Maladie cardiovasculaire et diabète chez les personnes atteintes d'une maladie mentale sévère 1ère partie : Epidémiologie et influence des médicaments psychotropes
Scheen, André; Gillain, Benoit; De Hert, Marc
2010 • In Médecine des Maladies Métaboliques, 4, p. 93-102
[fr] Les personnes atteintes de maladies mentales sévères telles que la schizophrénie, la dépression ou le trouble bipolaire sont en moins bonne santé physique et ont une espérance de vie moindre que la population générale. La surmortalité cardiovasculaire associée à la schizophrénie et au trouble bipolaire est en partie attribuée à une majoration des facteurs de risque coronarien modifiables : obésité, tabagisme, diabète, hypertension et dyslipidémie. Les antipsychotiques et peut-être d'autres psychotropes, les antidépresseurs par exemple, peuvent induire une prise de poids ou aggraver divers facteurs métaboliques de risque cardiovasculaire. Les patients présentant une maladie mentale sévère peuvent avoir un accès restreint à la médecine générale, avec des opportunités de dépistage et de prévention du risque cardiovasculaire inférieures à celles mises en place dans une population non-psychiatrique. L'European Psychiatric Association (EPA), soutenue par l'European Association for the Study of Diabetes (EASD) et l'European Society of Cardiology (ESC), a publié récemment une déclaration de position dans le but d'améliorer la prise en charge des patients souffrant de maladies mentales sévères. Ce premier article résume les données épidémiologiques concernant les maladies coronariennes et cérébro-vasculaires et le diabète dans cette population particulière ainsi que les conséquences cardio-métaboliques potentielles des psychotropes.Un second article décrira comment évaluer le risque de maladies cardiovasculaires et donnera des conseils quant à la prise en charge des facteurs de risque et du diabète dans la population psychiatrique. [en] People with severe mental illnesses, such as schizophrenia, depression or bipolar disorder, have worse physical health and reduced life expectancy compared to the general population. The excess cardiovascular mortality associated with schizophrenia and bipolar disorder is attributed in part to an increased risk of the modifiable coronary heart disease risk factors : obesity, smoking, diabetes, hypertension and dyslipidaemia. Antipsychotic medication and possibly other psychotropic medication like antidepressants can induce weight gain or worsen other metabolic cardiovascular risk factors. Patients may have limited access to general healthcare with less opportunity for cardiovascular risk screening and prevention than would be expected in a non-psychiatric population. The European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC) recently published a statement with the aim of improving the care of patients suffering from severe mental illness. This first paper summarizes the epidemiological data of coronary heart disease and stroke in this special population as well as the potential cardiometabolic consequences of psychotropic medications. A second article will explain how to evaluate the cardiovascular risk and give recommendations concerning the appropriate management of risk factors and diabetes in the psychiatric population.
Disciplines :
Endocrinology, metabolism & nutrition Cardiovascular & respiratory systems Psychiatry
Author, co-author :
Scheen, André ; Université de Liège - ULiège > Département des sciences cliniques > Diabétologie, nutrition et maladie métaboliques - Médecine interne générale
Gillain, Benoit
De Hert, Marc
Language :
French
Title :
Maladie cardiovasculaire et diabète chez les personnes atteintes d'une maladie mentale sévère 1ère partie : Epidémiologie et influence des médicaments psychotropes
Alternative titles :
[en] Cardiovascular disease and diabetes in patients with severe mental disease. 1st part : Epidemiology and influence of psychotropic medications.
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