Increased risk of diabetes mellitus among persons with psychotic symptoms: results from the WHO World Health Survey

Roberto Nuevo, Somnath Chatterji, David Fraguas, Emese Verdes, Nirmala Naidoo, Celso Arango, José Luis Ayuso-Mateos

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To analyze with a symptom-based approach the relationship between psychosis and diabetes mellitus in the general population.

METHOD: Nationally representative samples from the World Health Organization (WHO) World Health Survey, totaling 224,743 randomly selected adults 18 years and older from 52 countries worldwide, were interviewed to establish the presence of psychotic symptoms and diabetes mellitus. Presence of psychotic symptoms was established using questions pertaining to positive symptoms from the psychosis screening module of the Composite International Diagnostic Interview. Presence of diabetes was established with a response of "yes" to the question, "Have you ever been diagnosed with diabetes (high blood sugar)?" The World Health Survey was conducted between 2002 and 2004.

RESULTS: An increasing number of psychotic symptoms was related to increasing likelihood of diabetes mellitus (OR = 1.27; 95% CI, 1.24-1.30). As compared to no symptoms, at least 1 psychotic symptom substantially elevated the risk (OR = 1.71; 95% CI, 1.61-1.81). In people with a lifetime diagnosis of schizophrenia or psychosis, the prevalence of diabetes was higher in those with current psychotic symptoms (7.3% vs 5.2%; OR = 1.65; 95% CI, 1.21-2.26), suggesting that the persistence of symptoms over time could play a central role. After controlling for different potential confounders, there was a clear increase in the probability of having diabetes as the number of psychotic symptoms increased. The relationship between psychotic symptoms and diabetes was tested with multiple mediation models and path analyses for categorical outcomes. Only body mass index appeared as a relevant mediator in a model with a good fit (ie, χ21 = 3.2, P = .0742; comparative fit index = 0.999).

CONCLUSIONS: Psychotic symptoms are related to increased rates of diabetes mellitus in nonclinical samples, independent of several potential confounders-including a clinical diagnosis of psychosis or schizophrenia, previous antipsychotic treatment, depression, lifestyle, and individual or country socioeconomic status. The findings highlight the worldwide relevance of the problem and the importance of identifying the specific paths of this association.

Original languageEnglish
Pages (from-to)1592-9
Number of pages8
JournalJournal of Clinical Psychiatry
Volume72
Issue number12
DOIs
Publication statusPublished - Dec 2011

Fingerprint

Health Surveys
Psychotic Disorders
Diabetes Mellitus
Schizophrenia
Social Class
Antipsychotic Agents
Blood Glucose
Life Style
Body Mass Index
Interviews
Depression
Global Health
Population

Bibliographical note

© Copyright 2011 Physicians Postgraduate Press, Inc.

Keywords

  • World Health Organization
  • time factors
  • schizophrenia
  • comorbidity
  • diabetes mellitus
  • risk
  • health surveys
  • psychological interview
  • prevalence
  • psychotic disorders

Cite this

Nuevo, R., Chatterji, S., Fraguas, D., Verdes, E., Naidoo, N., Arango, C., & Ayuso-Mateos, J. L. (2011). Increased risk of diabetes mellitus among persons with psychotic symptoms: results from the WHO World Health Survey. Journal of Clinical Psychiatry, 72(12), 1592-9. https://doi.org/10.4088/JCP.10m06801
Nuevo, Roberto ; Chatterji, Somnath ; Fraguas, David ; Verdes, Emese ; Naidoo, Nirmala ; Arango, Celso ; Ayuso-Mateos, José Luis. / Increased risk of diabetes mellitus among persons with psychotic symptoms : results from the WHO World Health Survey. In: Journal of Clinical Psychiatry. 2011 ; Vol. 72, No. 12. pp. 1592-9.
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Nuevo, R, Chatterji, S, Fraguas, D, Verdes, E, Naidoo, N, Arango, C & Ayuso-Mateos, JL 2011, 'Increased risk of diabetes mellitus among persons with psychotic symptoms: results from the WHO World Health Survey', Journal of Clinical Psychiatry, vol. 72, no. 12, pp. 1592-9. https://doi.org/10.4088/JCP.10m06801

Increased risk of diabetes mellitus among persons with psychotic symptoms : results from the WHO World Health Survey. / Nuevo, Roberto; Chatterji, Somnath; Fraguas, David; Verdes, Emese; Naidoo, Nirmala; Arango, Celso; Ayuso-Mateos, José Luis.

In: Journal of Clinical Psychiatry, Vol. 72, No. 12, 12.2011, p. 1592-9.

