High Prevalence of Obesity, Hypertension, Hyperlipidemia, and Diabetes Mellitus in Japanese Outpatients with Schizophrenia: A Nationwide Survey.

Background: Patients with schizophrenia have significantly shorter life expectancy than the general population, and a problem they commonly face is an unhealthy lifestyle, which can lead to obesity and metabolic syndrome. There is a very clear need to determine the prevalence of obesity, hypertension, hyperlipidemia, and diabetes mellitus which are components of metabolic syndrome in patients with schizophrenia, but there has been a paucity of large-scale studies examining this situation in Japan. The aim of our study was to address this need.
Setting & Participants: We conducted a large-scale investigation of the prevalence of obesity, hypertension, hyperlipidemia, and diabetes mellitus using a questionnaire in 520 outpatient facilities and 247 inpatient facilities of the Japan Psychiatric Hospitals Association between January 2012 and July 2013. There were 7,655 outpatients and 15,461 inpatients with schizophrenia.
Results: The outpatients had significantly higher prevalence of obesity, hypertension, hypertriglyceridemia, hyper-LDL cholesterolemia, and diabetes mellitus than the inpatients. The prevalence of hypo-HDL cholesterolemia was higher in inpatients than outpatients. Age-specific analysis showed the prevalence of obesity, hypertension, hypertriglyceridemia, hyper-LDL cholesterolemia, and diabetes mellitus among outpatients to be 2- to 3-fold higher than among inpatients. In individuals aged ≥60 years, the prevalence of obesity and DM among outpatients was about 3-fold higher than among inpatients.
Conclusion: Japanese outpatients with schizophrenia were more likely to have physical risk such as obesity, hypertension, hyperlipidemia, and diabetes mellitus than inpatients. The physical risk to patients with schizophrenia may be affected by environmental parameters, such as type of care. The physical risk to Japanese patients with schizophrenia demands greater attention.
Competing Interests: Toshiyuki Someya has received research support or honoraria from Asahi Kasei Pharma Corp., Astellas Pharma Inc., Daiichi Sankyo Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan, K.K., GlaxoSmithKline K.K., Janssen Pharmaceutical K.K., Meiji Seika Pharma Co., Ltd., Mitsubishi Tanabe Pharma Co., Ltd., Mochida Pharmaceutical Co., Ltd., MSD K.K., Otsuka Pharmaceutical Co., Ltd., Pfizer Japan Inc., Shionogi & Co., Ltd., Tsumura & Co., and Yoshitomi Pharmaceutical Industries. Yutaro Suzuki has received research support or honoraria from Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma Co., Ltd., and Otsuka Pharmaceutical Co., Ltd. The other authors declare no potential conflicts of interest. Kazutaka Shimoda has received research support or honoraria from Daiichi Sankyo Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan, K.K., GlaxoSmithKline K.K., Meiji Seika Pharma Co., Ltd., Novartis Pharma K.K., Otsuka Pharmaceutical Co., Ltd., Pfizer Japan Inc., Shionogi & Co., Ltd., Takeda Pharmaceutical Co., Ltd., Tsumura & Co., Yoshitomi Pharmaceutical Industries, Ltd., Asahi Kasei Pharma Corporation, Astellas Pharma Inc., Janssen Pharmaceutical K.K., Kowa Pharmaceutical Co., Ltd., Meiji Seika Pharma Co., Mitsubishi Tanabe Pharma Corporation, Ltd., MSD K.K., Novartis Pharma K.K., and Ono Pharmaceutical Co., Ltd. Norio Yasui-Furukori has received research support or honoraria from Astellas Pharma Inc., Dainippon Sumitomo Pharma Co., Ltd., Eli Lilly Japan, K.K., GlaxoSmithKline K.K., Janssen Pharmaceutical K.K., Meiji Seika Pharma Co., Mochida Pharmaceutical Co. Ltd., MSD K.K., Otsuka Pharmaceutical Co. Ltd., Pfizer Japan Inc., Takeda Pharmaceutical Co. Ltd., and Yoshitomi Pharmaceutical Industries. Norio Sugawara has received grant or research support from the Grant-in-Aid for Young Scientists (B), Ministry of Education, Culture, Sports, Science and Technology, Japan Grant B., the Karoji Memorial Fund for Medical Research Grant, and the Senshin Medical Research Foundation. There are no patents, products in development, or marketed products to declare. This does not alter the authors’ adherence to PLOS ONE’s policies on sharing data and materials, as detailed online in the guide for authors. The other authors declare no potential conflicts of interest.