Screening for Metabolic Risk in Schizophrenia Falls Short

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August 29, 2011 — A review of current guidelines used to screen and monitor for cardiometabolic risk in patients with schizophrenia concludes there is a lot of room for improvement.

The review, led by Marc De Hert, MD, of University Psychiatric Centre, KU Leuven, Kortenberg, Belgium, was published in the August issue British Journal of Psychiatry.

“In recent years, physical health issues and specifically metabolic and cardiovascular comorbidity in different severe mental illnesses have become a major focus in both clinical care and research,” Dr. De Hert and colleagues write.

The need for screening for cardiometabolic risk among this population has been acknowledged in the psychiatric literature and general treatment guidelines, but clinicians find them suboptimal, according to the study authors.

“Not all guidelines have been developed with the same amount of rigour and authors’ independence,” they note.

“Clinicians should be able to identify and have access to guidelines, which are based on the best evidence,” but it can be difficult to actually identify a specific recommendation to use in daily practice, they write.

In this study, the authors performed a systematic review of the available clinical practice guidelines for screening and monitoring cardiometabolic risk factors for people with schizophrenia and related psychiatric disorders and used the Appraisal of Guidelines for Research and Evaluation (AGREE) to assess their quality.

The investigators looked at all guidelines and recommendations published between 2000 and 2010 and selected 18 for further evaluation.

They found that most of these guidelines scored best with regard to “scope and purpose” and “clarity of presentation: but that “rigour of development” was problematic in most guidelines.

By Fran Lowry
Medscape Medical News
http://www.medscape.com/viewarticle/748714

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