Nous avons conduit une étude pharmaco-épidémiologique, observationnelle, transversale et multicentrique destinée à évaluer le niveau de vigilance des psychiatres français vis-à-vis des facteurs de risque cardiovasculaire (FDR CV), chez des patients ambulatoires souffrant de trouble schizophrénique. Le niveau de vigilance pour un FDR CV donné était par la proportion de psychiatres l’ayant surveillé chez au moins 75 % de leurs patients sélectionnés. Au total, 382 psychiatres exerçant en secteur privé ont inclus 2242 patients. Les données de 2222 patients (âge moyen=41ans, hommes=59 %) ont été analysées. Près de 34 % des patients présentaient un surpoids, 23 % étaient obèses. La majorité des patients (77 %) recevait au moins un antipsychotique atypique comme traitement antipsychotique principal. Seuls 58 % des psychiatres étaient vigilants pour le poids de leurs patients, 38 % pour la tension artérielle, 25 % pour les antécédents familiaux de maladie coronaire précoce, 14 % pour la glycémie ; 35 % des psychiatres n’étaient vigilants à aucun FDR CV. Moins de 30 % des psychiatres avaient adressé leurs patients à risque à un spécialiste. En conclusion, cette étude met en évidence un déficit de prise en compte de ces facteurs de risque cardiovasculaire lors du suivi habituel des patients.

Schizophrenic patients have increased cardiovascular risk factors and morbi-mortality as compared with the general population.

To assess the level of French psychiatrists vigilance regarding cardiovascular risk factors in schizophrenic patients.

Prospective, transverse, multicentric observational study implemented in France in 2007 and conducted by psychiatrists with a liberal activity. The included patients had to meet the following selection criteria: patients ≥18 years old, fulfilling the DSM-IV-TR criteria for schizophrenia, treated or not treated for their schizophrenia, with an ambulatory follow-up, without schizophreniform, schizoaffective, or other psychotic disorder. The psychiatrists “vigilance level” for a given cardiovascular risk factor was defined as a systematic investigation of this cardiovascular risk factor for at least 75% of the schizophrenic patients included in the study by the psychiatrist.

A total of 382 psychiatrists included 2242 patients, the data collected for 2222 patients were finally analysed. The mean age was 41 years old, 59% were men. The mean BMI was 27kg/m², 34% of the patients were overweight, 23% were obese. The paranoid and residual schizophrenia were the most frequently described subtypes of the disease (41.3 and 25.0% respectively), 58% of the patients were moderately or markedly ill according to the CGI-S scale. Most of the patients were treated with atypical antipsychotics (77%). Only 58% of the psychiatrists were vigilant for the weight of their patients, 38% for the arterial tension, 25% for the family history of premature coronary disease, 14% for the glycemia, 12% for the triglycerides, 10% for HDL cholesterol, 6% for the waist measurement; 35% of the psychiatrists were vigilant for no cardiovascular risk factor. Less than 30% of the psychiatrists recommended their patients to other specialists to manage cardiovascular disorders.

Similarly to other countries, French psychiatrists provide insufficient care of cardiovascular risk factors of schizophrenic patients in their current clinical practice.