Obesity and psycho-pathological symptoms and psychosocial relationship with anti psychotics and DISC1 gene as genetic marker of schizophrenia susceptibility

Abstract

Schizophrenia is a chronic debilitating mental disorder with a lifetime risk estimated at about 1%, regardless of ethnicity. The ideal outcome of schizophrenia treatment is to improve psycho-social function and quality of life thus limiting the debilitating condition. This can be achieved by reducing the devastating effects of its psycho-pathological symptoms. Unfortunately, the introduction of atypical anti-psychotic drugs is linked to obesity, an issue of concern as it is a co-morbid condition that is closely related to metabolic syndrome. Additionally, there are substantial evidences that suggest Disrupted-in-Schizophrenia-1 gene (DISC1) function in neurodevelopment. This supported DISC1 locus as candidate gene of schizophrenia and a potential target for treatment of schizophrenia. The current research encompasses three different sub-studies. Firstly, the study investigated the relationship between psycho symptoms and psycho-social function and anti-psychotics in the prediction of psycho-social function among schizophrenia patients. Secondly, the study assessed the correlation of body mass index with antipsychotics. Subsequently, the data was compared with Malaysian Adult Nutrition Survey (MANS). Finally, the study assessed the association of DISC1 gene as genetic susceptibility marker of schizophrenia. A total of 240 schizophrenia patients and 350 control healthy individuals participated in the study. A cross sectional approach was adopted for the first and second study and unmatched case-control for the third study. Methods used include interview, psychiatric scales assessment and genotyping for DISC1 markers. There was an inverse relationship between psycho-symptoms and psychosocial functions. Disorganization (DIS) was the only significant predictor to all dimensions of psycho-social functions. Typical anti-psychotics significantly predicted social function negatively as compared to Sulpiride (b=-0.152, p=0.028).Obesity was 2-fold greater than the reference population. Body mass index was generally related to antipsychotic drugs (?2 = 33.42;p = 0.04).Finally, the study found two SNPs, rs4658971 and rs1538971 within DISC1 gene that predisposed to schizophrenia andrs2509382located in chromosome 11 that was associated with schizophrenia in males. The study concluded four important findings. Firstly, obesity was common among schizophrenia patients and this could be attributed to anti-psychotics. Secondly, DIS as predictor to all social dimensions emphasized the importance of cognition in schizophrenia. Thirdly, Sulpiride predicted better social function than typical antipsychotics. Lastly, the study provided significant evidence of DISC1 gene as marker of schizophrenia susceptibility.