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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.

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Title: Effect of lifestyle, medication and ethnicity on cardiometabolic risk in the year following the first episode of psychosis: prospective cohort study.
Authors: Gaughran, Fiona (AUTHOR), Stahl, Daniel (AUTHOR), Stringer, Dominic (AUTHOR), Hopkins, David (AUTHOR), Atakan, Zerrin (AUTHOR), Greenwood, Kathryn (AUTHOR), Patel, Anita (AUTHOR), Smith, Shubulade (AUTHOR), Gardner-Sood, Poonam (AUTHOR), Lally, John (AUTHOR), Heslin, Margaret (AUTHOR), Stubbs, Brendon (AUTHOR), Bonaccorso, Stefania (AUTHOR), Kolliakou, Anna (AUTHOR), Howes, Oliver (AUTHOR), Taylor, David (AUTHOR), Forti, Marta Di (AUTHOR), David, Anthony S. (AUTHOR), Murray, Robin M. (AUTHOR), Ismail, Khalida (AUTHOR)
Source: British Journal of Psychiatry. Dec2019, Vol. 215 Issue 6, p712-719. 8p.
Subjects: Cohort analysis, Psychoses, Longitudinal method, Ethnicity, Tobacco smoke, Obesity complications, Drug therapy for psychoses, Cardiovascular disease prevention, Prevention of obesity, Prediabetic state, Lifestyles, Evaluation research, Cardiovascular diseases, Research funding, Sex distribution, Antipsychotic agents, Research methodology, Research, Comparative studies, Obesity, Regression analysis, Disease complications
Geographic Terms: United Kingdom
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. [ABSTRACT FROM AUTHOR]
Copyright of British Journal of Psychiatry is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Effect of lifestyle, medication and ethnicity on cardiometabolic risk in the year following the first episode of psychosis: prospective cohort study.
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  Data: <searchLink fieldCode="AR" term="%22Gaughran%2C+Fiona%22">Gaughran, Fiona</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Stahl%2C+Daniel%22">Stahl, Daniel</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Stringer%2C+Dominic%22">Stringer, Dominic</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hopkins%2C+David%22">Hopkins, David</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Atakan%2C+Zerrin%22">Atakan, Zerrin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Greenwood%2C+Kathryn%22">Greenwood, Kathryn</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Patel%2C+Anita%22">Patel, Anita</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Smith%2C+Shubulade%22">Smith, Shubulade</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gardner-Sood%2C+Poonam%22">Gardner-Sood, Poonam</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lally%2C+John%22">Lally, John</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Heslin%2C+Margaret%22">Heslin, Margaret</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Stubbs%2C+Brendon%22">Stubbs, Brendon</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bonaccorso%2C+Stefania%22">Bonaccorso, Stefania</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kolliakou%2C+Anna%22">Kolliakou, Anna</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Howes%2C+Oliver%22">Howes, Oliver</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Taylor%2C+David%22">Taylor, David</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Forti%2C+Marta+Di%22">Forti, Marta Di</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22David%2C+Anthony+S%2E%22">David, Anthony S.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Murray%2C+Robin+M%2E%22">Murray, Robin M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ismail%2C+Khalida%22">Ismail, Khalida</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22British+Journal+of+Psychiatry%22">British Journal of Psychiatry</searchLink>. Dec2019, Vol. 215 Issue 6, p712-719. 8p.
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  Data: <bold>Background: </bold>The first episode of psychosis is a critical period in the emergence of cardiometabolic risk.<bold>Aims: </bold>We set out to explore the influence of individual and lifestyle factors on cardiometabolic outcomes in early psychosis.<bold>Method: </bold>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.<bold>Results: </bold>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).<bold>Conclusions: </bold>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. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of British Journal of Psychiatry is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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