January 2014

Common Childhood Determinants of Psychiatric and Cardiovascular Disorders Call for Common Prevention and Clinical Research

Author Affiliations
  • 1Centre de Recherche, Institut Universitaire en Santé Mentale de Québec, Québec City, Canada
  • 2Laval University, Faculté de Médecine, Québec City, Québec, Canada

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JAMA Pediatr. 2014;168(1):3-4. doi:10.1001/jamapediatrics.2013.3871

Today’s medicine maintains as 2 separate medical fields metabolic cardiovascular disorders (MCVDs) and major psychiatric disorders (MPDs) such as schizophrenia, bipolar disorder, and depression. Yet MCVD and MPD can affect the same patient, and they may share common genetic, environmental, and developmental roots. Confronting these facts innovatively may have unforeseen clinical and research significance.

One place where the fields of MCVD and MPD are often intertwined is in the clinic. Several MCVDs lead to neurodegenerative diseases: adult patients with diabetes, for instance, are at increased risk of Alzheimer disease and psychosis. Conversely, adult patients with MPD are more likely to develop cardiovascular or metabolic syndromes either because of their lifestyles or their medication. Weight gain and severe alterations of blood lipid levels are common adverse effects of antipsychotic medication, and studies point to large rates of diabetes in patients with bipolar disorder. This increased risk of cardiac events due to antipsychotics should thus raise concerns about an emerging practice: the increasing prescription of antipsychotics in the United States for children and adolescents.1 In a similar way, statins, the most prescribed drugs targeting blood cholesterol levels, are now being investigated for their effects on brain functioning and risk of secondary MPD.

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