Predictive value of cardiometabolic biomarkers and depressive symptoms for symptom severity and quality of life in patients with psychotic disorders

Cecilia Serrano de Haro Perez; Simone Ciufolini; Poonam Gardner Sood; Amir Krivoy; Allan H Young; Robin M Murray; Khalida Ismail; Zerrin Atakan; Kathryn Greenwood; Shubulade Smith; Fiona Gaughran; Mario F Juruena

doi:10.1016/j.jad.2021.10.038

Predictive value of cardiometabolic biomarkers and depressive symptoms for symptom severity and quality of life in patients with psychotic disorders

Cecilia Serrano de Haro Perez, Simone Ciufolini, Poonam Gardner Sood, Amir Krivoy, Allan H Young, Robin M Murray, Khalida Ismail, Zerrin Atakan, Kathryn Greenwood, Shubulade Smith, Fiona Gaughran, Mario F Juruena

King's College London
Department of Psychosis Studies
Psychology and Neuroscience
Univ London, Birkbeck University London, University College London, University of London Royal Veterinary College, University of London, St Georges University London, Imperial College London, Kings College London, Royal Holloway University London, Queen Mary University London, Div Populat Hlth Sci & Educ
Oncogenetics Unit, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Professor of Psychiatry and Medicine, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK.
Dept. of Psychological Medicine
Kings Coll London, Kings College London, University of London School of Pharmacy, University College London, University of London, Sch Pharm
Sussex Univ Hosp, University of Sussex, Sussex Cardiac Ctr
Senior Lecturer in Clinical Education
Department of Forensic and Neurodevelopmental Science
Lead Consultant Psychiatrist, National Psychosis Service, South London and Maudsley NHS Foundation Trust; and Reader, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, Denmark Hill, UK.
National Psychosis Service
Professor of Molecular Psychiatry, MRC London Institute for Medical Sciences; and Institute of Psychiatry, Psychology and Neuroscience, Kings College London; and the South London and Maudsley NHS Foundation Trust, UK.
Maudsley Advanced Treatment Service
SLaM South London and Maudsley NHS Foundation Trust
Department of Psychological Medicine

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

BACKGROUND: Patients with psychotic disorders show higher rates of the metabolic syndrome (MS) between the cluster of severe mental illnesses. Depressive symptoms can worsen outcomes of individuals with psychotic disorders. However, research on the association between MS and depression in psychotic disorders and their relevance to outcomes is lacking.

METHODS: We investigated the association between depression and cardiometabolic biomarkers in psychotic disorders and the predictive value of depressive symptoms on psychopathological severity and quality of life (QoL). 406 patients with psychotic disorders were recruited as part of the Improving Physical Health and Reducing Substance Use in Severe Mental Illness randomised controlled trial. Depression, psychotic symptoms, QoL, waist circumference, triglycerides, high-density lipoprotein cholesterol (HDL-C), blood pressure, and fasting glucose of patients were assessed at baseline and 12 months. Sensitivity analyses were conducted to test the effect of treatment.

RESULTS: More severe baseline symptoms of depression significantly predicted worse 12-month psychotic symptoms and lower mental health related QoL at 12 months. These associations held after controlling for alcohol use, gender, ethnicity, education, and mental health related QoL Baseline. Depressive symptoms also correlated with waist circumference at both baseline and 12 months, after controlling for multiple testing.

CONCLUSION: Individuals with psychotic disorders experiencing more severe depressive symptoms are more likely to have larger waist circumference contemporaneously and 12 months later, as well as more severe psychotic symptoms and worse QoL at follow-up. This highlights the need for evaluation of strategies to address depression in the management of psychotic disorders.

Original language	English
Pages (from-to)	95-103
Number of pages	9
Journal	Journal of Affective Disorders
Volume	298
Early online date	8 Nov 2021
DOIs	https://doi.org/10.1016/j.jad.2021.10.038
Publication status	Published - 1 Feb 2022

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10.1016/j.jad.2021.10.038

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Perez, C. S. D. H., Ciufolini, S., Sood, P. G., Krivoy, A., Young, A. H., Murray, R. M., Ismail, K., Atakan, Z., Greenwood, K., Smith, S., Gaughran, F., & Juruena, M. F. (2022). Predictive value of cardiometabolic biomarkers and depressive symptoms for symptom severity and quality of life in patients with psychotic disorders. Journal of Affective Disorders, 298, 95-103. https://doi.org/10.1016/j.jad.2021.10.038

