Key result
Psychotic disorders treated with antipsychotics linked to ~60% greater cardiometabolic disease risk versus controls.
Why the study?
The effects of psychotic disorders on cardiometabolic diseases and premature death needed to be determined in Asian populations.
Does the presence of psychotic disorders treated with antipsychotics increase the risk of cardiometabolic diseases and all-cause mortality in adults without baseline cardiometabolic diseases?
Cohort (n=96,324)
Does the presence of psychotic disorders treated with antipsychotics increase the risk of cardiometabolic diseases and all-cause mortality in adults without baseline cardiometabolic diseases?
Hazard Ratio: 1.595 (95% CI 1.565–1.626)
Absolute Event Rate: 92.18% vs 55.64%
p-value: p=<0.0001
In an Asian population without baseline cardiometabolic disease, psychotic disorders treated with antipsychotics are associated with a significantly increased risk of incident cardiometabolic diseases and premature all-cause mortality, particularly in younger individuals.
BACKGRUOUND: The effects of psychotic disorders on cardiometabolic diseases and premature death need to be determined in Asian populations. METHODS: In this population-based matched cohort study, the Korean National Health Insurance Service database (2002 to 2018) was used. The risk of type 2 diabetes mellitus (T2DM), acute myocardial infarction (AMI), ischemic stroke, composite of all cardiometabolic diseases, and all-cause death during follow-up was compared between individuals with psychotic disorders treated with antipsychotics (n=48,162) and 1:1 matched controls without psychiatric disorders among adults without cardiometabolic diseases before or within 3 months after baseline. RESULTS: In this cohort, 53,683 composite cases of all cardiometabolic diseases (during median 7.38 years), 899 AMI, and 1,216 ischemic stroke cases (during median 14.14 years), 7,686 T2DM cases (during median 13.26 years), and 7,092 deaths (during median 14.23 years) occurred. The risk of all outcomes was higher in subjects with psychotic disorders than matched controls (adjusted hazard ratios [95% confidence intervals]: 1.522 [1.446 to 1.602] for T2DM; 1.455 [1.251 to 1.693] for AMI; 1.568 [1.373 to 1.790] for ischemic stroke; 1.595 [1.565 to 1.626] for composite of all cardiometabolic diseases; and 2.747 [2.599 to 2.904] for all-cause mortality) during follow-up. Similar patterns of associations were maintained in subgroup analyses but more prominent in younger individuals (P for interaction <0.0001) when categorized as those aged 18-39, 40-64, or ≥65 years. CONCLUSION: Patients with psychotic disorders treated with antipsychotics were associated with increased risk of premature allcause mortality and cardiometabolic outcomes in an Asian population. This relationship was more pronounced in younger individuals, especially aged 18 to 39 years.
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Lee et al. (2024) conducted a cohort in Psychotic disorders (n=96,324). Psychotic disorders treated with antipsychotics vs. Matched controls without major psychiatric disorders was evaluated on Composite of all cardiometabolic diseases (HR 1.595, 95% CI 1.565 to 1.626, p=<0.0001). Psychotic disorders treated with antipsychotics were associated with a significantly increased risk of a composite of all cardiometabolic diseases (HR 1.595) and all-cause mortality (HR 2.747) compared to matched controls.
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