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

Curtis, Jackie; Newall, Hannah; Samaras, Katherine

doi:10.1111/j.1751-7893.2011.00315.x

Cited by 86 publications

(78 citation statements)

References 32 publications

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“…There are many established effective treatments for these conditions but actual treatment rates within the SMI population remain worryingly low (Nasrallah et al 2006;Hippisley-Cox et al 2007;Crawford et al 2014). The UK Lester Cardio-metabolic resource (Lester et al 2012) based on Australian work (Curtis et al 2012) is designed to support the shift in focus from screening to intervening and is a welcome contribution to the management of physical health in SMI. It does not however provide a solution to the questions of where, how and by whom interventions should be delivered.…”

Section: The Role Of Mental Health Servicesmentioning

confidence: 99%

Strategies to deal with comorbid physical illness in psychosis

Docherty

Stubbs

Gaughran

2016

Epidemiol Psychiatr Sci

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Individuals with serious mental illnesses such as psychosis still experience higher mortality rates than the general population, decades after data have linked the gap to increased rates of physical illness, delayed diagnosis, low treatment rates and worse outcomes from treatment received. The nature of the relationship between psychosis and comorbid physical illness is complex. Multiple strategies directed at different levels of disease process, health care systems and stakeholder culture are likely required to make sustained progress in reducing the mortality gap. Evidence for strategies that effectively reduce the burden of physical co-morbidity and lead to improved health outcomes are still in their infancy but growing at a reassuringly fast rate. This editorial considers the existing evidence base and makes suggestions for the development and future direction of this urgent research agenda and how this knowledge can be implemented in clinical practice.

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Section: The Role Of Mental Health Servicesmentioning

confidence: 99%

Strategies to deal with comorbid physical illness in psychosis

Docherty

Stubbs

Gaughran

2016

Epidemiol Psychiatr Sci

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“…An excellent model recently introduced across New South Wales, Australia, provides a systematic approach for all people with a first episode of psychosis based on an agreed clinical algorithm (Positive Cardiometabolic Health Algorithm, it can be downloaded from the Australian Health Education and Training Institute website: www.heti.nsw.gov.au/cmalgorithm) focused on key cardiovascular risks -weight gain, smoking, lipid and glucose abnormalities, hypertension, awareness of family history of cardiovascular disease or diabetes. 30 Prevention of weight gain from the commencement of antipsychotics is fundamental. There is evidence of a positive impact from lifestyle interventions (cognitivebehavioural therapy, exercise and diet) on attenuating weight gain for people with first-episode psychosis.…”

Section: Possibility Testmentioning

confidence: 99%

The cardiovascular health of young people with severe mental illness: addressing an epidemic within an epidemic

et al. 2012

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SummaryFor young people with emerging psychosis, early weight gain and its potential cardiac and metabolic consequences amplify worrying UK public health trends for young people in general. This paper will argue that if clinicians dismiss these changes as of secondary concern in psychiatric treatment for their young patients, they may be inadvertently condoning a first critical step on a path towards physical health inequalities. Greater recognition is needed for this patient population in their 20s and 30s, at ages not normally considered for active primary or secondary cardiovascular prevention, who are at high risk of dying prematurely. The early phase of psychosis presents an important treatment window for protecting cardiometabolic health.

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“…KBIM evolved over a number of years, beginning with the implementation of routine metabolic screening in a first-episode psychosis (FEP) service (Curtis et al 2011(Curtis et al , 2012. Mental health clinicians were seeing first-hand the rapid onset of substantial weight gain in large numbers of young people recently commenced on antipsychotic medication, which prompted a new focus on documenting the time-course of changes in key metabolic measures.…”

Section: Introductionmentioning

confidence: 99%

Bridging the gap: What have we done and what more can we do to reduce the burden of avoidable death in people with psychotic illness?

Suetani

Rosenbaum

Scott

et al. 2016

Epidemiol Psychiatr Sci

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Despite overwhelming evidence demonstrating a persisting gap in life expectancy between those with psychotic illness and the general population, there has been no widespread implementation of interventions to improve the physical wellbeing of people with psychotic illness. This article explores opportunities to 'Bridge the Gap' in life expectancy. We describe an Australian evidence-based intervention that has substantially improved the physical health of young people recently commenced on antipsychotic medication. Further epidemiological research, accompanied by cultural change within mental health services, is an essential precursor to the implementation of effective and sustainable lifestyle interventions. There are other relatively neglected areas of physical wellbeing for people with psychotic illness, such as screening and diagnosis of malignancies, which need more research and clinical attention. While there has been progress with intervention development and evaluation, translation of evidence-based short-term intervention studies into feasible and sustainable system-wide changes within routine mental health service settings remains a challenge. Developing an implementation framework to support such change is an urgent priority so as to bridge the persisting premature mortality in people living with psychotic illness.

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

Abstract: 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.

Cited by 86 publications

References 32 publications

Strategies to deal with comorbid physical illness in psychosis

Strategies to deal with comorbid physical illness in psychosis

The cardiovascular health of young people with severe mental illness: addressing an epidemic within an epidemic

Bridging the gap: What have we done and what more can we do to reduce the burden of avoidable death in people with psychotic illness?

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