Metabolic syndrome in people with schizophrenia: A review

World Psychiatry

Volumn 8, Issue 1, 2009, Pages 15-22

  De Hert, Marc ^a   Schreurs, Vincent ^a   Vancampfort, Davy ^b   Van Winkel, Ruud ^a,c  

^a UNIVERSITY HOSPITALS LEUVEN   (Belgium)

^b UNIVERSITY OF LEUVEN   (Belgium)

^c Department of Psychiatry and Psychology   (Netherlands)

Author keywords

Antipsychotics; Metabolic syndrome; Schizophrenia

Indexed keywords

AMISULPRIDE; ARIPIPRAZOLE; CLOZAPINE; LIPID; NEUROLEPTIC AGENT; OLANZAPINE; PLACEBO; QUETIAPINE; RISPERIDONE; ZIPRASIDONE;

ABDOMINAL OBESITY; BODY WEIGHT; CARDIOVASCULAR DISEASE; CARDIOVASCULAR RISK; CLINICAL TRIAL; COMORBIDITY; DIET THERAPY; DIETARY INTAKE; DRUG SAFETY; GLUCOSE METABOLISM; HEALTH BEHAVIOR; HEALTH CARE ACCESS; HUMAN; LIFESTYLE; LIFESTYLE MODIFICATION; METABOLIC SYNDROME X; MONOTHERAPY; MORTALITY; PATIENT ASSESSMENT; PATIENT MONITORING; PHYSICAL ACTIVITY; PHYSICAL DISEASE; PRACTICE GUIDELINE; PRIORITY JOURNAL; REVIEW; RISK ASSESSMENT; RISK BENEFIT ANALYSIS; SCHIZOAFFECTIVE PSYCHOSIS; SCHIZOPHRENIA; SIDE EFFECT; WEIGHT CHANGE; WEIGHT GAIN;

EID: 62549143468     PISSN: 17238617     EISSN: None     Source Type: Journal    
DOI: 10.1002/j.2051-5545.2009.tb00199.x     Document Type: Review

References (129)

