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Background: Obesity has recently become a concern for physicians treating schizophrenic patients. Obesity is associated with hypertension, dyslipidemia, and diabetes mellitus. In this pilot study, we investigate which anthropometric measurement, body mass index or waist circumference, is a better predictor of cardiovascular risk factors in patients with schizophrenia., Method: This cross-sectional study, conducted from January 2001 to January 2002, examined body fat distribution and its relation to cardiovascular risk factors in 62 patients with schizophrenia (DSM-IV) recruited from an outpatient psychiatric clinic., Results: Chi-square analysis revealed that an increased waist circumference was associated with dyslipidemia (p < .01), hypertension (p < .05), and abnormal serum glucose (p < .05), whereas an increased body mass index was only associated with dyslipidemia (p < .05). In logistic regression analysis, after controlling for age, gender, race, ethnicity, smoking, and body mass index, increased waist circumference remained significantly associated with dyslipidemia (odds ratio = 2.08, 95% CI = 1.01 to 1.15, p < .05) and hypertension (odds ratio = 2.05, 95% CI = 1.02 to 1.17, p < .05)., Conclusions: Waist circumference revealed a stronger correlation than body mass index to cardiovascular risk factors in patients with schizophrenia. We propose the measurement of waist circumference as a screening tool for cardiovascular risk factors in this population. Waist circumference measurement can provide an opportunity for primary prevention of coronary heart disease and diabetes mellitus in patients with schizophrenia.

Fourteen Hispanic and six non-Hispanic outpatients with HIV-spectrum illness and major depressive disorder were enrolled in a 6-week, open-label, flexible-dose study of citalopram (dose range=10-40 mg/day). The depressive symptoms of 50% of the 14 patients who completed the study responded to citalopram (mean dose=34 mg/day). The treatment response rate, effective citalopram dose, total number of reported adverse events, and attrition rate did not differ between the ethnic groups. Two patients discontinued because of adverse events (rash, nausea), and four patients discontinued because of noncompliance with the protocol. The findings suggest that citalopram is an effective and well-tolerated antidepressant for Hispanic and non-Hispanic HIV-infected patients.

BACKGROUND: Metabolic syndrome, a constellation of truncal obesity, dyslipidemia, disturbed insulin and glucose metabolism, and hypertension, is associated with the development of diabetes mellitus and coronary heart disease. However, the prevalence of metabolic syndrome in Hispanic patients with schizophrenia and whether they differ from comparable non-Hispanic patients is uncertain. METHOD: This cross-sectional study, conducted from January 2002 to May 2002, included 48 patients with schizophrenia who were recruited from an outpatient psychiatric clinic. Metabolic syndrome was defined using the criteria of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. RESULTS: The prevalence of metabolic syndrome was 63% in all patients with schizophrenia. The metabolic syndrome was present in 41% of non-Hispanic patients and in 74% of Hispanic patients with schizophrenia. Metabolic syndrome was present in 70% of Cuban Americans and 88% of other Hispanic subgroups with schizophrenia. Metabolic syndrome was associated with waist circumference (p <.05) and high-density lipoprotein cholesterol (p <.05) in logistic regression analysis. CONCLUSIONS: These data suggest that schizophrenic patients have a 3-fold greater risk to develop metabolic syndrome than the general population. Hispanic schizophrenic patients have a significantly greater prevalence of metabolic syndrome than non-Hispanic schizophrenic patients (p <.05). An increased waist circumference is the strongest clinical correlate with metabolic syndrome in schizophrenic patients.

To date, the authors know of no prospective studies of sustained-release bupropion in depressed HIV-seropositive patients. The purpose of this study was to evaluate the efficacy and tolerability of sustained-release bupropion in 20 depressed HIV-positive adult outpatients. Twenty outpatients with HIV spectrum illness, a DSM-IV-diagnosed major depressive disorder confirmed with the Structured Clinical Interview for DSM-IV, and Mini-Mental State Examination scores >20 were recruited into a 6-week, open-label, flexible-dose study of sustained-release bupropion (100-300 mg/day). Twelve patients (60%) responded to sustained-release bupropion at a mean dose of 265 mg/day. Five patients (25%) discontinued study participation secondary to adverse events. Preliminary findings suggest that sustained-release bupropion is effective for the treatment of depression in HIV-positive patients, regardless of HIV clinical staging. Furthermore, it appears to be well tolerated in patients with AIDS-related medical conditions.