Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2015

Open Access 01-12-2015 | Study protocol

Protocol for CHANGE: a randomized clinical trial assessing lifestyle coaching plus care coordination versus care coordination alone versus treatment as usual to reduce risks of cardiovascular disease in adults with schizophrenia and abdominal obesity

Authors: Helene Speyer, Hans Christian Brix Nørgaard, Carsten Hjorthøj, Thomas Axel Madsen, Søren Drivsholm, Charlotta Pisinger, Christian Gluud, Ole Mors, Jesper Krogh, Merete Nordentoft

Published in: BMC Psychiatry | Issue 1/2015

Login to get access

Abstract

Background

Life expectancy in patients with schizophrenia is reduced by 20 years for males and 15 years for females compared to the general population. About 60% of the excess mortality is due to physical illnesses, with cardiovascular disease being the single largest cause of death.

Methods/design

The CHANGE trial is an investigator-initiated, independently funded, randomized, parallel-group, superiority, multi-centre trial with blinded outcome assessment. 450 patients aged 18 years or above, diagnosed with schizophrenia spectrum disorders and increased waist circumference, will be recruited and randomized 1:1:1 to 12-months interventions. We will compare the effects of 1) affiliation to the CHANGE team, offering a tailored, manual-based intervention targeting physical inactivity, unhealthy dietary habits, and smoking, and facilitating contact to their general practitioner to secure medical treatment of somatic comorbidity; versus 2) affiliation to a care coordinator who will secure guideline-concordant monitoring and treatment of somatic comorbidity by facilitating contact to their general practitioner; versus 3) treatment as usual to evaluate the potential add-on effects of lifestyle coaching plus care coordination or care coordination alone to treatment as usual. The primary outcome is the 10-year risks of cardiovascular disease assessed at 12 months after randomization.

Discussion

The premature mortality observed in this vulnerable population has not formerly been addressed specifically by using composite surrogate outcomes for mortality. The CHANGE trial expands the evidence for interventions aiming to reduce the burden of metabolic disturbances with a view to increase life expectancy. Here, we present the trial design, describe the methodological concepts in detail, and discuss the rationale and challenges of the intermediate outcomes.

