In a study conducted by researchers from the NIHR Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust (SLaM) and King's College London, people with established psychosis have extremely high levels of cardiovascular risk factors. The study has been published in Psychological Medicine.
This is the largest study of its kind in the UK involving more than 400 outpatients with psychosis. Data was collected as part of the NIHR-funded IMPaCT trial and the study was conducted within five mental health NHS Trusts in urban and rural locations across England.
48 percent of the sample was obese with a BMI of 30 or more. Most of the men and women had a waist circumference above the International Diabetes Federation's (IDF) threshold for central obesity. 83 per cent of patients were centrally obese (having excessive fat around the stomach and abdomen): 95 per cent of females and 74 per cent of males.
57 percent of the participants met the IDF's criteria for metabolic syndrome, which is a cluster of biochemical and physiological abnormalities associated with the development of heart disease, stroke and type-2 diabetes. A fifth of the participants met the criteria for diabetes and 30 per cent were at a high risk of developing diabetes.
While cardiovascular risk factors have been associated with psychosis, this particular study reports some of the highest rates worldwide, thus reinforcing the need to incorporate weight and cardiovascular risk assessment and management into the routine care of people with psychosis. The study also identified lifestyle choices that are likely to add to cardiovascular risk including smoking (62 percent of the participants were smokers) and lack of exercise (only 12 percent of participants engaged in high intensity physical activity).
Dr Fiona Gaughran, senior author from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London, and the National Psychosis Unit at SLaM, said: 'We already know that diagnosis of a psychotic illness such as schizophrenia or bipolar disorder is associated with a reduced life expectancy of between 10 to 25 years. This mortality gap is largely due to natural causes, including cardiac disease. The worryingly high levels of cardiovascular risk shown in our study indicate that a much greater emphasis on physical activity is needed for those with severe mental illnesses, as well as a more significant focus on supporting attempts to quit smoking."
The study did not find any difference in rates of cardiovascular risk between different anti-psychotic medications. The researchers highlight the need to reduce cardiovascular risk in people with psychosis, prevent weight gain and promote a healthy lifestyle in the early stage of their illness.
Source: King's College London
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