The heart of the matter: cardiometabolic care in youth with psychosis

Abstract

Weight gain, obesity and metabolic disturbances in youth with psychosis are significant contributors to the health burden of people with psychosis, with a two- to threefold increase in rates compared with the general population and a 20% reduction in life expectancy. Several studies have now described cardiometabolic benefits of a range of interventions, including a structured diet and exercise programmes and metformin for patients receiving antipsychotic medications. Despite the development of Australian consensus guidelines and screening algorithms to detect such metabolic abnormalities, there is a lack of guidelines for clinicians to determine appropriate, timely, targeted prevention and intervention to manage these complications in the youth population. The Bondi Early Psychosis Programme targets young people (aged 15-25 years) experiencing their first episode of psychosis. This service has developed a model of metabolic screening and a treatment algorithm to provide clinicians with recommendations for targeted interventions. Positive Cardiometabolic Health: an early intervention framework for patients on psychotropic medication describes a method for early detection, prevention and intervention strategies targeting antipsychotic-induced metabolic abnormalities and cardiovascular risk factors. Although further research is required, there is sufficient evidence to support early intervention and prevention strategies to improve physical health outcomes in young people with first-episode psychosis.