The Link Between Schizophrenia and Cardiovascular Disease
By: Sai Srihaas Potu
Schizophrenia is a mental health condition that usually appears in late adolescence or early adulthood. Its impact on speech, thinking, emotions, and other areas of life can affect a person’s social interactions and everyday activities. It is a fairly uncommon condition, affecting around 0.25% to 0.64% of people in the United States, according to the National Institute of Mental Health (NIMH). It can have a profound impact on a person’s life, as well as the lives of those around them. Recently, researchers have started to find links between schizophrenia and other health problems.
A new study expands and deepens the biological and genetic links between cardiovascular disease and schizophrenia. Cardiovascular disease (CVD) is the leading cause of premature death among schizophrenia patients, who die from heart and blood vessel disorders at a rate double that of people without a mental disorder.
The results of this study have important clinical implications as they will add to our growing awareness that cardiovascular disease is under-recognized and under-treated in mentally ill individuals. The presence of CVD in patients with schizophrenia is not linked to a person’s lifestyle or medication side effects. Thus, doctors must realize that patients with schizophrenia are at risk for cardiovascular disease independent of these factors.
Led by principal investigator Anders M. Dale an international team of researchers used a novel statistical model to magnify the analytical powers of genome-wide association studies or GWAS. These are studies in which differing bits of sequential DNA, called single nucleotide polymorphisms or SNPs, in persons and groups are compared to find common genetic variants that might be linked to a trait or disease. The researchers boosted the power of GWAS by adding information based on genetic pleiotropy, the concept that at least some genes influence multiple traits or phenotypes.
The approach of the researchers was completely different from what previous studies have used. In this study, they used all available genetic information for multiple traits and diseases, not just SNPs below a given statistical threshold. By doing this, the researchers significantly increased their chances of discovering new genes by leveraging the combined power across multiple GWAS models of pleiotropic traits and diseases.
The scientists confirmed nine SNPs linked to schizophrenia in prior studies but also identified 16 new loci, some of which are also associated with CVD. The research team identified triglyceride and lipoprotein levels, waist-hip ratio, systolic blood pressure, and body mass index as prevalent risk factors. Their findings suggest that shared biological and genetic mechanisms can help explain why schizophrenia patients have a greater risk of cardiovascular disease. The method that the researchers used can help examine the genetic overlap between several diseases and traits as well. Examining this overlap can help scientists learn more about the mechanisms for these diseases and help identify potential therapeutic targets for common diseases.
Schizophrenia is a lifelong condition, but effective treatment can help a person manage the symptoms, prevent relapses, and avoid hospitalization. Each person’s experience will be different, and a doctor will tailor the treatment to suit the individual. Some potential treatment options include:
Antipsychotic drugs. These can be for daily use or less frequent use if the person opts for injectable medications, which can last up to 3 months between injections.
Counseling. This can help a person develop coping skills and pursue their life goals.
Coordinated special care. This integrates medication, family involvement, and education services in a holistic approach.
Some common medications for schizophrenia include risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), ziprasidone (Geodon), clozapine (Clozaril), and haloperidol (Haldol).
That said, many of these drugs have adverse effects, including neurological symptoms and weight gain. However, newer medications may have less severe side effects. It is essential for a person to continue with their treatment plan, even if the symptoms improve. If a person stops taking medication, the symptoms may return.
Schizophrenia is a long-term condition that can have a profound impact on a person’s ability to function in life. These effects can also impact the people around the patient. Treatment is available and can help a person manage their symptoms. People with schizophrenia will also benefit from the support of their family, friends, and community services. Anyone caring for someone with schizophrenia can help by learning how to spot the onset of an episode, encouraging the person to adhere to their treatment plan, and supporting them through their experience.
Recently, researchers have developed a new form of treatment for schizophrenia called cognitive-behavioral therapy. CBT is a psychosocial treatment that aims to re‐mediate distressing emotional experiences or dysfunctional behavior by changing how a person interprets and evaluates the experience or cognates on its consequence and meaning. This approach helps to link the person's feelings and patterns of thinking which underpin distress. CBT is now recommended by the National Institute for Health and Care Excellence (NICE) as an add‐on treatment for people with a diagnosis of schizophrenia.
Schizophrenia has been defined as a clinical entity for over a century, but despite decades of research, a definitive set of biological markers for the disorder is still not available, nor are treatments that prevent or cure the disease. Researchers are continuing to develop new treatment options that can help subdue the symptoms of schizophrenia, however, there is no possible way to cure the disorder itself. Scientists are working to understand the neuropsychological mechanisms that control the effects of schizophrenia in order to develop more reliable and accessible treatment options for patients with the disease.
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