Metabolic syndrome following a first episode of psychosis: results of a 1-year longitudinal study conducted in metropolitan Lisbon, Portugal

Abstract

Objective We aimed to assess the prevalence and course of metabolic syndrome (MetS) and the associated metabolic parameters during the year following a first episode pf psychosis (FEP). Methods We performed a 1-year longitudinal observation of 60 patients who experienced FEP. MetS was defined using the modified definition of the National Cholesterol Education Program Adult Treatment Panel III. We assessed the metabolic parameters and socio-demographic and psychopathological data for the participants. Results The mean age of the participants was 27.1 years, and 33.3% of them were women. There was an increase in the prevalence of MetS from 6.7% to 11.7% during the year following the baseline assessment during the year following the baseline assessment ( p = 0.250). There were also significant increases in the prevalences of abnormal triglyceride concentration, waist circumference, and high-density lipoprotein (HDL)-cholesterol concentration during this period. In addition, there was a considerable worsening of the metabolic profile of the participants. No baseline parameters were identified to be predictors of MetS over the 1-year follow-up period. Conclusions We can conclude that metabolic abnormalities are common in patients with FEP and that these rapidly worsen during the first year following the diagnosis of FEP. Studies on interventions are needed to reduce metabolic risk to cardiovascular diseases following the FEP.

Assessing the generalisability of the psychosis metabolic risk calculator (PsyMetRiC) for young people with first-episode psychosis with validation in a Hong Kong Chinese Han population: a 4-year follow-up study

“…The HK sample has a longer follow up period than that of the original UK sample, which might explain the slightly higher proportion of patients developing MetS in the HK sample but generally similar as that was reported in previous studies. 10 , 11 Demographically, the current sample obtained from one HK region has a similar pattern of demographic characteristics as the previous territory-wide studies in HK, 19 , 26 but differed significantly from that of the UK sample, specifically being younger, with fewer smokers and a higher proportion of females. The HK population also differed significantly from the UK sample in many of the metabolic measurements at baseline, including triglycerides, HDL, and FBG.…”

“… 2 Even among younger individuals at psychosis onset, the rate of MetS was found to be 13% 10 and significantly increased over time. 11 Furthermore, about twice as many patients with a first-episode psychosis (FEP) as age and sex matched healthy controls had at least one altered MetS component. 12 FEP are patients who experienced signs or symptoms of psychosis, such as hallucinations, delusions, with the level of severity and period that warrant a psychiatric diagnosis, for the first time in their life.…”

A Marked Low-Grade Inflammation and a Significant Deterioration in Metabolic Status in First-Episode Schizophrenia: A Five-Year Follow-Up Study

“…Moreover, the peripheral and central changes are not only connected through immune regulators but also via the endocrine and metabolic systems. Studies have convincingly shown that metabolic abnormalities precede the psychotic disorder [ 63 ]; they worsen rapidly after the diagnosis of FEP [ 64 , 65 ], and deteriorate even more in the chronic phase of the disease, against the background of AP treatment [ 4 , 11 ]. The elevation of hexoses at the timepoint of 5.1 years indicates the appearance of disturbances in glucose metabolism.…”

Weight and metabolic changes in early psychosis―association with daily quantification of medication exposure during the first hospitalization

“…22,23 Observational studies from outpatient settings provide more generalizable information, but cannot control medication adherence and additional lifestyle factors, including substance abuse, diet, and exercise. 24,25 Also, the available studies typically did not quantify daily medication exposure and mostly evaluated changes in metabolic parameters only after at least 3 months of treatment. We know relatively little about how the development of weight and metabolic changes relates to precise daily quantification of medication exposure during the first weeks of the first hospitalization for psychotic illness.…”

“…We need attempts to replicate results of randomized controlled trials in observational studies, including a broader range of antipsychotic medications, especially early in the course of illness or in antipsychotic naïve groups 22,23 . Observational studies from outpatient settings provide more generalizable information, but cannot control medication adherence and additional lifestyle factors, including substance abuse, diet, and exercise 24,25 . Also, the available studies typically did not quantify daily medication exposure and mostly evaluated changes in metabolic parameters only after at least 3 months of treatment.…”