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Effect of lifestyle, medication and ethnicity on cardiometabolic risk in the year following the first episode of psychosis: prospective cohort study.

Gaughran, F; Stahl, D; Stringer, D; Hopkins, D; Atakan, Z; Greenwood, K; Patel, A; Smith, S; Gardner-Sood, P; Lally, J; et al. Gaughran, F; Stahl, D; Stringer, D; Hopkins, D; Atakan, Z; Greenwood, K; Patel, A; Smith, S; Gardner-Sood, P; Lally, J; Heslin, M; Stubbs, B; Bonaccorso, S; Kolliakou, A; Howes, O; Taylor, D; Forti, MD; David, AS; Murray, RM; Ismail, K; IMPACT team (2019) Effect of lifestyle, medication and ethnicity on cardiometabolic risk in the year following the first episode of psychosis: prospective cohort study. Br J Psychiatry, 215 (6). pp. 712-719. ISSN 1472-1465 https://doi.org/10.1192/bjp.2019.159
SGUL Authors: Firdosi, Muhammad Mudasir

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Abstract

BACKGROUND: The first episode of psychosis is a critical period in the emergence of cardiometabolic risk. AIMS: We set out to explore the influence of individual and lifestyle factors on cardiometabolic outcomes in early psychosis. METHOD: This was a prospective cohort study of 293 UK adults presenting with first-episode psychosis investigating the influence of sociodemographics, lifestyle (physical activity, sedentary behaviour, nutrition, smoking, alcohol, substance use) and medication on cardiometabolic outcomes over the following 12 months. RESULTS: Rates of obesity and glucose dysregulation rose from 17.8% and 12%, respectively, at baseline to 23.7% and 23.7% at 1 year. Little change was seen over time in the 76.8% tobacco smoking rate or the quarter who were sedentary for over 10 h daily. We found no association between lifestyle at baseline or type of antipsychotic medication prescribed with either baseline or 1-year cardiometabolic outcomes. Median haemoglobin A1c (HbA1c) rose by 3.3 mmol/mol in participants from Black and minority ethnic (BME) groups, with little change observed in their White counterparts. At 12 months, one-third of those with BME heritage exceeded the threshold for prediabetes (HbA1c >39 mmol/mol). CONCLUSIONS: Unhealthy lifestyle choices are prevalent in early psychosis and cardiometabolic risk worsens over the next year, creating an important window for prevention. We found no evidence, however, that preventative strategies should be preferentially directed based on lifestyle habits. Further work is needed to determine whether clinical strategies should allow for differential patterns of emergence of cardiometabolic risk in people of different ethnicities.

Item Type: Article
Additional Information: This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike licence (http://creativecommons.org/licenses/by-nc-sa/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the same Creative Commons licence is included and the original work is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use. Copyright © The Royal College of Psychiatrists 2019
Keywords: First episode psychosis, cardiometabolic risk, ethnicity, glucose dysregulation, weight, Adolescent, Adult, Aged, Antipsychotic Agents, Cardiovascular Diseases, Ethnic Groups, Female, Glycated Hemoglobin A, Humans, Life Style, Male, Middle Aged, Obesity, Prediabetic State, Prospective Studies, Psychotic Disorders, Regression Analysis, Risk Factors, Sex Factors, United Kingdom, Young Adult, IMPACT team, Humans, Cardiovascular Diseases, Prediabetic State, Obesity, Antipsychotic Agents, Risk Factors, Regression Analysis, Prospective Studies, Life Style, Psychotic Disorders, Sex Factors, Adolescent, Adult, Aged, Middle Aged, Ethnic Groups, Female, Male, Young Adult, United Kingdom, Glycated Hemoglobin A, First episode psychosis, cardiometabolic risk, weight, glucose dysregulation, ethnicity, 11 Medical and Health Sciences, 17 Psychology and Cognitive Sciences, Psychiatry
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Journal or Publication Title: Br J Psychiatry
ISSN: 1472-1465
Language: eng
Dates:
DateEvent
December 2019Published
26 July 2019Published Online
Publisher License: Creative Commons: Attribution-Noncommercial-Share Alike 4.0
Projects:
Project IDFunderFunder ID
MR/N027078/1Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
MR/L022176/1Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
MC_U120097115Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
G0700995Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
ICA-CL-2017-03-001Department of Healthhttp://dx.doi.org/10.13039/501100000276
MR/N026063/1Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
PubMed ID: 31347480
Web of Science ID: WOS:000512660000005
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/112826
Publisher's version: https://doi.org/10.1192/bjp.2019.159

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