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

Gaughran, Fiona, Stahl, Daniel, Stringer, Dominic, Gardner-Sood, Poonam, Hopkins, David, Lally, John, Atakan, Zerrin, Greenwood, Kathryn, Patel, Anita, Smith, Shubulade, Heslin, Margaret, Stubbs, Brenond, Bonaccorso, Stefania, Kolliakou, Anna, Howes, Oliver, Taylor, David, Di Forti, Marta, David, Anthony, Murray, Robin M and Ismail, Khalida (2019) Effect of lifestyle, medication and ethnicity on cardiometabolic risk in the year following the first episode of psychosis: a prospective cohort study. British Journal of Psychiatry. ISSN 0007-1250

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Abstract

Background
The first episode of psychosis (FEP) is a critical period in the emergence of cardiometabolic risk.

Aims
We set out to explore the influence of individual and lifestyle factors on cardometabolic outcomes in early psychosis.

Method
A prospective cohort study of 293 UK adults presenting with FEP investigating the influence of socio-demographics, 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 one year. Little change was seen over time in the 76.8% tobacco smoking rate or the quarter who were sedentary for over 10 hours daily. We found no association between lifestyle at baseline or type of anti-psychotic medication prescribed with either baseline or one-year cardiometabolic outcomes. Median 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 pre-diabetes (HbA1c >39mmol/mol).

Conclusion
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
Keywords: First episode psychosis; cardiometabolic risk; weight; glucose dysregulation; ethnicity
Schools and Departments: School of Psychology > Psychology
Depositing User: Joshua Jenkin
Date Deposited: 26 Jun 2019 08:54
Last Modified: 08 Aug 2019 13:45
URI: http://sro.sussex.ac.uk/id/eprint/84597

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