Trial registration

Clinical Trials.gov NCT01585493. Date of registration 27th of March 2012.
Appendix
Available only for authorised users
Literature
1.
Nordentoft M, Wahlbeck K, Hällgren J, Westman J, Osby U, Alinaghizadeh H, et al. Excess mortality, causes of death and life expectancy in 270,770 patients with recent onset of mental disorders in Denmark, Finland and Sweden. PLoS One. 2013;8(1), e55176. doi:10.1371/journal.pone.0055176.CrossRefPubMedPubMedCentral
2.
Lawrence D, Hancock KJ, Kisely S. The gap in life expectancy from preventable physical illness in psychiatric patients in Western Australia: retrospective analysis of population based registers. Bmj. 2013;346(may21 1):f2539. doi:10.1136/bmj.f2539.CrossRefPubMedPubMedCentral
3.
Saha S, Chant D, Mcgrath J. Syst Rev Mortality Schizophrenia. 2013;64(10):1123–31.
4.
Chan A-W, Tetzlaff JM, Gotzsche PC, Altman DG, Mann H, Berlin JA, et al. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ (Clin Res Ed). 2013;346, e7586.
5.
Laursen TM, Nordentoft M. Heart disease treatment and mortality in schizophrenia and bipolar disorder - changes in the Danish population between 1994 and 2006. J Psychiatr Res. 2011;45(1):29–35. doi:10.1016/j.jpsychires.2010.04.027.CrossRefPubMed
6.
Galassi A, Reynolds K, He J. Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. Am J Med. 2006;119(10):812–9. doi:10.1016/j.amjmed.2006.02.031.CrossRefPubMed
7.
DE Hert M, Schreurs V, Vancampfort D, VAN Winkel R. Metabolic syndrome in people with schizophrenia: a review. World Psychiatr. 2009;8(1):15–22. Retrieved from http://​www.​pubmedcentral.​nih.​gov/​articlerender.​fcgi?​artid = 2656262&tool = pmcentrez&rendertype = abstract.CrossRef
8.
Dipasquale S, Pariante CM, Dazzan P, Aguglia E, McGuire P, Mondelli V. The dietary pattern of patients with schizophrenia: a systematic review. J Psychiatr Res. 2013;47(2):197–207. doi:10.1016/j.jpsychires.2012.10.005.CrossRefPubMed
9.
Smith DJ, Langan J, McLean G, Guthrie B, Mercer SW. Schizophrenia is associated with excess multiple physical-health comorbidities but low levels of recorded cardiovascular disease in primary care: cross-sectional study. BMJ Open. 2013;3(4):1–10. doi:10.1136/bmjopen-2013-002808.CrossRef
10.
Daumit GL, Goff DC, Meyer JM, Davis VG, Nasrallah HA, McEvoy JP, et al. Antipsychotic effects on estimated 10-year coronary heart disease risk in the CATIE schizophrenia study. Schizophr Res. 2008;105(1-3):175–87. doi:10.1016/j.schres.2008.07.006.CrossRefPubMedPubMedCentral
11.
Andreassen O, Djurovic S, Thompson WK, Schork AJ, Kendler KS, O’Donovan MC, et al. Improved detection of common variants associated with schizophrenia by leveraging pleiotropy with cardiovascular-disease risk factors. Am J Hum Genet. 2013;92(2):197–209. doi:10.1016/j.ajhg.2013.01.001.CrossRefPubMedPubMedCentral
12.
Janney CA, Ganguli R, Richardson CR, Holleman RG, Tang G, Cauley JA, et al. Sedentary behavior and psychiatric symptoms in overweight and obese adults with schizophrenia and schizoaffective disorders (WAIST Study). Schizophr Res. 2013;145(1-3):63–8. doi:10.1016/j.schres.2013.01.010.CrossRefPubMed
13.
DE Hert M, Correll CU, Bobes J, Cetkovich-Bakmas M, Cohen D, Asai I, et al. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. Official J World Psychiat Assoc. 2011;10(1):52–77.CrossRef
14.
Vancampfort D, Guelinkcx H, Probst M, Stubbs B, Rosenbaum S, Ward PB, et al. Associations between metabolic and aerobic fitness parameters in patients with schizophrenia. J Nerv Ment Dis. 2015;203(1):23–7. doi:10.1097/NMD.0000000000000229.CrossRefPubMed
15.
De Leon J, Diaz FJ. A meta-analysis of worldwide studies demonstrates an association between schizophrenia and tobacco smoking behaviors. Schizophr Res. 2005;76(2-3):135–57. doi:10.1016/j.schres.2005.02.010.CrossRefPubMed
16.
