Increased cardiometabolic dysfunction in first-degree relatives of patients with psychotic disorders

Introduction: Elevated prevalence of comorbid cardio-vascular and metabolic dysfunction (CMD) is consistently reported in patients with severe psychotic disorders such as schizophrenia (SZ), schizoaffective (SZA) and bipolar disorder (BP-P). Since both psychosis and CMD are substantively heritable in nature, we attempted to investigate the occurrence of CMD disorders in first-degree relatives of probands with psychosis. Methods: Our sample included 861 probands with a diagnosis of SZ (n = 354), SZA (n = 212) and BP-P (n = 295), 776 first-degree relatives of probands and 416 healthy controls. Logistic regression was used to compare prevalence of any CMD disorders (diabetes, hypertension, hyperlipidemia or coronary artery disease) across groups. Post hoc tests of independence checked for CMD prevalence across psychosis diagnosis (SZ, SZA and BP-P), both in relatives of probands and within probands themselves. Results: After controlling for potential confounders, first-degree relatives with (p < 0.001) and without (p = 0.03) Axis I non-psychotic or Axis- II cluster disorders were at a significant risk for CMD compared to controls. No significant difference (p = 0.42) was observed in prevalence of CMD between relatives of SZ, SZA and BP-P, or between psychosis diagnoses for probands (p = 0.25). Discussion: Prevalence of CMD was increased in the first-degree relatives of psychosis subjects. This finding suggests the possibility of overlapping genetic contributions to CMD and psychosis. Increased somatic disease burden in relatives of psychotic disorder probands points to need for early detection and preventive efforts in this population.