Cardiovascular risk factors extremely high in people with psychosis « King’s College London

Extremely high levels of cardiovascular risk factors have been found in people with established psychosis, with central obesity evident in over 80 per cent of participants, in a study by researchers from the NIHR Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust (SLaM) and King’s College London.

In the largest study of its kind in the UK, drawing on a sample of more than 400 outpatients with psychosis, it was discovered that nearly half of the sample were obese (48 per cent), with a body mass index (BMI) of 30 or more. Additionally, nearly all women and most men had a waist circumference above the International Diabetes Federation’s (IDF) threshold for central obesity. According to this measure 83 per cent of patients were centrally obese: 95 per cent of females and 74 per cent of males. Central obesity refers to excessive fat around the stomach and abdomen, to the extent that it is likely to have a negative impact on health.

The majority of participants tested (57 per cent) 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 met the criteria for diabetes and 30 per cent showed a higher risk of going on to develop diabetes.

Although cardiovascular risk factors are common in psychosis, this UK study reports some of the highest rates worldwide, reinforcing the need to incorporate weight and cardiovascular risk assessment and management into the routine care of people with psychosis.

Data was collected as part of the NIHR-funded IMPaCT trial and the study took place within community mental health teams in five mental health NHS Trusts in urban and rural locations across England.

The study, published in Psychological Medicine, also identified lifestyle choices likely to add to cardiovascular risk, with 62 per cent of the sample reported to be smokers, greatly in excess of the general UK population smoking rates of 20 per cent. Lack of exercise was also commonplace, with only 12 per cent of participants engaging 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.

‘While previous research has demonstrated that people gain weight on starting anti-psychotics, our study of people who have had psychosis for nearly 16 years on average found no difference in the rates of cardiovascular risk between the various different anti-psychotic medications. Research is urgently needed into the best ways to reduce existing cardiovascular risk in people with psychosis, prevent weight gain and promote healthy lifestyles in the early stages of the illness.’

The research paper summarises independent research funded by the National Institute for Health Research (NIHR) under its IMPaCT Programme Grant (Reference Number RP-PG-0606-1049).

via King’s College London –Cardiovascular risk factors extremely high in people with psychosis

 

The full paper, published in Psychological Medicine, “Cardiovascular risk factors and metabolic syndrome in people with established psychotic illnesses: baseline data from the IMPaCT randomized controlled trial” by P. Gardner-Sood, J. Lally, S. Smith et al. is published open access and can be viewed here.

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One Response to Cardiovascular risk factors extremely high in people with psychosis « King’s College London

  1. WHEN are psychiatrists going to wake up enough to see that the 5 main causes of brain stress leading to excess neurotransmitter production and consequent hallucinations are all ORGANIC.

    As it is, their ignorance causes a huge amount of distress, that is an ignorance which results in failure to get patients scanned for vascular or neural dysfunction or analysed for disease factors, the abysmal unstandardised and often cruel interview techniques – with a one way clipboard and pen in hand and a load of back up not saying anything, the refutation of dietary positive and negative necessities, and their huge salaries whilst they keep these poor people in small places with very little to do.

    The most arrogant psychiatrists cannot be bothered to establish the physical problems which can lead to death for patients prescribed with high risk drugs like Clozapine. Forget patients are people, and forget contraindications are contraindications.

    It’s a wonder they think the patients have bodies at all.

    Rather than ascribe symptoms to the obvious – such as insufficient oxygen reaching the brain because of vascular problems, they define causes as – ‘underlying mental health issues’.

    They are the nearest thing to madness in the NHS, and thank goodness for the mental health nurses who at least have the humility to read up on the most recent research and be open to scientific explanations.

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