Cardiovascular and metabolic risk in outpatients with schizoaffective disorder treated with antipsychotics: results from the CLAMORS study.

AIM To assess the coronary heart disease (CHD) risk and prevalence of the metabolic syndrome (MS) in patients with schizoaffective disorder (SD) receiving antipsychotics. METHODS Patients meeting DSM-IV criteria for SD and receiving antipsychotic treatment were recruited in a retrospective, cross-sectional, multicenter study (the CLAMORS study). MS was defined as at least three of the following components: waist circumference greater than 102 cm (men)/greater than 88 cm (women); serum triglycerides greater or equal to 150 mg/dl; HDL cholesterol less than 40 mg/dl (men)/less than 50 mg/dl (women); blood pressure greater or equal to 130/85 mmHg; fasting blood glucose greater or equal to 110 mg/dl. The 10-year CHD risk was assessed by the Systematic coronary risk evaluation (SCORE) (cardiovascular mortality) and Framingham (any cardiovascular event) functions. Clinical severity was assessed using the PANSS and CGI-S scales. RESULTS A total of 268 valuable patients with SD (127 men, 48.1%), 41.9±12.3 years (mean±S.D.), were analyzed. The 10-year overall cardiovascular mortality and CV-event risk were 0.8±1.6 (SCORE) and 6.5±6.8 (Framingham), respectively. A high/very high risk of any CV event (Framingham≥10%) was associated with severity [CGI-S=3-4; OR: 4.32 (1.15-16.26), P=0.03)]. MS was present in 26.5% (95%CI: 21.2-31.8) of subjects, without gender differences, but significantly associated with patient's impression of severity: CGI=3-4; OR=1.90 (0.83-4.36), and CGI=5-7; OR=3.13 (1.06-9.24), P=0<0.001, and age [OR=1.91 (1.09-3.34), P<0.024)]. CONCLUSIONS CHD risk and MS prevalence were high among patients with SD, being MS prevalence associated with age and severity of disease.