Body mass index, obesity, and psychopathology in patients with schizophrenia.

A number of studies have reported that patients with schizophrenia have a higher body mass index (BMI) than the general population. Few Asian studies have examined BMI in patients with schizophrenia. The aims of the current study were to evaluate the distribution of BMI and prevalence of obesity in a large sample of Chinese patients with schizophrenia (n = 973) and to examine the sociodemographic and clinical correlates of overweight (BMI ≥ 25 kg/m) and obesity (BMI ≥ 30 kg/m). There was a preponderance of patients who were overweight (58.7%) and obese (73.6%) as compared with control subjects. Regression modeling of clinical and symptom factors in schizophrenia patients revealed that females were almost twice as likely to be obese compared with males and patients with comorbid medical conditions were more likely to be obese compared with those who did not have a comorbid medical condition (odds ratio, 1.6). Those prescribed typical antipsychotic medications were 1.7 times more likely to be obese, whereas individuals prescribed with both typical and atypical antipsychotic medications were 2.2 times more likely to be obese as compared with those prescribed atypical antipsychotics. A significant predictor interaction for obesity was observed between sex and typical antipsychotics, sex and comorbid medical conditions, and years of education and comorbid medical conditions. The higher prevalence of obesity in patients with schizophrenia is a matter of clinical and public health concern; interventions to reduce weight to healthy levels would result in both improved health and quality of life among patients with schizophrenia.

Validity of the Personality Diagnostic Questionnaire-4 (PDQ-4+) among mentally ill prison inmates in Singapore.

We examined the validity of the Personality Diagnostic Questionnaire--4+ (PDQ-4+) as a screening instrument for personality disorders among mentally ill prison inmates in Singapore. A total of 313 prison inmates completed the PDQ-4+ and the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II). The subjects were 303 (96.8%) males and 10 (3.2%) females with a mean (SD) age of 40.7 (8.8) years. Kappa agreement between PDQ-4+ and SCID-II for the presence at least one personality disorder was moderate with high sensitivity and low specificity. For specific personality disorders and clusters, we found that the PDQ-4+ diagnosed more subjects as having each of the personality disorders than SCID-II with high negative predictive values. The area under the curve indicated moderate discriminatory capabilities. Our results suggest that the PDQ-4+ could be used as a potential screening instrument for personality disorders in prison inmates.