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No. 2 (2024)

PSYCHOPHARMACOTHERAPY

Prevalence and Risk Factors for Long QT Interval Syndrome in Patients with Schizophrenia during Antipsychotic Treatment

https://doi.org/10.21265/PSYPH.2024.31.31.004

Published 2024-06-30

  • S.A. Galkin
    • ,
  • E.G. Kornetova
    • ,
  • I.A. Mednova
    • ,
  • V.V. Tiguntsev
    • ,
  • A.N. Kornetov

S.A. Galkin
Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences; Siberian State Medical University

E.G. Kornetova
Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences

I.A. Mednova
Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences

V.V. Tiguntsev
Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences; Siberian State Medical University

A.N. Kornetov
Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences; Siberian State Medical University

Abstract

Relevance. The development of long QT interval syndrome as an adverse reaction to antipsychotic therapy in patients with schizophrenia is an urgent interdisciplinary problem, since it significantly increases the risk of sudden death. However, not all patients with schizophrenia taking antipsychotics develop this syndrome, which indicates the existence of additional risk factors that remain poorly understood.

The aim — identification of the frequency of occurrence and risk factors for the long QT-interval syndrome in patients with schizophrenia during antipsychotic treatment.

Material and methods. The study included 165 patients with an established diagnosis of schizophrenia. All patients had a standard 12-lead electrocardiogram recording at the time of admission to the hospital. The QT interval was measured and the QTc was calculated using the Bazett formula. QTc was considered to be prolonged (long QT-interval syndrome), with values > 450 ms in men and > 460 ms in women. The components of the metabolic syndrome were determined according to the 2005 criteria of the International Diabetes Federation. The anthropometric examination of patients was performed according to the V.V. Bunak method in Chitetsov›s modification for adult samples with calculation of the basic integral anthropometric indices.

Results. Long QT-interval syndrome was detected in 16 (9.7 %) patients. This group included 12 men and 4 women, i.e. 15.6 % of all men and 4.5 % of all women (p = 0.057). The type of antipsychotic used, as well as the total antipsychotic load, did not differ between the patient groups (p > 0.05), and the duration of basic therapy differed only at the trend level (p = 0.068). A comparison of the groups according to the prevalence of metabolic syndrome and its individual components showed a statistically significant difference in the frequency of abdominal obesity (p = 0.032) and arterial hypertension (p = 0.010). Statistically significant differences in the frequency of occurrence of constitutional and morphological types in patients were also obtained, depending on the presence/absence of long QT-interval syndrome (p = 0.041). According to ANOVA, statistically significant factors influencing the individual values of the QTc interval in patients with schizophrenia were abdominal obesity (p = 0.041), arterial hypertension (p = 0.015) and constitutional morphological type (p = 0.003).

Conclusion. The results of the study showed that long QT-interval syndrome was observed in 9.7 % of hospitalized patients with schizophrenia receiving antipsychotics. Risk factors for the development of this syndrome were abdominal obesity, arterial hypertension, as well as belonging to a hypersthenic or mesosthenic constitutional and morphological body type.

Keywords

schizophrenia, QT interval, risk factors, metabolic disorders, constitutional features

PDF (Русский)

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