Metabolic disturbances are risk factors for readmission to psychiatric hospitals in non-smokers but not in smokers: results from a Swiss psychiatric cohort and in first-episode psychosis patients
BackgroundPsychiatric patients are at high risk of readmission, and a high body mass index has previously been shown as a risk factor. We sought to replicate this finding and 1) to prospectively assess the association of metabolic syndrome and its five components with readmission in psychiatric hosp...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-02-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1256416/full |
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| author | Nermine Laaboub Isabella Locatelli Claire Grosu Marianna Piras Tram Ho Ngoc Setareh Ranjbar Martin Preisig Julien Elowe Armin von Gunten Philippe Conus Chin B. Eap Chin B. Eap Chin B. Eap Chin B. Eap |
| author_facet | Nermine Laaboub Isabella Locatelli Claire Grosu Marianna Piras Tram Ho Ngoc Setareh Ranjbar Martin Preisig Julien Elowe Armin von Gunten Philippe Conus Chin B. Eap Chin B. Eap Chin B. Eap Chin B. Eap |
| author_sort | Nermine Laaboub |
| collection | DOAJ |
| description | BackgroundPsychiatric patients are at high risk of readmission, and a high body mass index has previously been shown as a risk factor. We sought to replicate this finding and 1) to prospectively assess the association of metabolic syndrome and its five components with readmission in psychiatric hospitals and 2) to identify other clinical and sociodemographic predictors of readmission.MethodsBetween 2007 and 2019, data on 16727 admissions of 7786 adult and elderly patients admitted to the Department of Psychiatry of the Lausanne University Hospital, were collected. Metabolic syndrome was defined according to the International Diabetes Federation definition. Cox frailty models were used to investigate the associations between readmission and metabolic disturbances.ResultsA total of 2697 (35%) patients were readmitted to our psychiatric hospital. Novel risk factors for readmission in non-smokers were identified, including being overweight (HR=1.26; 95%CI=[1.05; 1.51]) or obese (HR=1.33; 95%CI=[1.08; 1.62]), displaying hypertriglyceridemia (HR=1.21; 95%CI=[1.04; 1.40]) and metabolic syndrome (HR=1.26; 95%CI=[1.02; 1.55]). Central obesity and hyperglycemia increased the risk of readmission when considering the Health of the Nation Outcome Scales variable. In first-episode psychosis patients, obesity (HR=2.23; 95%CI=[1.14; 4.30]) and high-density lipoprotein hypocholesterolemia (HR=1.90; 95%CI=[1.14; 3.20]) doubled the risk of readmission.ConclusionThe observed interaction between smoking and metabolic variables are compatible with a ceiling effect; metabolic variables increase the risk of readmission in non-smokers but not in smokers who are already at higher risk. Future studies should determine whether better metabolic monitoring and treatment can reduce readmission risk. |
| first_indexed | 2024-03-08T03:11:44Z |
| format | Article |
| id | doaj.art-5b6b5185cebd4616be382d27727f5098 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-03-08T03:11:44Z |
| publishDate | 2024-02-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Psychiatry |
| spelling | doaj.art-5b6b5185cebd4616be382d27727f50982024-02-13T04:31:55ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402024-02-011510.3389/fpsyt.2024.12564161256416Metabolic disturbances are risk factors for readmission to psychiatric hospitals in non-smokers but not in smokers: results from a Swiss psychiatric cohort and in first-episode psychosis patientsNermine Laaboub0Isabella Locatelli1Claire Grosu2Marianna Piras3Tram Ho Ngoc4Setareh Ranjbar5Martin Preisig6Julien Elowe7Armin von Gunten8Philippe Conus9Chin B. Eap10Chin B. Eap11Chin B. Eap12Chin B. Eap13Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, SwitzerlandCentre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, SwitzerlandUnit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, SwitzerlandUnit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, SwitzerlandUnit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, SwitzerlandCenter for Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, SwitzerlandCenter for Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, SwitzerlandService of Adult Psychiatry North-West, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, SwitzerlandService