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An Association of Socio-Demographic and Lifestyle Factors with Diabetes and Hypertension in Patients with Schizophrenia and Related Disorders

Brar, Jaspreet (2013) An Association of Socio-Demographic and Lifestyle Factors with Diabetes and Hypertension in Patients with Schizophrenia and Related Disorders. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

Background: Diabetes and hypertension are implicated in the shortened lifespan of patients with schizophrenia. While obesity and atypical antipsychotics are well-established risk factors, the roles of socio-demographic and lifestyle factors have not been examined systematically.
Design: A systematic review examining socio-demographic and lifestyle factors in diabetes and hypertension was carried out. A cross-sectional study examined the associations between socio-demographic and lifestyle factors, and diabetes and hypertension in patients with schizophrenia, their non-psychiatric first degree relatives, and non-psychiatric controls.
Methods: The systematic review was carried out using established guidelines. Cross-sectional data from the Diagnostic Interview for Genetic Studies were analyzed to examine associations between socio-demographic and lifestyle risk factors, and diabetes and hypertension in the three groups.
Results: The systematic review based on 26 studies showed a strong effect of age and African-American race on the prevalence of diabetes. Age was also associated with the metabolic syndrome, although the effect of race was equivocal. Sex was an effect modifier for diabetes and the metabolic syndrome in some, but not all studies, with higher rates in females.
Patients with schizophrenia had higher rates of diabetes and hypertension compared to controls. Multivariate analyses that included age, race, sex, years of schooling, marital status, occupational status, and living arrangement showed that only increasing age and African-American race were significant risk factors for diabetes and hypertension.
Patients with schizophrenia had higher rates of smoking, alcohol and marijuana use compared to controls. The rates of smoking and marijuana use in patients were also higher than the rates in their 1st degree relatives. Multivariate analyses that included age, race, sex and years of schooling, failed to show any significant associations for smoking, alcohol or marijuana use with diabetes or hypertension.
Conclusions: Only established non-modifiable factors, namely age and race, were confirmed as risk factors for diabetes and hypertension in the systematic review and cross-sectional study.
Public Health Significance: The dissertation confirms the need for developing services for minority, mainly African-American, patients with schizophrenia in order to reduce the disease burden and mortality associated with diabetes and hypertension.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Brar, Jaspreetjsb11@pitt.eduJSB11
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairRichardson, Galegar@pitt.eduGAR
Committee MemberMazumdar, Satimaz1@pitt.eduMAZ1
Committee MemberNimgaonkar, Vishwajitnimga@pitt.eduNIMGA
Committee MemberSekikawa, Akiraakira@pitt.eduAKIRA
Date: 29 January 2013
Date Type: Completion
Defense Date: 19 November 2012
Approval Date: 29 January 2013
Submission Date: 1 December 2012
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Number of Pages: 136
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Schizophrenia, Diabetes, Hypertension, Metabolic Syndrome, Risk Factor, Socio-Demographic, Lifestyle, Smoking, Alcohol, Marijuana
Date Deposited: 29 Jan 2013 22:04
Last Modified: 01 Jan 2018 06:15
URI: http://d-scholarship.pitt.edu/id/eprint/16874

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