Please use this identifier to cite or link to this item:
Scopus Web of Science® Altmetric
Type: Journal article
Title: Effect of age, family history of diabetes, and antipsychotic drug treatment on risk of diabetes in people with psychosis: a population-based cross-sectional study
Author: Foley, D.
Mackinnon, A.
Morgan, V.
Watts, G.
Castle, D.
Waterreus, A.
Galletly, C.
Citation: Lancet Psychiatry, 2015; 2(12):1092-1098
Issue Date: 2015
ISSN: 2215-0366
Statement of
Debra L Foley, Andrew Mackinnon, Vera A Morgan, Gerald F Watts, David J Castle, Anna Waterreus, Cherrie A Galletly
Abstract: Background: Psychosis is associated with an increased risk of diabetes mellitus. A positive synergy between antipsychotic drug effects and a pre-existing liability to diabetes mellitus might explain the especially high relative risk of diabetes mellitus in young adults with psychosis. We aimed to assess the individual and joint effect of age, family history of diabetes mellitus, and currently prescribed antipsychotic drug treatment on risk for diabetes mellitus. Methods: In this study, we used data from the 2010 Australian National Survey of Psychosis—an observational study done at seven sites in five Australian states. We included data from 1155 people with psychosis aged 18–64 years who were in contact with psychiatric services and who gave a fasting blood sample to test for current diabetes mellitus. Using logistic regression, we modelled the association of diabetes mellitus with age, family history of diabetes mellitus, and current antipsychotic drug treatment. We compared model fit with and without two-way and three-way interaction terms and used likelihood ratio tests to establish which terms to include in the final model. Findings: After adjustment for older age, which was an independent risk factor, compared with not taking antipsychotic drugs, antipsychotic drug treatment was associated with diabetes mellitus only in those without a family history of diabetes mellitus (clozapine adjusted odds ratio [OR] 7·22, 95% CI 1·62–32·20, p=0·01; quetiapine 5·91, 1·33–26·30, p=0·02; aripiprazole 5·06, 0·86–29·64, p=0·07; risperidone 4·17, 0·90–19·24, p=0·07; and olanzapine 2·23, 0·45–11·06, p=0·32). Antipsychotic drug treatment was not associated with additional risk of diabetes mellitus in those with a family history (clozapine adjusted OR 1·51, 95% CI 0·64–3·54, p=0·34; quetiapine 1·09, 0·49–2·43, p=0·82; aripiprazole 0·43, 0·12–1·49, p=0·18; risperidone 1·12, 0·48–2·63, p=0·79; and olanzapine 0·67, 0·26–1·71, p=0·39). Interpretation: People with psychosis are at increased risk of diabetes mellitus if they have a family history of diabetes mellitus or if they have no family history of diabetes mellitus but are taking antipsychotic drugs. Increasing age increases risk but independently of family history or antipsychotic drug treatment. Clinicians should not think the absence of a family history of diabetes mellitus protects their patients from the diabetic side-effects of antipsychotics. Funding: Australian Federal Government and Orygen.
Keywords: Humans
Diabetes Mellitus
Antipsychotic Agents
Medical History Taking
Risk Factors
Cross-Sectional Studies
Psychotic Disorders
Age Distribution
Middle Aged
Young Adult
Rights: © 2015 Elsevier Ltd. All rights reserved.
DOI: 10.1016/S2215-0366(15)00276-X
Appears in Collections:Aurora harvest 3
Psychiatry publications

Files in This Item:
There are no files associated with this item.

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.