@article{c5d3563168214ffe86da555d85c9301b,

title = "Predictive value of cardiometabolic biomarkers and depressive symptoms for symptom severity and quality of life in patients with psychotic disorders",

abstract = "BACKGROUND: Patients with psychotic disorders show higher rates of the metabolic syndrome (MS) between the cluster of severe mental illnesses. Depressive symptoms can worsen outcomes of individuals with psychotic disorders. However, research on the association between MS and depression in psychotic disorders and their relevance to outcomes is lacking.METHODS: We investigated the association between depression and cardiometabolic biomarkers in psychotic disorders and the predictive value of depressive symptoms on psychopathological severity and quality of life (QoL). 406 patients with psychotic disorders were recruited as part of the Improving Physical Health and Reducing Substance Use in Severe Mental Illness randomised controlled trial. Depression, psychotic symptoms, QoL, waist circumference, triglycerides, high-density lipoprotein cholesterol (HDL-C), blood pressure, and fasting glucose of patients were assessed at baseline and 12 months. Sensitivity analyses were conducted to test the effect of treatment.RESULTS: More severe baseline symptoms of depression significantly predicted worse 12-month psychotic symptoms and lower mental health related QoL at 12 months. These associations held after controlling for alcohol use, gender, ethnicity, education, and mental health related QoL Baseline. Depressive symptoms also correlated with waist circumference at both baseline and 12 months, after controlling for multiple testing.CONCLUSION: Individuals with psychotic disorders experiencing more severe depressive symptoms are more likely to have larger waist circumference contemporaneously and 12 months later, as well as more severe psychotic symptoms and worse QoL at follow-up. This highlights the need for evaluation of strategies to address depression in the management of psychotic disorders.",

author = "Perez, {Cecilia Serrano de Haro} and Simone Ciufolini and Sood, {Poonam Gardner} and Amir Krivoy and Young, {Allan H} and Murray, {Robin M} and Khalida Ismail and Zerrin Atakan and Kathryn Greenwood and Shubulade Smith and Fiona Gaughran and Juruena, {Mario F}",

note = "Funding Information: This paper summarises independent research funded by the National Institute for Health Research (NIHR) under its IMPACT Programme (Grant Reference Number RP-PG- 0606–1049) in collaboration with Genetics and Psychosis Project funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. FG is in part supported by the National Institute for Health Research{\textquoteright}s (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, the Maudsley Charity and the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust. Professor Young's research is funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. Dr Juruena's independent research is funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London Maudsley NHS Foundation Trust (SLaM), King's College London and SLaM. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health, or the Department of Health and Social Care. Funding Information: This paper summarises independent research funded by the National Institute for Health Research (NIHR) under its IMPACT Programme (Grant Reference Number RP-PG- 0606?1049) in collaboration with Genetics and Psychosis Project funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. FG is in part supported by the National Institute for Health Research's (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, the Maudsley Charity and the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust. Professor Young's research is funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. Dr Juruena's independent research is funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London Maudsley NHS Foundation Trust (SLaM), King's College London and SLaM. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health, or the Department of Health and Social Care. Publisher Copyright: {\textcopyright} 2021",

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doi = "10.1016/j.jad.2021.10.038",

language = "English",

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Perez, CSDH, Ciufolini, S, Sood, PG, Krivoy, A, Young, AH , Murray, RM , Ismail, K, Atakan, Z, Greenwood, K, Smith, S , Gaughran, F & Juruena, MF 2022, 'Predictive value of cardiometabolic biomarkers and depressive symptoms for symptom severity and quality of life in patients with psychotic disorders', Journal of Affective Disorders, vol. 298, pp. 95-103. https://doi.org/10.1016/j.jad.2021.10.038

TY - JOUR

T1 - Predictive value of cardiometabolic biomarkers and depressive symptoms for symptom severity and quality of life in patients with psychotic disorders