Research output: Contribution to journalArticle

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T1 - Increased risk of diabetes mellitus among persons with psychotic symptoms

T2 - results from the WHO World Health Survey

AU - Nuevo, Roberto

AU - Chatterji, Somnath

AU - Fraguas, David

AU - Verdes, Emese

AU - Naidoo, Nirmala

AU - Arango, Celso

AU - Ayuso-Mateos, José Luis

N1 - © Copyright 2011 Physicians Postgraduate Press, Inc.

PY - 2011/12

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N2 - OBJECTIVE: To analyze with a symptom-based approach the relationship between psychosis and diabetes mellitus in the general population.METHOD: Nationally representative samples from the World Health Organization (WHO) World Health Survey, totaling 224,743 randomly selected adults 18 years and older from 52 countries worldwide, were interviewed to establish the presence of psychotic symptoms and diabetes mellitus. Presence of psychotic symptoms was established using questions pertaining to positive symptoms from the psychosis screening module of the Composite International Diagnostic Interview. Presence of diabetes was established with a response of "yes" to the question, "Have you ever been diagnosed with diabetes (high blood sugar)?" The World Health Survey was conducted between 2002 and 2004.RESULTS: An increasing number of psychotic symptoms was related to increasing likelihood of diabetes mellitus (OR = 1.27; 95% CI, 1.24-1.30). As compared to no symptoms, at least 1 psychotic symptom substantially elevated the risk (OR = 1.71; 95% CI, 1.61-1.81). In people with a lifetime diagnosis of schizophrenia or psychosis, the prevalence of diabetes was higher in those with current psychotic symptoms (7.3% vs 5.2%; OR = 1.65; 95% CI, 1.21-2.26), suggesting that the persistence of symptoms over time could play a central role. After controlling for different potential confounders, there was a clear increase in the probability of having diabetes as the number of psychotic symptoms increased. The relationship between psychotic symptoms and diabetes was tested with multiple mediation models and path analyses for categorical outcomes. Only body mass index appeared as a relevant mediator in a model with a good fit (ie, χ21 = 3.2, P = .0742; comparative fit index = 0.999).CONCLUSIONS: Psychotic symptoms are related to increased rates of diabetes mellitus in nonclinical samples, independent of several potential confounders-including a clinical diagnosis of psychosis or schizophrenia, previous antipsychotic treatment, depression, lifestyle, and individual or country socioeconomic status. The findings highlight the worldwide relevance of the problem and the importance of identifying the specific paths of this association.

AB - OBJECTIVE: To analyze with a symptom-based approach the relationship between psychosis and diabetes mellitus in the general population.METHOD: Nationally representative samples from the World Health Organization (WHO) World Health Survey, totaling 224,743 randomly selected adults 18 years and older from 52 countries worldwide, were interviewed to establish the presence of psychotic symptoms and diabetes mellitus. Presence of psychotic symptoms was established using questions pertaining to positive symptoms from the psychosis screening module of the Composite International Diagnostic Interview. Presence of diabetes was established with a response of "yes" to the question, "Have you ever been diagnosed with diabetes (high blood sugar)?" The World Health Survey was conducted between 2002 and 2004.RESULTS: An increasing number of psychotic symptoms was related to increasing likelihood of diabetes mellitus (OR = 1.27; 95% CI, 1.24-1.30). As compared to no symptoms, at least 1 psychotic symptom substantially elevated the risk (OR = 1.71; 95% CI, 1.61-1.81). In people with a lifetime diagnosis of schizophrenia or psychosis, the prevalence of diabetes was higher in those with current psychotic symptoms (7.3% vs 5.2%; OR = 1.65; 95% CI, 1.21-2.26), suggesting that the persistence of symptoms over time could play a central role. After controlling for different potential confounders, there was a clear increase in the probability of having diabetes as the number of psychotic symptoms increased. The relationship between psychotic symptoms and diabetes was tested with multiple mediation models and path analyses for categorical outcomes. Only body mass index appeared as a relevant mediator in a model with a good fit (ie, χ21 = 3.2, P = .0742; comparative fit index = 0.999).CONCLUSIONS: Psychotic symptoms are related to increased rates of diabetes mellitus in nonclinical samples, independent of several potential confounders-including a clinical diagnosis of psychosis or schizophrenia, previous antipsychotic treatment, depression, lifestyle, and individual or country socioeconomic status. The findings highlight the worldwide relevance of the problem and the importance of identifying the specific paths of this association.

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KW - time factors

KW - schizophrenia

KW - comorbidity

KW - diabetes mellitus

KW - risk

KW - health surveys

KW - psychological interview

KW - prevalence

KW - psychotic disorders

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