1. Brown S. Excess mortality of schizophrenia. A meta-analysis. Br J Psychiatry 1997;171:502-8.
2. Brown S, Inskip H, Barraclough B. Causes of the excess mortality of schizophrenia. Br J Psychiatry 2000;177:212-7.
3. Capasso RM, Lineberry TW, Bostwick JM et al. Mortality in schizophrenia and schizoaffective disorder: an Olmsted County, Minnesota cohort: 1950-2005. Schizophr Res 2008;98:287-94.
4. Carney CP, Jones L, Woolfson RF. Medical comorbidity in women and men with schizophrenia: a population-based controlled study. J Gen Intern Med 2006;21:1133-7.
5. Colton CW, Manderscheid RW. Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Prev Chronic Dis 2006; 3:A42.
6. De Hert M, Mckenzie K, Peuskens J. Risk factors for suicide in young people suffering from schizophrenia: a long term follow-up study. Schizophr Res 2001;47:127-34.
7. Fleischhacker W, Cetkovich-Bakmas M, De Hert M et al. Comorbid somatic illnesses in patients with severe mental disorders: clinical, policy, and research challenges. J Clin Psychiatry 2008;69:514-9.
8. Hennekens CH, Hennekens AR, Hollar D et al. Schizophrenia and increased risks of cardiovascular disease. Am Heart J 2005;150:1115-21.
9. Joukamaa M, Heliovaara M, Knekt P. Mental disorders and cause-specific mortality. Br J Psychiatry 2001;179:498-502.
10. Lawrence DM, Holman CD, Jablensky AV et al. Death rate from ischaemic heart disease in Western Australian psychiatric patients 1980-1998. Br J Psychiatry 2003;182:31-6.
11. Ösby U, Correia N, Brandt L et al. Mortality and causes of death in schizophrenia in Stockholm county, Sweden. Schizophr Res 2000;45:21-8.
12. Ösby U, Correia N, Brandt L et al. Time trends in schizophrenia mortality in Stockholm County, Sweden: cohort study. BMJ 2000;321:483-4.
13. Saha S, Chant D, Mcgrath J. A systematic review of mortality in schizophrenia: is the differential mortality gap worsening over time? Arch Gen Psychiatry 2007;64:1123-31.
14. American Diabetes Association/American Psychiatric Association. Consensus development conference on antipsychotic drugs and obesity and diabetes. Diabetes Care 2004;27:596-601.
15. Casey DE, Haupt DW, Newcomer JW et al. Antipsychotic-induced weight gain and metabolic abnormalities: implications for increased mortality in patients with schizophrenia. J Clin Psychiatry 2004;65(Suppl. 7):4-18.
16. Correll CU. Balancing efficacy and safety in treatment with antipsychotics. CNS Spectr 2007;12(Suppl. 17):12-20.
17. Dixon L, Postrado L, Delahanty J et al. The association of medical comorbidity in schizophrenia with poor physical and mental health. J Nerv Ment Dis 1999;187:496-502.
18. Henderson DC. Schizophrenia and comorbid metabolic disorders. J Clin Psychiatry 2005;66(Suppl. 6):11-20.
19. Holt RIG, Pevelert RC, Byrne CD. Schizophrenia, the metabolic syndrome and diabetes. Diabet Med 2004;21:515-23.
20. Holt RIG, Pevelert RC. Antipsychotic drugs and diabetes - an application of the Austin Bradford Hill criteria. Diabetologia 2006;49:1467-73.
21. Kohen D. Diabetes mellitus and schizophrenia: historical perspective. Br J Psychiatry 2004;184:64-6.
22. Leucht S, Burkard T, Henderson J et al. Physical illness and schizophrenia: a review of the literature. Acta Psychiatr Scand 2007;116:317-33.
23. Meyer JM, Nasrallah HA. Medical illness and schizophrenia. Washington: American Psychiatric Publishing, 2003.
24. Sartorius N. Physical illness in people with mental disorders. World Psychiatry 2007,6:3-4.
25. Newcomer JW. Second-generation (atypical) antipsychotics and metabolic effects: a comprehensive literature review. CNS Drugs 2005;19:1-93.
26. Cradock-O'Leary J, Young AS, Yano EM et al. Use of general medical services by VA patients with psychiatric disorders. Psychiatr Serv 2002;53:874-8.
27. Druss BG, Bradford WD, Rosenheck RA et al. Quality of medical care and excess mortality in older patients with mental disorders. Arch Gen Psychiatry 2001;58:565-72.
28. Frayne SM, Halanych JH, Miller DR et al. Disparities in diabetes care: impact of mental illness. Arch Intern Med 2005;65:2631-8.
29. Haddad PM, Sharma SG. Adverse effects of atypical antipsychotics; differential risk and clinical implications. CNS Drugs 2007;21:911-36.
30. Citrome L. Metabolic syndrome and cardiovascular disease. J Psychopharmacol 2005;19:84-93.
