scholarly journals Medical outcome of pregnancy in women with psychotic disorders and their infants in the first year after birth

2003 ◽  
Vol 182 (1) ◽  
pp. 63-67 ◽  
Author(s):  
Louise M. Howard ◽  
Claudia Goss ◽  
Morven Leese ◽  
Graham Thornicroft
Keyword(s):  
General Practice ◽  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
General Practice Research Database ◽  
Practice Research ◽  
Obstetric Outcomes ◽  
Research Database ◽  
Increased Risk ◽  
Significant Difference ◽  
History Of

BackgroundThere has been little research into the health of infants of women with psychotic disorders.AimsTo investigate the antenatal care of mothers with a history of psychotic disorders, obstetric outcomes and the subsequent health of their babies.MethodA matched, controlled cohort study was carried out using the General Practice Research Database. Women with a history of a psychotic disorder, who gave birth in 1996–1998, were compared with women matched for age and general practice (199 cases and 787 controls) and their infants.ResultsCases had a higher proportion of stillbirths (OR=4.03, 95% CI 1.14–4.25, P=0.03) and neonatal deaths (P<0.001). There was no difference in gestational age at antenatal booking. Mothers with psychotic disorders were less likely than controls to attend for infant immunisations 90–270 days after birth (RR=0.94, 95% CI 0.88–0.99, P=0.03). There was no significant difference in the rates of accidents and hospital contacts for infants.ConclusionsThere is an increased risk of stillbirth and neonatal death in women with a history of psychotic disorder, and it is therefore important for health care professionals to focus on optimal obstetric care. The physical health of babies who live with mothers with psychotic disorders is not significantly different from that of matched baby controls.

scholarly journals Risk of hip fracture in patients with a history of schizophrenia

2007 ◽  
Vol 190 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Louise Howard ◽  
Graham Kirkwood ◽  
Morven Leese
Keyword(s):  
Hip Fracture ◽  
Antipsychotic Medication ◽  
Univariate Analysis ◽  
General Practice Research Database ◽  
Practice Research ◽  
Research Database ◽  
Mineral Density ◽  
Increased Risk ◽  
History Of ◽  
Clinically Significant

BackgroundThere is evidence of an association between decreased bone mineral density schizophrenia, and prolactin-raising antipsychotic medication. However, it is not known whether this is clinically significant.AimsTo investigate whether patients with a history of schizophrenia are at increased risk of hip fracture.MethodIn a case-control study, we compared cases of ‘hip fracture’ on the General Practice Research Database (n=16 341) with matched controls (n=29 889).ResultsHip fracture was associated with schizophrenia (OR=1.73; 95% CI 1.32-2.28), and prolactin-raising antipsychotics (OR=2.6; 95% CI 2.432.78), in the univariate analysis. In the multivariate analysis, prolactin-raising antipsychotics were independently associated with hip fracture but schizophrenia was not. A significant interaction between gender and antipsychotics was found in the association with hip fracture (P=0.042); OR=2.12 (95% C11.73-2.59)for men, OR=l.93 (95% C11.78-2.10) for women.ConclusionsThe association between prolactin-raising antipsychotic medication and hip fracture may have serious implications for public health. Mental health service patients may require preventive measures including dietary and lifestyle advice.

scholarly journals Risk of Mortality (including Sudden Cardiac Death) and Major Cardiovascular Events in Users of Olanzapine and Other Antipsychotics: A Study with the General Practice Research Database

2013 ◽  
Vol 2013 ◽  
pp. 1-13 ◽  
Author(s):  
Meghan E. Jones ◽  
Giedra Campbell ◽  
Deven Patel ◽  
Elizabeth Brunner ◽  
Chetan C. Shatapathy ◽  
...  
Keyword(s):  
General Practice ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
General Practice Research Database ◽  
Practice Research ◽  
Research Database ◽  
Cardiac Mortality ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Typical Antipsychotics

Objective. Assess risk of cardiac events and mortality among users of olanzapine and other antipsychotics relative to nonusers. Methods. The General Practice Research Database was used to identify cohorts of antipsychotic users and nonusers with psychiatric illness. Outcomes included cardiac mortality, sudden cardiac death (SCD), all-cause mortality (excluding suicide), coronary heart disease (CHD), and ventricular arrhythmias (VA). Results. 183,392 antipsychotic users (including 20,954 olanzapine users) and 193,920 psychiatric nonusers were identified. There was a significantly higher rate of cardiac mortality (adjusted RR [aRR]: 1.53, CI, 1.12–2.09) in olanzapine users relative to psychiatric nonusers, consistent with findings for both atypical and typical antipsychotics. Relative to psychiatric nonusers, no increased risk of all-cause mortality was observed among olanzapine users (aRR: 1.04, CI, 0.93–1.17), but elevated all-cause mortality risk was observed when compared to all antipsychotic users (aRR: 1.75, CI, 1.64–1.87). There was no increased risk of CHD or VA among olanzapine users relative to psychiatric nonusers, consistent with findings for atypical but not typical antipsychotics. SCD cases were uncommon. Conclusions. Use of antipsychotic agents was associated with increased risk of all-cause and cardiac mortality. Patients treated with olanzapine were found to be at increased risk of cardiac mortality versus psychiatric nonusers.

Risk of cataract and glaucoma in patients with multiple sclerosis

2011 ◽  
Vol 18 (5) ◽  
pp. 628-638 ◽  
Author(s):  
Marloes T Bazelier ◽  
Sigrid Mueller-Schotte ◽  
Hubert GM Leufkens ◽  
Bernard MJ Uitdehaag ◽  
Tjeerd van Staa ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
General Practice Research Database ◽  
Population Based ◽  
Practice Research ◽  
Research Database ◽  
Hazard Ratios ◽  
Increased Risk ◽  
History Of ◽  
The Uk ◽  
Hospital Registry

Background: The aim of the study was to evaluate whether multiple sclerosis (MS) is associated with risk of cataract or glaucoma. Methods: We conducted a population-based cohort study utilizing the UK General Practice Research Database (1987–2009) linked to the national hospital registry of England (1997–2008). Incident MS patients (5576 cases) were identified and each was matched to six patients without MS (controls) by age, gender, and practice. Cox proportional hazard models were used to estimate hazard ratios (HRs) of incident cataract and glaucoma in MS. Time-dependent adjustments were made for age, history of diseases and drug use. Results: MS patients had no overall increased risk of cataract, adjusted (adj.) HR 1.15 (95% CI 0.94–1.41) or glaucoma, adj. HR 1.02 (95% CI 0.78–1.33). Risk of cataract (adj. HR 2.45 (95% CI 1.56–3.86)) and glaucoma (adj. HR 1.70 (95% CI 1.01–2.86)) was significantly greater in patients < 50 years, particularly in men < 50 years: cataract, adj. HR 4.23 (95% CI 2.22–8.05) and glaucoma, adj. HR 2.76 (95% CI 1.28–5.93). Conclusion: This is the first study which showed that the risk of cataract and glaucoma is elevated in MS patients younger than 50 years, particularly men.

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