of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, SwitzerlandService of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, SwitzerlandUnit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, SwitzerlandSchool of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, SwitzerlandCenter for Research and Innovation in Clinical Pharmaceutical Sciences, University of Lausanne, Lausanne, SwitzerlandInstitute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, SwitzerlandBackgroundPsychiatric patients are at high risk of readmission, and a high body mass index has previously been shown as a risk factor. We sought to replicate this finding and 1) to prospectively assess the association of metabolic syndrome and its five components with readmission in psychiatric hospitals and 2) to identify other clinical and sociodemographic predictors of readmission.MethodsBetween 2007 and 2019, data on 16727 admissions of 7786 adult and elderly patients admitted to the Department of Psychiatry of the Lausanne University Hospital, were collected. Metabolic syndrome was defined according to the International Diabetes Federation definition. Cox frailty models were used to investigate the associations between readmission and metabolic disturbances.ResultsA total of 2697 (35%) patients were readmitted to our psychiatric hospital. Novel risk factors for readmission in non-smokers were identified, including being overweight (HR=1.26; 95%CI=[1.05; 1.51]) or obese (HR=1.33; 95%CI=[1.08; 1.62]), displaying hypertriglyceridemia (HR=1.21; 95%CI=[1.04; 1.40]) and metabolic syndrome (HR=1.26; 95%CI=[1.02; 1.55]). Central obesity and hyperglycemia increased the risk of readmission when considering the Health of the Nation Outcome Scales variable. In first-episode psychosis patients, obesity (HR=2.23; 95%CI=[1.14; 4.30]) and high-density lipoprotein hypocholesterolemia (HR=1.90; 95%CI=[1.14; 3.20]) doubled the risk of readmission.ConclusionThe observed interaction between smoking and metabolic variables are compatible with a ceiling effect; metabolic variables increase the risk of readmission in non-smokers but not in smokers who are already at higher risk. Future studies should determine whether better metabolic monitoring and treatment can reduce readmission risk.https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1256416/fullpsychiatryreadmissionrelapsemetabolic syndromemetabolic disturbancesfirst-episode psychosis |
| spellingShingle | Nermine Laaboub Isabella Locatelli Claire Grosu Marianna Piras Tram Ho Ngoc Setareh Ranjbar Martin Preisig Julien Elowe Armin von Gunten Philippe Conus Chin B. Eap Chin B. Eap Chin B. Eap Chin B. Eap Metabolic disturbances are risk factors for readmission to psychiatric hospitals in non-smokers but not in smokers: results from a Swiss psychiatric cohort and in first-episode psychosis patients Frontiers in Psychiatry psychiatry readmission relapse metabolic syndrome metabolic disturbances first-episode psychosis |
| title | Metabolic disturbances are risk factors for readmission to psychiatric hospitals in non-smokers but not in smokers: results from a Swiss psychiatric cohort and in first-episode psychosis patients |
| title_full | Metabolic disturbances are risk factors for readmission to psychiatric hospitals in non-smokers but not in smokers: results from a Swiss psychiatric cohort and in first-episode psychosis patients |
| title_fullStr | Metabolic disturbances are risk factors for readmission to psychiatric hospitals in non-smokers but not in smokers: results from a Swiss psychiatric cohort and in first-episode psychosis patients |
| title_full_unstemmed | Metabolic disturbances are risk factors for readmission to psychiatric hospitals in non-smokers but not in smokers: results from a Swiss psychiatric cohort and in first-episode psychosis patients |
| title_short | Metabolic disturbances are risk factors for readmission to psychiatric hospitals in non-smokers but not in smokers: results from a Swiss psychiatric cohort and in first-episode psychosis patients |
| title_sort | metabolic disturbances are risk factors for readmission to psychiatric hospitals in non smokers but not in smokers results from a swiss psychiatric cohort and in first episode psychosis patients |
| topic | psychiatry readmission relapse metabolic syndrome metabolic disturbances first-episode psychosis |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1256416/full |
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