Swedish clinical guidelines—Prevention and management of metabolic risk in patients with severe psychiatric disorders

Abstract

Individuals with severe psychiatric disorders are more likely than the population at large to develop metabolic derangements such as overweight and diabetes. Cardiovascular disease is also more frequently seen in this group. Contributing factors may include inappropriate diet or lack of physical activity, but antipsychotic medication may also play a role. Seven Swedish specialist medical societies have collaborated in formulating a set of concise clinically applicable guidelines—reproduced here in modified form—for the prevention and management of metabolic risk in this patient group. The importance of implementation is emphasized.

• Severe mental illness
• Severe mental disorder
• Schizophrenia
• Bipolar disorder
• Physical health
• Weight gain
• Diabetes
• Cardiovascular disease
• Guidelines
• Clinical practice guidelines

Guidelines working group

Adolfsson, Rolf, M.D., Professor, Department of Clinical Sciences, Psychiatry, Umeå University (Swedish Psychiatric Association); Attvall, Stig, M.D., Ph.D., Assoc. Professor, Sahlgrenska University Hospital, Gothenburg (Swedish Association of Diabetology); Erlinge, David, M.D., Ph.D., Professor, Department of Cardiology, Lund University Hospital (Swedish Society of Cardiology); Gothefors, Dan, M.D., Karsudden Hospital, Katrineholm (Swedish Psychiatric Association) (Correspondence: [email protected]); Jarbin, Håkan, M.D., Ph.D., Child and Adolescent Psychiatric Clinic, Halland County (Swedish Association of Child and Adolescent Psychiatry); Lindström, Kjell, M.D., Ph.D., General Practitioner, Unit for Research and Development in Primary Care, Jönköping (Swedish Association of General Practice); Linné von Hausswolff-Juhlin, Yvonne, M.D., Ph.D., Assoc. Professor, Stockholm Center for Eating Disorders (Swedish Association for the Study of Obesity); Morgell, Roland, M.D., General Practitioner, Jordbro Health Care Center, Haninge (Swedish Association of General Practice); Toft, Eva, M.D., Ph.D., Assoc. Professor, Ersta Hospital, Stockholm (Swedish Association of Internal Medicine); Ösby, Urban, M.D., Ph.D., Department of Psychiatry, Danderyd University Hospital.

Translation by Michael Bransome, M.D., Senior Consultant in General Psychiatry, Center for Dependency Disorders, Stockholm County (Medical translator).

Conflicts of interest:

Gothefors, Dan. MD. Karsudden hospital, Katrineholm. Swedish Psychiatric Association (Correspondence: [email protected]). Conflicts of interest; 2005-2006 was an employee of Bristol-Myers Squibb.

Adolfsson, Rolf. MD, Professor. Department of Clinical Sciences, Psychiatry, Umeå University. Swedish Psychiatric Association. Conflicts of interest; none Attvall, Stig. MD, PhD, Assoc Professor. Sahlgrenska University Hospital, Gothenburg. Swedish Association of Diabetology. Conflicts of interest; none Erlinge, David. MD, PhD, Professor. Dept of Cardiology, Lund University Hospital. Swedish Society of Cardiology. Conflicts of interest; none reported Jarbin, Håkan. MD, PhD. Child and Adolescent Psychiatric Clinic, Halland County. Swedish Association of Child and Adolescent Psychiatry. Conflicts of interest; Lectures for Pfizer, GSK och Janssen-Cilag.

Lindström, Kjell. MD, PhD, General Practitioner. Unit for Research and Development in Primary Care, Jönköping. Swedish Association of General Practice. Conflicts of interest; owns 1500 stocks in MEDA.

Linné von Hausswolff-Juhlin, Yvonne, MD, PhD, Assoc Professor. Stockholm Center for Eating Disorders. Swedish Association for the Study of Obesity. Conflicts of interest; none reported Morgell, Roland, MD, General Practitioner. Jordbro Health Care Center, Haninge. Swedish Association of General Practice. Conflicts of interest; none Toft, Eva, MD, PhD, Assoc Professor. Ersta Hospital, Stockholm. Swedish Association of Internal Medicine. Conflicts of interest; Lectures for SanofiAventis, Wyeth, MSD. Involved in clinical trials for Pfizer, Bayer, SanofiAventis.

Ösby, Urban; MD, PhD. Department of Psychiatry, Danderyd University Hospital. Conflicts of interest; none reported.