Wu R-R, Zhao J-P, Jin H, Shao P, Fang M-S, Guo X-F, et al. Lifestyle intervention and metformin for treatment of antipsychotic-induced weight gain: a randomized controlled trial. JAMA. 2008;299(2):185–93. doi:10.1001/jama.2007.56-b.CrossRefPubMed
17.
McKibbin CL, Patterson TL, Norman G, Patrick K, Jin H, Roesch S, et al. A lifestyle intervention for older schizophrenia patients with diabetes mellitus: a randomized controlled trial. Schizophr Res. 2006;86(1-3):36–44. doi:10.1016/j.schres.2006.05.010.CrossRefPubMed
18.
Kwon JS, Choi J-S, Bahk W-M, Yoon Kim C, Hyung Kim C, Chul Shin Y, et al. Weight management program for treatment-emergent weight gain in olanzapine-treated patients with schizophrenia or schizoaffective disorder: A 12-week randomized controlled clinical trial. J Clin Psychiatry. 2006;67(4):547–53.CrossRefPubMed
19.
Littrell KH, Hilligoss NM, Kirshner CD, Petty RG, Johnson CG. The effects of an educational intervention on antipsychotic-induced weight gain. J Nurs Sigma Theta Tau. 2003;35(3):237–41.
20.
Methapatara W, Srisurapanont M. Pedometer walking plus motivational interviewing program for Thai schizophrenic patients with obesity or overweight: a 12-week, randomized, controlled trial. Psychiatry Clin Neurosci. 2011;65(4):374–80. doi:10.1111/j.1440-1819.2011.02225.x.CrossRefPubMed
21.
Attux C, Martini LC, Elkis H, Tamai S, Freirias A, Camargo MDGM, et al. A 6-month randomized controlled trial to test the efficacy of a lifestyle intervention for weight gain management in schizophrenia. BMC Psychiatry. 2013;13:60. doi:10.1186/1471-244X-13-60.CrossRefPubMedPubMedCentral
22.
Brar JS, Ganguli R, Pandina G, Turkoz I, Berry S, Mahmoud R. Effects of behavioral therapy on weight loss in overweight and obese patients with schizophrenia or schizoaffective disorder. J Clin Psychiatry. 2005;66(2):205–12.CrossRefPubMed
23.
Scheewe TW, Backx FJG, Takken T, Jörg F, van Strater ACP, Kroes AG, et al. Exercise therapy improves mental and physical health in schizophrenia: a randomised controlled trial. Acta Psychiatr Scand. 2013;127(6):464–73. doi:10.1111/acps.12029.CrossRefPubMed
24.
Evins AE, Cather C, Pratt SA, Pachas GN, Hoeppner SS, Goff DC, et al. Maintenance treatment with varenicline for smoking cessation in patients with schizophrenia and bipolar disorder: a randomized clinical trial. Jama. 2014;311(2):145–54. doi:10.1001/jama.2013.285113.CrossRefPubMedPubMedCentral
25.
Caemmerer J, Correll CU, Maayan L. Acute and maintenance effects of non-pharmacologic interventions for antipsychotic associated weight gain and metabolic abnormalities: a meta-analytic comparison of randomized controlled trials. Schizophr Res. 2012;140(1-3):159–68. doi:10.1016/j.schres.2012.03.017.CrossRefPubMed
26.
Bonfioli E, Berti L, Goss C, Muraro F, Burti L. Health promotion lifestyle interventions for weight management in psychosis: a systematic review and meta-analysis of randomised controlled trials. BMC Psychiatry. 2012;12(1):78. doi:10.1186/1471-244X-12-78.CrossRefPubMedPubMedCentral
27.
Krogh J, Speyer H, Nørgaard HCB, Moltke A, Nordentoft M. Can exercise increase fitness and reduce weight in patients with schizophrenia and depression? Frontiers Psychiat. 2014;5:89. doi:10.3389/fpsyt.2014.00089.CrossRef
28.
Scheewe TW, van Haren NEM, Sarkisyan G, Schnack HG, Brouwer RM, de Glint M, et al. Exercise therapy, cardiorespiratory fitness and their effect on brain volumes: a randomised controlled trial in patients with schizophrenia and healthy controls. J European College Neuropsychopharmacol. 2013;23(7):675–85. doi:10.1016/j.euroneuro.2012.08.008.CrossRef
29.
Daumit GL, Dickerson FB, Wang N-Y, Dalcin A, Jerome GJ, Anderson CAM, et al. A behavioral weight-loss intervention in persons with serious mental illness. N Engl J Med. 2013;368(17):1594–602. doi:10.1056/NEJMoa1214530.CrossRefPubMedPubMedCentral
30.
Tsoi DT, Porwal M, Webster AC. Interventions for smoking cessation and reduction in individuals with schizophrenia. Cochrane Database Syst Rev. 2013;2, CD007253. doi:10.1002/14651858.CD007253.pub3.PubMed
31.
Williams JM, Anthenelli RM, Morris CD, Treadow J, Thompson JR, Yunis C, et al. A randomized, double-blind, placebo-controlled study evaluating the safety and efficacy of varenicline for smoking cessation in patients with schizophrenia or schizoaffective disorder. J Clin Psychiatry. 2012;73(5):654–60. doi:10.4088/JCP.11m07522.CrossRefPubMed
32.
De Hert M, Dekker JM, Wood D, Kahl KG, Holt RIG, Möller H-J. Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC. J Assoc European Psychiat. 2009;24(6):412–24. doi:10.1016/j.eurpsy.2009.01.005.CrossRef
33.
Laursen TM, Mortensen PB, MacCabe JH, Cohen D, Gasse C. Cardiovascular drug use and mortality in patients with schizophrenia or bipolar disorder: a Danish population-based study. Psychol Med. 2014;44(8):1625–37. doi:10.1017/S003329171300216X.CrossRefPubMed
34.
Kilbourne AM, Bramlet M, Barbaresso MM, Nord KM, Goodrich DE, Lai Z, et al. SMI Life Goals: Description of a randomized trial of a Collaborative Care Model to improve outcomes for persons with serious mental illness. Contemp Clin Trials. 2014;39(1):74–85. doi:10.1016/j.cct.2014.07.007.CrossRefPubMedPubMedCentral
35.
World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders. Int Class. 1992;10:1–267.
36.
37.
Consultation, W. H. O. E. Waist Circumference and Waist-Hip Ratio Report of a WHO Expert Consultation. 2008. p. 8–11.
38.
Jørgensen T, Borch-Johnsen K, Thomsen TF, Ibsen H, Glümer C, Pisinger C. A randomized non-pharmacological intervention study for prevention of ischaemic heart disease: baseline results Inter99. European J Cardiovascular Prev Rehabil. 2003;10(5):377–86. doi:10.1097/01.hjr.0000096541.30533.82.CrossRef
39.
De Backer G. European guidelines on cardiovascular disease prevention in clinical practice Third Joint Task Force of European and other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of eight societies and by invited experts). Eur Heart J. 2003;24(17):1601–10. doi:10.1016/S0195-668X(03)00347-6.CrossRefPubMed
40.
Prochaska JO, DiClemente CC. Stages of change in the modification of problem behaviors. Prog Behav Modif. 1992;28:183–218.PubMed
41.
Marshall M, Lockwood A. Assertive community treatment for people with severe mental disorders (Review), (2). 2010.
42.
Graeber DA, Moyers TB, Griffith G, Guajardo E, Tonigan S. A pilot study comparing motivational interviewing and an educational intervention in patients with schizophrenia and alcohol use disorders. Community Ment Health J. 2003;39(3):189–202.CrossRefPubMed
43.
44.
Fysisk aktivitet b. (2011) (Vol. 6, pp. 303–303). doi:10.4220/sykepleienf.2011.0196
45.
Lind, M., and Karin, O. G. (2011). Individuel Rygeafvænning.
46.
47.
Thomsen TF, Davidsen M, Ibsen H, Jorgensen T, Jensen G, Borch-Johnsen K. A New Method for Chd Prediction and Prevention Based on Regional Risk Scores and Randomized Clinical Trials; PRECARD(R) and the Copenhagen Risk Score. European J Cardiovascular Prev Rehabil. 2001;8(5):291–7. doi:10.1177/174182670100800508.CrossRef
48.
Andersen LB. A maximal cycle exercise protocol to predict maximal oxygen uptake. Scand J Med Sci Sports. 1995;5(3):143–6.CrossRefPubMed
49.
Andersen LG, Groenvold M, Jørgensen T, Aadahl M. Construct validity of a revised Physical Activity Scale and testing by cognitive interviewing. Scand J Public Health. 2010;38(7):707–14. doi:10.1177/1403494810380099.CrossRefPubMed
50.
Durnin BYJVGA, Womersley J. And its estimation from skinfold thickness : measurements on. 1973.
51.
Andreasen NC. Methods for assessing positive and negative symptoms. Mod Probl Pharmacopsychiatry. 1990;24:73–88.CrossRefPubMed
52.
Keefe RSE, Goldberg TE, Harvey PD, Gold JM, Poe MP, Coughenour L. The Brief Assessment of Cognition in Schizophrenia: reliability, sensitivity, and comparison with a standard neurocognitive battery. Schizophr Res. 2004;68(2-3):283–97. doi:10.1016/j.schres.2003.09.011.CrossRefPubMed
