Patients with psychosis tend to have extremely high levels of cardiovascular risk factors, with central obesity (abdominal obesity) occurring in over 80 percent of participants in a new UK study.
“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,” said senior author Dr. Fiona Gaughran, from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, and the National Psychosis Unit at SLaM.
”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.”
For the study, researchers observed a sample of more than 400 outpatients with psychosis and discovered that nearly half of the sample were obese (48 percent), 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 percent of patients were centrally obese: 95 percent of females and 74 percent of males.
Furthermore, 57 percent of the participants met the criteria for metabolic syndrome, which is a cluster of biochemical and physiological abnormalities connected to the development of heart disease, stroke, and type II diabetes.
One-fifth of the participants met the criteria for diabetes and 30 percent showed a higher risk of going on to develop diabetes.
Lifestyle choices likely added to the cardiovascular risk, as 62 percent of the participants were smokers, far more than the general UK population smoking rates of 20 percent. Lack of exercise was also common, with only 12 percent of the sample taking part in high-intensity physical activity.
“While previous research has demonstrated that people gain weight on starting antipsychotics, 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 antipsychotic medications,” said Gaughran.
“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 findings are published in the journal Psychological Medicine.
Source: King’s College London