The heart of the matter: cardiometabolic care in youth with psychosis

Early Interv Psychiatry. 2012 Aug;6(3):347-53. doi: 10.1111/j.1751-7893.2011.00315.x. Epub 2012 Jan 6.

Abstract

Aim: Weight gain, obesity and metabolic disturbances in youth with psychosis are significant contributors to the health burden of people with psychosis, with a two- to threefold increase in rates compared with the general population and a 20% reduction in life expectancy. Several studies have now described cardiometabolic benefits of a range of interventions, including a structured diet and exercise programmes and metformin for patients receiving antipsychotic medications. Despite the development of Australian consensus guidelines and screening algorithms to detect such metabolic abnormalities, there is a lack of guidelines for clinicians to determine appropriate, timely, targeted prevention and intervention to manage these complications in the youth population.

Methods: The Bondi Early Psychosis Programme targets young people (aged 15-25 years) experiencing their first episode of psychosis. This service has developed a model of metabolic screening and a treatment algorithm to provide clinicians with recommendations for targeted interventions.

Results: Positive Cardiometabolic Health: an early intervention framework for patients on psychotropic medication describes a method for early detection, prevention and intervention strategies targeting antipsychotic-induced metabolic abnormalities and cardiovascular risk factors.

Conclusion: Although further research is required, there is sufficient evidence to support early intervention and prevention strategies to improve physical health outcomes in young people with first-episode psychosis.

MeSH terms

  • Adolescent
  • Adult
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / therapeutic use
  • Cardiovascular Diseases / prevention & control*
  • Early Medical Intervention
  • Female
  • Humans
  • Male
  • Psychotic Disorders / complications*
  • Psychotic Disorders / drug therapy
  • Psychotic Disorders / therapy
  • Risk Factors
  • Weight Gain / drug effects
  • Young Adult

Substances

  • Antipsychotic Agents