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
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: |
Date | Event |
---|
December 2019 | Published | 26 July 2019 | Published Online |
|
Publisher License: |
Creative Commons: Attribution-Noncommercial-Share Alike 4.0 |
Projects: |
|
PubMed ID: |
31347480 |
Web of Science ID: |
WOS:000512660000005 |
![](http://static.pubmed.gov/portal/portal3rc.fcgi/2745237/img/27842) |
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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