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Research shows increased risk for diabetes among certain individuals with psychosis, taking antipsychotics

Analysis of an observational study cohort showed an increased risk for diabetes among individuals with psychosis taking antipsychotics with no family history of diabetes, while those with a family history exhibited no additional risk for diabetes.

“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,” Debra L Foley, PhD, of the National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia, and colleagues wrote.

To assess how age, family history of diabetes and current antipsychotic treatment affected risk for diabetes, researchers analyzed data from the 2010 Australian National Survey of Psychosis for 1,155 individuals with psychosis aged 18 to 64 years.

Antipsychotic drug treatment was associated with diabetes among individuals without a family history of diabetes after adjusting for age, which was an independent risk factor. Specifically, adjusted odds ratios were 7.22 (95% CI, 1.62-32.2; P = .01) for clozapine; 5.91 (95% CI, 1.33-26.3; P = .02) for quetiapine; 5.06 (95% CI, 0.86-29.64; P = .07) for aripiprazole; 4.17 (95% CI, 0.9-19.24; P = .07) for risperidone; and 2.23 (95% CI, 0.45-11.06; P = .32) for olanzapine.

Researchers found that antipsychotic drug treatment was not associated with additional risk for diabetes among those with a family history of the disease.

“In this study, antipsychotic drug treatment was associated with an increased risk of type 2 diabetes only in those without a family history of diabetes. Age was an independent risk factor. Therefore, the risk of type 2 diabetes that until now has been attributed to antipsychotic drug effects alone is likely to be overestimated in those with a family history of diabetes and underestimated in those without a family history of diabetes,” Foley and colleagues wrote. “The effects of some antipsychotic drugs on risk of diabetes might be missed entirely if family history is not taken into account.” – by Amanda Oldt

Disclosure: Foley reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosures.