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Coronary Artery Disease in Patients Suffering From Schizophrenia

Not Applicable
Conditions
Schizophrenia
Cardiovascular Disease
Interventions
Other: Illness history
Other: Measure of social conditions
Other: Measure of psychiatric condition
Procedure: Cardiovascular measurement
Registration Number
NCT02885792
Lead Sponsor
Aalborg Psychiatric Hospital
Brief Summary

Schizophrenia is a severe mental illness associated with excess mortality and affecting nearly 1% of the population. The average life expectancy for patients diagnosed with schizophrenia has been 55-60 years through the last generations in Denmark, while the general population has over the same period of time experienced an increase in life expectancy. As a result, the standardized mortality rate for patients with schizophrenia has increased markedly over the last three decades and is currently a major public health concern. Causes of death are mainly cardiovascular disease and patients diagnosed with schizophrenia has a relative risk of cardiovascular disease that is about 2-fold higher than the general population.

Detailed Description

Little is known about severe progression of premature coronary arteriosclerosis in patients suffering from schizophrenia. Coronary artery calcium score is a well-defined measure to predict cardiovascular disease events, however there has not yet been any attempt to investigate whether there is an association between coronary artery calcium score and premature morbidity and mortality in patients diagnosed with schizophrenia.

The objective of this study is to investigate the progression of arteriosclerosis in patients with schizophrenia at different stages of the disease, and to offer and implement adequate treatment for these patients according to their somatic condition. This study will identify risk factors of somatic diseases in these patients, with specific focus on early diagnoses, prevention, intervention and treatment of arteriosclerosis in schizophrenic patients.

The investigation is about the possibility of detecting any differences between developing arteriosclerosis in schizophrenia patients versus the general population, and how common risk factors are contributing to this process. The results of this study should provide important modifications in the clinical guidelines for treatment of patients diagnosed with schizophrenia.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
300
Inclusion Criteria
  • Participants with a diagnosis of F20 schizophrenia.
  • Informed statement of consent
  • Age > 18
Exclusion Criteria
  • Incompetency to create stabile relation or make agreements
  • Pregnancy and also breastfeeding women
  • Participants with severe claustrophobia
  • Participants with lack of ability to cooperate with the planned study program.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Debuting and chronic schizophreniaIllness historyILLNESS HISTORY: * Existing psychiatric and somatic diagnosis and treatment * Charlson co-morbidity MEASURE OF SOCIAL CONDITIONS - For example Lubben Social Network Scale-6 and Brief Trauma Questionnaire. MEASURE OF PSYCHIATRIC CONDITION:: * Positive and Negative Syndrome Scale (PANSS) * Clinical Global Impression Scale (CGI) * Columbia Suicide Severity Rating Scale (C-SSRS) * Beck Cognitive Insight Scale * Birchwood Insight Scale CARDIOVASCULAR MEASUREMENT: CT Coronary angiography (CT-CAG) * Echocardiography * Heart rate variability (HRV) * Pulmonary function test (PFT) * Toe blood pressure (TBP) * Blood test * Body composition analysis * CT scan of upper abdomen * Cardiovascular magnetic resonance imaging (CMR) * Adipose tissue biopsy
Debuting and chronic schizophreniaMeasure of social conditionsILLNESS HISTORY: * Existing psychiatric and somatic diagnosis and treatment * Charlson co-morbidity MEASURE OF SOCIAL CONDITIONS - For example Lubben Social Network Scale-6 and Brief Trauma Questionnaire. MEASURE OF PSYCHIATRIC CONDITION:: * Positive and Negative Syndrome Scale (PANSS) * Clinical Global Impression Scale (CGI) * Columbia Suicide Severity Rating Scale (C-SSRS) * Beck Cognitive Insight Scale * Birchwood Insight Scale CARDIOVASCULAR MEASUREMENT: CT Coronary angiography (CT-CAG) * Echocardiography * Heart rate variability (HRV) * Pulmonary function test (PFT) * Toe blood pressure (TBP) * Blood test * Body composition analysis * CT scan of upper abdomen * Cardiovascular magnetic resonance imaging (CMR) * Adipose tissue biopsy
Debuting and chronic schizophreniaMeasure of psychiatric conditionILLNESS HISTORY: * Existing psychiatric and somatic diagnosis and treatment * Charlson co-morbidity MEASURE OF SOCIAL CONDITIONS - For example Lubben Social Network Scale-6 and Brief Trauma Questionnaire. MEASURE OF PSYCHIATRIC CONDITION:: * Positive and Negative Syndrome Scale (PANSS) * Clinical Global Impression Scale (CGI) * Columbia Suicide Severity Rating Scale (C-SSRS) * Beck Cognitive Insight Scale * Birchwood Insight Scale CARDIOVASCULAR MEASUREMENT: CT Coronary angiography (CT-CAG) * Echocardiography * Heart rate variability (HRV) * Pulmonary function test (PFT) * Toe blood pressure (TBP) * Blood test * Body composition analysis * CT scan of upper abdomen * Cardiovascular magnetic resonance imaging (CMR) * Adipose tissue biopsy
Debuting and chronic schizophreniaCardiovascular measurementILLNESS HISTORY: * Existing psychiatric and somatic diagnosis and treatment * Charlson co-morbidity MEASURE OF SOCIAL CONDITIONS - For example Lubben Social Network Scale-6 and Brief Trauma Questionnaire. MEASURE OF PSYCHIATRIC CONDITION:: * Positive and Negative Syndrome Scale (PANSS) * Clinical Global Impression Scale (CGI) * Columbia Suicide Severity Rating Scale (C-SSRS) * Beck Cognitive Insight Scale * Birchwood Insight Scale CARDIOVASCULAR MEASUREMENT: CT Coronary angiography (CT-CAG) * Echocardiography * Heart rate variability (HRV) * Pulmonary function test (PFT) * Toe blood pressure (TBP) * Blood test * Body composition analysis * CT scan of upper abdomen * Cardiovascular magnetic resonance imaging (CMR) * Adipose tissue biopsy
Matched controlsCardiovascular measurementCARDIOVASCULAR MEASUREMENT: * CT Coronary angiography (CT-CAG) * Echocardiography * Heart rate variability (HRV) * Pulmonary function test (PFT) * Toe blood pressure (TBP) * Blood test * Body composition analysis * CT scan of upper abdomen * Cardiovascular magnetic resonance imaging (CMR) * Adipose tissue biopsy
Primary Outcome Measures
NameTimeMethod
CT coronary angiography - a quantitative clinical measurement6 years

CT coronary angiography is a non-invasive procedure that uses simple CT-scan without contrast to measure coronary calcifications

Secondary Outcome Measures
NameTimeMethod
Echocardiography - Clinical objective evaluation6 years

Echocardiography is a non-invasive procedure that uses ultrasound waves to generate live images of the patient's heart

CT-scan of upper abdomen (CTUA) - Clinical objective evaluation6 years

CTUA uses X-rays to produce cross-sectional images of the heart and liver

Cardiovascular magnetic resonance imaging(CMR) - Clinical objective evaluation6 years

CMR uses a strong magnetic field including radio waves to generate images of the heart

Urine sample - Objective clinical evaluation6 years

Urine sample measures the content of melatonin, which is a hormone that controls the natural cycle of sleeping and waking hours.

Global Assessment of Functioning (GAF) - Clinical evaluation6 years

The GAF is a clinical evaluation of the patient's overall functioning level, including psychological, social and interpersonal, and occupational functioning of mental health-illness.

Body Composition analysis (BCA) - Clinical objective evaluation6 years

Using a standard weight to measure body composition for each patient

Charlson Co-morbidity index - Self-report questionnaire6 years

Measure of illness history with focus on which additional somatic or psychiatric diagnosis patients have.

Pulmonary function test (PFT) - Clinical objective evaluation6 years

PFT also known as spirometry is a procedure that measures lung function

Toe brachial index (TBI) - Clinical objective evaluation6 years

TBP is a procedure that measures the relationship between the systolic blood pressure at the toe and the arm

Blood test - Clinical objective evaluation6 years

Blood test is used to identify biomedical markers. A volume of 20 ml will be needed from each patient.

Lubben Social Network Scale-6 (LSNS-6) - Self-report questionnaire6 years

The LSNS-6 is a self-report questionnaire measuring social isolation, including relations to family and friends.

Positive and Negative Syndrome Scale (PANNS) - Clinical psychiatric evaluation6 years

The PANNS measures symptom severity in schizophrenia with focus on two distinct syndromes. The postive syndromes including productive symptoms, and the negative syndrome, including deficit features.

Clinical Global Impression Scale (CGI) - Clinical psychiatric evaluation6 years

The CGI is a measure of symptom severity, therapeutic response and general improvement.

Heart rate variability (HRV) - Clinical objective evaluation6 years

HRV is a non-invasive procedure that detects the function of the autonomic nervous system on the heart rhythm.

Existing psychiatric and somatic diagnosis and treatment - Self-report questionnaire6 years

Measure of illness history with focus on previous diagnosis and treatment

Adipose tissue biopsy - Clinical objective evaluation6 years

Adipose tissue biopsy is an invasive procedure that we use to understand the composition of fat acid for each patient in order to understand the correlation between fat acid and cardiovascular disease.

Trial Locations

Locations (1)

Aalborg University Hospital, Psychiatric Hospital

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Aalborg, Denmark

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