31. Citrome L. The effectiveness criterion: balancing efficacy against the risks of weight gain. J Clin Psychiatry 2007;68(Suppl. 12): 12-7.
32. Elman I, Borsook D, Lukas SE. Food intake and reward mechanisms in patients with schizophrenia: implications for metabolic disturbances and treatment with second-generation antipsychotic agents. Neuropsychopharmacology 2006;31:2091-120.
33. Nasrallah HA. Atypical antipsychotic-induced metabolic side effects: insights from receptor-binding profiles. Mol Psychiatry 2008;13:27-55.
34. Newcomer JW. Antipsychotic medications: metabolic and cardiovascular risk. J Clin Psychiatry 2007;68(Suppl. 4):8-13.
35. Newcomer J. Metabolic syndrome and mental Illness. Am J Manag Care 2007;13:170-77.
36. De Hert M, Peuskens B, van Winkel R et al. Body weight and self-esteem in patients with schizophrenia evaluated with B-WISE®. Schizophr Res 2006;88:222-6.
37. Ryan MC, Thakore J. Physical consequences of schizophrenia and its treatment: the metabolic syndrome. Life Sci 2002;71:239-57.
38. Scheen AJ, De Hert M. Drug induced diabetes mellitus: the example of atypical antipsychotics. Rev Med Liege 2005;60:455-60.
39. Scheen A, De Hert M. Abnormal glucose metabolism in patients treated with antipsychotics. Diabetes Metabolism 2007;33:169-75.
40. Thakore JH. Metabolic syndrome and schizophrenia. Br J Psychiatry 2005;186:455-6.
41. Tschoner A, Engl J, Laimer M et al. Metabolic side effects of antipsychotic medication. Int J Clin Pract 2007;61:1356-70.
42. van Winkel R, De Hert M, Wampers M et al. Major changes in glucose metabolism including new-onset diabetes within 3 months after initiation or switch of atypical antipsychotic medication in patients with schizophrenia and schizoaffective disorder. J Clin Psychiatry 2008;69:472-9.
43. Simon V, van Winkel R, De Hert M. Are weight gain and metabolic side-effects of atypical antipsychotics dose-dependent? A literature review. J Clin Psychiatry (in press).
44. Reaven GM. Syndrome X: review. Blood Pressure 1992;4(Suppl.): 13-6.
45. Alberti KGMM, Zimmet P, Shaw J. Metabolic syndrome - a new world-wide definition. A consensus statement from the International Diabetes Federation. Diabetic Med 2006;23:469-80.
46. Expert Panel on Detection and Evaluation of Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 2001;285:2486-97.
47. Grundy SM, Cleeman JI, Daniels SR et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735-52.
48. International Diabetes Federation. The IDF consensus worldwide definition of the metabolic syndrome. Brussels: International Diabetes Federation, 2005.
49. Sarafidis PA, Nilsson PM. The metabolic syndrome: a glance at its history. J Hypertension 2006;24:621-6.
50. Byrne CD, Wild SH. The global burden of the metabolic syndrome and its consequences for diabetes and cardiovascular disease. In: Byrne CD, Wild SH (eds). The metabolic syndrome. West Sussex: Wiley, 2005:1-42.
51. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002;287:356-9.
52. Ford ES, Giles WH, Mokdad AH. Increasing prevalence of the metabolic syndrome among US adults. Diabetes Care 2004;27: 2444-9.
53. Grundy SM. The changing face of cardiovascular risk. J Am Coll Cardiol 2005;46:173-6.
54. Hu G, Qiao Q, Tuomilehto J et al. Prevalence of the metabolic syndrome and its relation to all-cause and cardiovascular mortality in nondiabetic European men and women. Arch Intern Med 2004;164:1066-76.
55. Isomaa B, Almgren P, Tuomi T et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001;24:683-9.
56. Lorenzo C, Hunt KJ, Williams K et al. The National Cholesterol Education Program - Adult Treatment Panel III, International Diabetes Federation, and World Health Organization definitions of the metabolic syndrome as predictors of incident cardiovascular disease and diabetes. Diabetes Care 2007;30:8-13.
57. Sacks FM. Metabolic syndrome: epidemiology and consequences. J Clin Psychiatry 2004;65:3-12.
58. Yusuf S, Hawken S, Ounpuu S et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004;364:937-52.
59. Gale E. The myth of the metabolic syndrome. Diabetologica 2005; 48:679-83.
60. Kahn R, Buse J, Ferrannini E et al. The metabolic syndrome: time for a critical appraisal. Joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2005;28:2289-304.