53.
Björkman T, Svensson B. Quality of life in people with severe mental illness. Reliability and validity of the Manchester Short Assessment of Quality of Life (MANSA). Nord J Psychiatry. 2005;59(4):302–6. doi:10.1080/08039480500213733.CrossRefPubMed
54.
Pedersen G, Hagtvet KA, Karterud S. Generalizability studies of the Global Assessment of Functioning-Split version. Compr Psychiatry. 2007;48(1):88–94. doi:10.1016/j.comppsych.2006.03.008.CrossRefPubMed
55.
Mossey JM, Shapiro E. Self-rated health: a predictor of mortality among the elderly. Am J Public Health. 1982;72(8):800–8. doi:10.2105/AJPH.72.8.800.CrossRefPubMedPubMedCentral
56.
Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385–96.CrossRefPubMed
57.
Toft U, Kristoffersen LH, Lau C, Borch-Johnsen K, Jørgensen T. The Dietary Quality Score: validation and association with cardiovascular risk factors: the Inter99 study. Eur J Clin Nutr. 2007;61(2):270–8. doi:10.1038/sj.ejcn.1602503.CrossRefPubMed
58.
Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom K-O. The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire. Addiction. 1991;86(9):1119–27. doi:10.1111/j.1360-0443.1991.tb01879.x.CrossRef
59.
Juel K, Helweg-Larsen K. The Danish registers of causes of death. Dan Med Bull. 1999;46(4):354–7.PubMed
60.
Mors O, Perto GP, Mortensen PB. The Danish Psychiatric Central Research Register. Scand J Public Health. 2011;39(7 Suppl):54–7. doi:10.1177/1403494810395825.CrossRefPubMed
61.
Nordentoft M, Pedersen MG, Pedersen CB, Blinkenberg S, Mortensen PB. The new asylums in the community: severely ill psychiatric patients living in psychiatric supported housing facilities. A Danish register-based study of prognostic factors, use of psychiatric services, and mortality. Soc Psychiatry Psychiatr Epidemiol. 2012;47(8):1251–61. doi:10.1007/s00127-011-0432-2.CrossRefPubMed
62.
Pedersen CB. The Danish Civil Registration System. Scand J Public Health. 2011;39(7 Suppl):22–5. doi:10.1177/1403494810387965.CrossRefPubMed
63.
Andersen JS, Olivarius NDF, Krasnik A. The Danish National Health Service Register. Scand J Public Health. 2011;39(7 Suppl):34–7. doi:10.1177/1403494810394718.CrossRefPubMed
64.
Schmidt M, Pedersen L, Sorensen HT. The Danish Civil Registration System as a tool in epidemiology. Eur J Epidemiol. 2014;29(8):541–9. doi:10.1007/s10654-014-9930-3.CrossRefPubMed
65.
Jakobsen JC, Gluud C, Winkel P, Lange T, Wetterslev J. The thresholds for statistical and clinical significance - a five-step procedure for evaluation of intervention effects in randomised clinical trials. BMC Med Res Methodol. 2014;14(1):34. doi:10.1186/1471-2288-14-34.CrossRefPubMedPubMedCentral
66.
Ebrahim S, Taylor F, Ward K, Beswick A, Burke M, G DS. Multiple risk factor interventions for primary prevention of coronary heart disease (Review), (1). 2013.
67.
Després J-P. Abdominal obesity and cardiovascular disease: is inflammation the missing link? Can J Cardiol. 2012;28(6):642–52. doi:10.1016/j.cjca.2012.06.004.CrossRefPubMed
68.
Donders ART, van der Heijden GJMG, Stijnen T, Moons KGM. Review: a gentle introduction to imputation of missing values. J Clin Epidemiol. 2006;59(10):1087–91. doi:10.1016/j.jclinepi.2006.01.014.CrossRefPubMed
69.
Jorgensen AW, Lundstrom LH, Wetterslev J, Astrup A, Gotzsche PC. Comparison of results from different imputation techniques for missing data from an anti-obesity drug trial. PLoS One. 2014;9(11), e111964. doi:10.1371/journal.pone.0111964.CrossRefPubMedPubMedCentral
70.
Moher D, Schulz KF, Altman DG. The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials. Clin Oral Investig. 2003;7(1):2–7. doi:10.1007/s00784-002-0188-x.PubMed
71.
Jørgensen T, Kart R, Toft U, Aadahl M, Glümer C, Pisinger C. Effect of screening and lifestyle counselling on incidence of ischaemic heart disease in general population. Inter99 Randomised Trial. 2014;3617(June):1–11. doi:10.1136/bmj.g3617.