AU - Perez, Cecilia Serrano de Haro

AU - Ciufolini, Simone

AU - Sood, Poonam Gardner

AU - Krivoy, Amir

AU - Young, Allan H

AU - Murray, Robin M

AU - Ismail, Khalida

AU - Atakan, Zerrin

AU - Greenwood, Kathryn

AU - Smith, Shubulade

AU - Gaughran, Fiona

AU - Juruena, Mario F

N1 - Funding Information: This paper summarises independent research funded by the National Institute for Health Research (NIHR) under its IMPACT Programme (Grant Reference Number RP-PG- 0606–1049) in collaboration with Genetics and Psychosis Project funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. FG is in part supported by the National Institute for Health Research’s (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, the Maudsley Charity and the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust. Professor Young's research is funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. Dr Juruena's independent research is funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London Maudsley NHS Foundation Trust (SLaM), King's College London and SLaM. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health, or the Department of Health and Social Care. Funding Information: This paper summarises independent research funded by the National Institute for Health Research (NIHR) under its IMPACT Programme (Grant Reference Number RP-PG- 0606?1049) in collaboration with Genetics and Psychosis Project funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. FG is in part supported by the National Institute for Health Research's (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, the Maudsley Charity and the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust. Professor Young's research is funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. Dr Juruena's independent research is funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London Maudsley NHS Foundation Trust (SLaM), King's College London and SLaM. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health, or the Department of Health and Social Care. Publisher Copyright: © 2021

PY - 2022/2/1

Y1 - 2022/2/1

N2 - BACKGROUND: Patients with psychotic disorders show higher rates of the metabolic syndrome (MS) between the cluster of severe mental illnesses. Depressive symptoms can worsen outcomes of individuals with psychotic disorders. However, research on the association between MS and depression in psychotic disorders and their relevance to outcomes is lacking.METHODS: We investigated the association between depression and cardiometabolic biomarkers in psychotic disorders and the predictive value of depressive symptoms on psychopathological severity and quality of life (QoL). 406 patients with psychotic disorders were recruited as part of the Improving Physical Health and Reducing Substance Use in Severe Mental Illness randomised controlled trial. Depression, psychotic symptoms, QoL, waist circumference, triglycerides, high-density lipoprotein cholesterol (HDL-C), blood pressure, and fasting glucose of patients were assessed at baseline and 12 months. Sensitivity analyses were conducted to test the effect of treatment.RESULTS: More severe baseline symptoms of depression significantly predicted worse 12-month psychotic symptoms and lower mental health related QoL at 12 months. These associations held after controlling for alcohol use, gender, ethnicity, education, and mental health related QoL Baseline. Depressive symptoms also correlated with waist circumference at both baseline and 12 months, after controlling for multiple testing.CONCLUSION: Individuals with psychotic disorders experiencing more severe depressive symptoms are more likely to have larger waist circumference contemporaneously and 12 months later, as well as more severe psychotic symptoms and worse QoL at follow-up. This highlights the need for evaluation of strategies to address depression in the management of psychotic disorders.

AB - BACKGROUND: Patients with psychotic disorders show higher rates of the metabolic syndrome (MS) between the cluster of severe mental illnesses. Depressive symptoms can worsen outcomes of individuals with psychotic disorders. However, research on the association between MS and depression in psychotic disorders and their relevance to outcomes is lacking.METHODS: We investigated the association between depression and cardiometabolic biomarkers in psychotic disorders and the predictive value of depressive symptoms on psychopathological severity and quality of life (QoL). 406 patients with psychotic disorders were recruited as part of the Improving Physical Health and Reducing Substance Use in Severe Mental Illness randomised controlled trial. Depression, psychotic symptoms, QoL, waist circumference, triglycerides, high-density lipoprotein cholesterol (HDL-C), blood pressure, and fasting glucose of patients were assessed at baseline and 12 months. Sensitivity analyses were conducted to test the effect of treatment.RESULTS: More severe baseline symptoms of depression significantly predicted worse 12-month psychotic symptoms and lower mental health related QoL at 12 months. These associations held after controlling for alcohol use, gender, ethnicity, education, and mental health related QoL Baseline. Depressive symptoms also correlated with waist circumference at both baseline and 12 months, after controlling for multiple testing.CONCLUSION: Individuals with psychotic disorders experiencing more severe depressive symptoms are more likely to have larger waist circumference contemporaneously and 12 months later, as well as more severe psychotic symptoms and worse QoL at follow-up. This highlights the need for evaluation of strategies to address depression in the management of psychotic disorders.

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U2 - 10.1016/j.jad.2021.10.038

DO - 10.1016/j.jad.2021.10.038

M3 - Article

C2 - 34699852

SN - 0165-0327

VL - 298

SP - 95

EP - 103

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

ER -

Predictive value of cardiometabolic biomarkers and depressive symptoms for symptom severity and quality of life in patients with psychotic disorders

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