61. Rosen J, Wirshing D. Diabetes and the metabolic syndrome in mental health. Philadelphia: Lippincott, 2008.
62. Almeras N, Deprés JP, Villeneuve J et al. Development of an atherogenic metabolic risk profile associated with the use of atypical antipsychotics. J Clin Psychiatry 2004;65:557-64.
63. Arango C, Bobes J, Aranda P et al. A comparison of schizophrenia outpatients treated with antipsychotics with and without metabolic syndrome: findings from the CLAMORS study. Schizophr Res (in press).
64. Attux C, Quintana MI, Chaves AC. Weight gain, dyslipidemia and altered parameters for metabolic syndrome on first episode psychotic patients after six-month follow-up. Rev Bras Psiquiatr (in press).
65. Basu R, Brar JS, Chengappa KN et al. The prevalence of the metabolic syndrome in patients with schizoaffective disorder - bipolar subtype. Bipolar Disord 2004;6:314-8.
66. Bobes J, Arango C, Aranda P et al. Cardiovascular and metabolic risk in outpatients with schizophrenia treated with antipsychotics: Results of the CLAMORS Study. Schizophr Res 2007;90:162-73.
67. Cerit C, Özten E, Yildiz M. The prevalence of metabolic syndrome and related factors in patients with schizophrenia. Turk J Psychiatry 2008;19:1-8.
68. Cohn T, Prud'homme D, Streiner D et al. Characterizing coronary heart disease risk in chronic schizophrenia: high prevalence of the metabolic syndrome. Can J Psychiatry 2004;49:753-60.
69. Correll CU, Frederickson AM, Kane JM et al. Metabolic syndrome and the risk of coronary heart disease in 367 patients treated with second-generation antipsychotic drugs. J Clin Psychiatry 2006; 67:575-83.
70. Correll CU, Frederickson AM, Kane JM et al. Does antipsychotic polypharmacy increase the risk for metabolic syndrome? Schizophr Res 2007;89:91-100.
71. De Hert M, van Winkel R, Van Eyck D et al. Prevalence of the metabolic syndrome in patients with schizophrenia treated with antipsychotic medication. Schizophr Res 2006;83:87-93.
72. De Hert M, van Winkel R, Van Eyck D et al. Prevalence of diabetes, metabolic syndrome and metabolic abnormalities in schizophrenia over the course of the illness: a cross-sectional study. Clin Pract Epidemiol Ment Health 2006;2:14.
73. De Hert M, Hanssens L, Wampers M et al. Prevalence and incidence rates of metabolic abnormalities and diabetes in a prospective study of patients treated with second-generation antipsychotics. Schizophr Bull 2007;33:560.
74. De Hert M, Schreurs V, Sweers K et al. Typical and atypical antipsychotics differentially affect long-term incidence rates of the metabolic syndrome in first-episode patients with schizophrenia: a retrospective chart review. Schizophr Res 2008;101:295-303.
75. De Hert M, Falissard B, Mauri M et al. Epidemiological study for the evaluation of metabolic disorders in patients with schizophrenia: the METEOR study. Eur Neuropsychopharmacol 2008;18(Suppl. 4):S444.
76. Ellingrod VL, Miller DD, Taylor SF et al. Metabolic syndrome and insulin resistance in schizophrenia patients receiving antipsychotics genotyped for the methylenetetrahydrofolate reductase (MTH-FR) 677C/T and 1298A/C variants. Schizophr Res 2008;98:47-54.
77. Hagg S, Lindblom Y, Mjörndal T et al. High prevalence of the metabolic syndrome among a Swedish cohort of patients with schizophrenia. Int Clin Psychopharmacol 2006;21:93-8.
78. Heiskanen T, Niskanen L, Lyytikainen R et al. Metabolic syndrome in patients with schizophrenia. J Clin Psychiatry 2003;64:575-9.
79. L'Italien GJ, Casey DE, Kan HJ et al. Comparison of metabolic syndrome incidence among schizophrenia patients treated with aripiprazole versus olanzapine or placebo. J Clin Psychiatry 2007; 68:1510-6.
80. Kato MM, Currier MB, Gomez CM et al. Prevalence of metabolic syndrome in Hispanic and non-Hispanic patients with schizophrenia. Prim Care Comp J Clin Psychiatry 2004;6:74-7.
81. Lamberti JS, Olson D, Crilly JF et al. Prevalence of the metabolic syndrome among patients receiving clozapine. Am J Psychiatry 2006;7:1273-6.
82. McEvoy JP, Meyer JM, Goff DC et al. Prevalence of the metabolic syndrome in patients with schizophrenia: baseline results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CAT-IE) schizophrenia trial and comparison with national estimates from NHANES III. Schizophr Res 2005;80:19-32.