72.
Kodama S, Saito K, Tanaka S, Maki M, Yachi Y, Asumi M, et al. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA. 2009;301(19):2024–35. doi:10.1001/jama.2009.681.CrossRefPubMed
73.
Siersma V, Als-Nielsen B, Chen W, Hilden J, Gluud LL, Gluud C. Multivariable modelling for meta-epidemiological assessment of the association between trial quality and treatment effects estimated in randomized clinical trials. Stat Med. 2007;26(14):2745–58. doi:10.1002/sim.2752.CrossRefPubMed
74.
Jakobsen JC, Gluud C. The Necessity Randomized. Clin Trials. 2013;3(4):1453–68.
75.
Wood L, Egger M, Gluud LL, Schulz KF, Juni P, Altman DG, et al. Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta-epidemiological study. BMJ (Clin Res Ed). 2008;336(7644):601–5. doi:10.1136/bmj.39465.451748.AD.CrossRef
76.
Pildal J, Hrobjartsson A, Jorgensen KJ, Hilden J, Altman DG, Gotzsche PC. Impact of allocation concealment on conclusions drawn from meta-analyses of randomized trials. Int J Epidemiol. 2007;36(4):847–57. doi:10.1093/ije/dym087.CrossRefPubMed
77.
Savovic J, Jones H, Altman D, Harris R, Juni P, Pildal J, et al. Influence of reported study design characteristics on intervention effect estimates from randomised controlled trials: combined analysis of meta-epidemiological studies. Health Technol Assessment (Winchester, England). 2012;16(35):1–82. doi:10.3310/hta16350.
78.
Bero L. Industry sponsorship and research outcome: a Cochrane review. JAMA Int Med. 2013;173(7):580–1. doi:10.1001/jamainternmed.2013.4190.CrossRef
79.
Lundh A, Sismondo S, Lexchin J, Busuioc OA, Bero L. Industry sponsorship and research outcome. Cochrane Database Syst Rev. 2012;12, MR000033. doi:10.1002/14651858.MR000033.pub2.PubMed
80.
Winkel P, Hilden J, Hansen JF, Kastrup J, Kolmos HJ, Kjoller E, et al. Clarithromycin for stable coronary heart disease increases all-cause and cardiovascular mortality and cerebrovascular morbidity over 10 years in the CLARICOR randomised, blinded clinical trial. Int J Cardiol. 2015;182C:459–65. doi:10.1016/j.ijcard.2015.01.020.CrossRef
81.
Gluud C, Brok J, Gong Y, Koretz RL. Hepatology may have problems with putative surrogate outcome measures. J Hepatol. 2007;46(4):734–42. doi:10.1016/j.jhep.2007.01.003.CrossRefPubMed
Metadata
Title
Protocol for CHANGE: a randomized clinical trial assessing lifestyle coaching plus care coordination versus care coordination alone versus treatment as usual to reduce risks of cardiovascular disease in adults with schizophrenia and abdominal obesity
Authors
Helene Speyer
Hans Christian Brix Nørgaard
Carsten Hjorthøj
Thomas Axel Madsen
Søren Drivsholm
Charlotta Pisinger
Christian Gluud
Ole Mors
Jesper Krogh
Merete Nordentoft
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2015
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-015-0465-2

Other articles of this Issue 1/2015

BMC Psychiatry 1/2015 Go to the issue

Research article

Differential characteristics of young and midlife adult users of psychotherapy, psychotropic medications, or both: information from a population representative sample in São Paulo, Brazil

Research article

Understanding recovery in the context of lived experience of personality disorders: a collaborative, qualitative research study

Research article

Assessing health status in informal schizophrenia caregivers compared with health status in non-caregivers and caregivers of other conditions

Research article

Effectiveness of guided self-help in decreasing expressed emotion in family caregivers of people diagnosed with depression in Thailand: a randomised controlled trial

Research article

Paternal and maternal bonding styles in childhood are associated with the prevalence of chronic pain in a general adult population: the Hisayama Study

Research article

Sleeping problems in Chinese illicit drug dependent subjects