enduring serious mental illnesses (SMI) with devastating effects on psychosocial functioning and may culminate in suicide. Over the past years, it has become apparent that subjects with these conditions can also develop the metabolic syndrome, which is a series of obesity-related physical conditions with an endocrine basis. This book brings together reviews that help put into context exactly why subjects with SMI develop obesity, prediabetic status, overt type 2 diabetes mellitus and related cardiovascular events. The relationship between prolactin and bone mineral density in subjects under medical treatment and the underlying dopaminergic mechanisms as well as the immunological changes occurring as an integral part of SMI and their effects on endocrine function are discussed and reviewed. Psychiatrists, diabetologists, cardiologists, family practitioners, public health physicians as well as basic science researchers will find valuable guidelines when screening for type 2 diabetes mellitus and cardiovascular disease in SMI.

Major depressive disorder (MDD) is a serious, debilitating, life-shortening illness that affects many persons of all ages and backgrounds. The lifetime risk for MDD is 7-12% for men and 20-25% for women (Kessler et al., 2003). MDD is a disabling disorder that costs the U.S. over $200 billion per year in direct and indirect costs (Greenberg et al., 2015), and is the leading cause of disability worldwide (WHO, 2018). Depression also has detrimental effects on all aspects of social functioning (e.g., self-care, social role, and family life, including household, marital, kinship, and parental roles). While there have been several treatments that are efficacious, many individuals suffering from depression experience life-long challenges due to the chronic and episodic nature of the disease. Identifying strategies to find the right treatments for the right patients is critical. Ongoing research has explored the importance of examining physiologic biomarkers, as well as clinical characteristics to gain a better understanding of subtypes of depression, which will lead to improved treatments and better outcomes. This book provides an introduction to the etiology and pathophysiology of depression, common comorbidities and differential diagnoses, pharmacotherapy strategies, psychotherapeutic and neuromodulation interventions, novel and non-traditional treatment strategies, and considerations in special populations.

This practical guide helps nursing students and other healthcare professionals promote and improve the health and wellbeing of those with mental health problems by looking closely at the disparities that people with mental health problems face in relation to their physical health. It includes: • Evidence-based techniques such as motivational interviewing and promoting physical activity. • MCQs at the start of each chapter for readers to test their knowledge. • Reflection points, activities and case studies to link theory to practice. • Summaries of key messages to take away. This is essential reading for all nursing students and healthcare professionals.

This accessible, practical text provides mental health practitioners with the core knowledge and skills they need to be able to care effectively for the physical health of those who have been diagnosed with mental illness. Linked closely to professional standards, and with a clear values- and evidence-base, the book aims to raise awareness of the physical health needs of individuals with mental health problems, outline the physical health assessment process and suggest health enhancing interventions for use in clinical practice. Consideration will be given to the following aspects of physical wellbeing; - cardiovascular health - diabetes - sexual health - respiratory health - cancer - wound care - substance misuse - infection control - medicine management Further chapters on legal and ethical issues explain the need to practise appropriately within the Mental Health Act and the Mental Capacity Act, while a linking theme throughout the book stresses the importance of health promotion. Backed up by case examples and with a range of reflective exercises throughout, The Physical Care of People with Mental Health Problems is a key text for students and practitioners working in mental health services. It will also be useful reading for practice nurses, district nurses, midwives and all allied health practitioners.