83. Meyer JM, Nasrallah HA, McEvoy JP et al. The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Schizophrenia Trial: clinical comparison of subgroups with and without the metabolic syndrome. Schizophr Res 2005;80:9-18.
84. Meyer JM, Davis VG, Goff DC et al. Change in metabolic syndrome parameters with antipsychotic treatment in the CATIE Schizophrenia Trial: prospective data from phase 1. Schizophr Res 2008;101:273-86.
85. Mulder H, Franke B, van der Aart-van der Beek A et al. The association between HTR2C gene polymorphisms and the metabolic syndrome in patients with schizophrenia. J Clin Psychopharmacol 2007;27:338-43.
86. Perez-Iglesias R, Crespo-Facorro B, Martinez-Garcia O et al. Weight gain induced by haloperidol, risperidone and olanzapine after 1 year: findings of a randomized clinical trial in a drug-naïve population. Schizophr Res (in press).
87. Rejas J, Bobes J, Arango C et al. Concordance of standard and modified NCEP ATP III criteria for identification of metabolic syndrome in outpatients with schizophrenia treated with antipsychotics: a corollary from the CLAMORS study. Schizophr Res 2008;99:23-8.
88. Saari KM, Lindeman SM, Viilo KM et al. A 4-fold risk of metabolic syndrome in patients with schizophrenia: the northern Finland 1966 birth cohort study. J Clin Psychiatry 2005;66:559-63.
89. Saddichha S, Ameen S, Akhtar S. Incidence of new onset metabolic syndrome with atypical antipsychotics in first episode schizophrenia: a six-week prospective study in Indian female patients. Schizophr Res 2007;95:247.
90. Saddichha S, Manjunatha N, Ameen S et al. Metabolic syndrome in first episode schizophrenia - a randomized double-blind controlled, short-term prospective study. Schizophr Res 2008;101:266-72.
91. Schorr SG, Lucas MJG, Slooff CJ et al. The prevalence of metabolic syndrome in schizophrenic patients in the Netherlands. Schizophr Res 2008;102(Suppl.):241.
92. Schorr SG, Slooff CJ, Postema R et al. A 12-month follow-up study of treating overweight schizophrenic patients with aripiprazole. Acta Psychiatr Scand 2008;118:246-50.
93. Schorr SG, Slooff CJ, Bruggeman R et al. Incidence of metabolic syndrome and its reversibility in a cohort of schizophrenic patients followed for one year. Schizophr Res 2008;102(Suppl.):241.
94. Sicras-Mainar A, Blanca-Tamayo M, Rejas-Gutiérrez J et al. Metabolic syndrome in outpatients receiving antipsychotic therapy in routine clinical practice: a cross-sectional assessment of a primary health care database. Eur Psychiatry 2008;23:100-8.
95. Srisurapanont M, Likhitsathian S, Boonyanaruthee V et al. Metabolic syndrome in Thai schizophrenic patients: a naturalistic one-year follow-up study. BMC Psychiatry 2007;23:7-14.
96. Straker D, Correll CU, Kramer-Ginsberg E et al. Cost-effective screening for the metabolic syndrome in patients treated with second generation antipsychotic medications. Am J Psychiatry 2005;162:1217-21.
97. Suvisaari JM, Saarni SI, Perälä J et al. Metabolic syndrome among persons with schizophrenia and other psychotic disorders in a general population survey. J Clin Psychiatry 2007;68:1045-55.
98. Teixeira PJR, Rocha FL. The prevalence of metabolic syndrome among psychiatric inpatients in Brazil. Rev Bras Psiquiatr 2007: 29:350-6.
99. van Winkel R, van Os J, Celic I et al. Psychiatric diagnosis as an independent risk factor for metabolic disturbances: results from a comprehensive, naturalistic screening program. J Clin Psychiatry 2008;69:1319-27.
100. Nasrallah HA, Meyer JM, Goff DC et al. Low rates of treatment for hypertension, dyslipidemia and diabetes in schizophrenia: data from the CATIE schizophrenia trial sample at baseline. Schizophr Res 2006;86:15-22.
101. de Leon J, Diaz FJ. Planning for the optimal design of studies to personalize antipsychotic prescriptions in the post-CATIE era: the clinical and pharmacoepidemiological data suggest that pursuing the pharmacogenetics of metabolic syndrome complications (hypertension, diabetes mellitus and hyperlipidemia) may be a reasonable strategy. Schizophr Res 2007;96:185-97.
102. Correll CU. Assessing and maximizing the safety and tolerability of antipsychotics used in the treatment of children and adolescents. J Clin Psychiatry 2008;69(Suppl. 4):26-36.
103. Daniels SR, Greer FR and the Committee on Nutrition. Lipid screening and cardiovascular health in childhood. Pediatrics 2008;122:198-208.
104. Kumra S, Oberstar JV, Sikich L et al. Efficacy and tolerability of second-generation antipsychotics in children and adolescents with schizophrenia. Schizophr Bull 2008;34:60-71.
105. Barnett AH, Mackin P, Chaudhry I et al. Minimising metabolic and cardiovascular risk in schizophrenia: diabetes, obesity and dyslipidaemia. J Psychopharmacol 2007;21:357-73.
106. Citrome L, Yeomans D. Do guidelines for severe mental illness promote physical health and well-being? J Psychopharmacol, 2005;19:102-9.
107. Cohn TA, Sernyak MJ. Metabolic monitoring for patients treated with antipsychotic medications. Can J Psychiatry 2006;51:492-501.
108. De Hert M, Van Eyck D, De Nayer A. Metabolic abnormalities associated with second generation antipsychotics: fact or fiction? Development of guidelines for screening and monitoring. Int Clin Psychopharmacol 2006;21(Suppl. 2):11-5.
109. De Nayer A, De Hert M, Scheen A et al. Conference report: Belgian consensus on metabolic problems associated with second-generation antipsychotics. Int J Psy Clin Pract 2005;9:130-7.
110. Marder SR, Essock SM, Miller AL et al. Physical health monitoring of patients with schizophrenia. Am J Psychiatry 2004;161:1334-49.
111. Sernyak MJ. Implementation of monitoring and management guidelines for second generation antipsychotics. J Clin Psychiatry 2007;68:14-8.
112. van Winkel R, De Hert M, Van Eyck D et al. Screening for diabetes and other metabolic abnormalities in patients with schizophrenia: evaluation of incidence and screening methods. J Clin Psychiatry 2006;67:1493-500.
113. Buckley PF, Miller D, Singer B et al. Clinicians' recognition of the metabolic adverse effects of antipsychotic medications. Schizophr Res 2005;79:281-8.
114. Newcomer JW, Nasrallah HA, Loebel AD. The atypical antipsychotic therapy and metabolic issues national survey. J Clin Psychopharmacol 2004;24:1-6.
115. Faulkner G, Cohn TA. Pharmacologic and nonpharmacologic strategies for weight gain and metabolic disturbance in patients treated with antipsychotic medications. Can J Psychiatry 2006;51:502-11.
116. Faulkner G, Cohn T, Remington G. Interventions to reduce weight gain in schizophrenia. Schizophr Bull 2007;33:654-6.
117. Lakka TA, Laaksonen DE. Physical activity in prevention and treatment of the metabolic syndrome. Appl Physiol Nutr Metab 2007;32:76-88.
118. Fagard R. Exercise characteristics and the blood pressure response to dynamic physical training. Med Sci Sports Exerc 2001;33:484-92.
119. Pescatello LS, Franklin BA, Fagard R et al. Exercise and hypertension. Med Sci Sports Exerc 2004;36:533-53.
120. Blair SN, Brodney S. Effects of physical inactivity and obesity on morbidity and mortality: current evidence and research issues. Med Sci Sports Exerc 1999;31:S646-62.
121. Lambers S, Van Laethem C, Van Acker K et al. Influence of combined exercise training on indices of obesity, diabetes and cardiovascular risk in type 2 diabetes patients. Clin Rehabil 2008;22:483-92.
122. Saltin B, Helge JW. Metabolic capacity of skeletal muscles and health. UgeskrLaeger 2000;162:59-64.
123. Vancampfort D, Knapen J, De Hert M et al. Physical activity interventions for people who have schizophrenia: a critical review. Submitted for publication.
124. Haskell WL, Lee IM, Pate RR et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007;39:1423-34.
125. Pedersen BK, Saltin B. Evidence for prescribing exercise as therapy in chronic disease. Scand J Med Sci Sports 2006;16:3-63.
126. De Hert M, Kalnicka D, van Winkel R et al. Treatment with rosuvastatin for severe dyslipidemia in patients with schizophrenia and schizoaffective disorder. J Clin Psychiatry 2006;67:1889-96.
127. Hanssens L, De Hert M, van Winkel R et al. Pharmacological treatment of severe dyslipidaemia in patients with schizophrenia. Int J Clin Psychopharmacol 2007;22:43-9.
128. Fourth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. European guidelines on cardiovascular disease prevention in clinical practice: executive summary. Eur J Cardiovasc Prev Rehabil 2007;14(Suppl. 2):E1-40.
129. The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD). Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary. Eur Heart J 2007;28:88-136.