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Cardiovascular risk factors and metabolic syndrome in people with established psychotic illnesses: baseline data from the IMPaCT randomized controlled trial

  • P. Gardner-Sood (a1), J. Lally (a1) (a2), S. Smith (a3) (a4), Z. Atakan (a1), K. Ismail (a3) (a5), K. E. Greenwood (a6), A. Keen (a3), C. O'Brien (a3), O. Onagbesan (a7), C. Fung (a3), E. Papanastasiou (a3), J. Eberherd (a3) (a8), A. Patel (a9), R. Ohlsen (a10), D. Stahl (a11), A. David (a3), D. Hopkins (a12) (a13), R. M. Murray (a1) (a2), F. Gaughran (a2) (a14) and on behalf of the IMPaCT team...

Abstract

Background

The aims of the study were to determine the prevalence of cardiometabolic risk factors and establish the proportion of people with psychosis meeting criteria for the metabolic syndrome (MetS). The study also aimed to identify the key lifestyle behaviours associated with increased risk of the MetS and to investigate whether the MetS is associated with illness severity and degree of functional impairment.

Method

Baseline data were collected as part of a large randomized controlled trial (IMPaCT RCT). The study took place within community mental health teams in five Mental Health NHS Trusts in urban and rural locations across England. A total of 450 randomly selected out-patients, aged 18–65 years, with an established psychotic illness were recruited. We ascertained the prevalence rates of cardiometabolic risk factors, illness severity and functional impairment and calculated rates of the MetS, using International Diabetes Federation (IDF) and National Cholesterol Education Program Third Adult Treatment Panel criteria.

Results

High rates of cardiometabolic risk factors were found. Nearly all women and most men had waist circumference exceeding the IDF threshold for central obesity. Half the sample was obese (body mass index ≥ 30 kg/m2) and a fifth met the criteria for type 2 diabetes mellitus. Females were more likely to be obese than males (61% v. 42%, p < 0.001). Of the 308 patients with complete laboratory measures, 57% (n = 175) met the IDF criteria for the MetS.

Conclusions

In the UK, the prevalence of cardiometabolic risk factors in individuals with psychotic illnesses is much higher than that observed in national general population studies as well as in most international studies of patients with psychosis.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

* Address for correspondence: F. Gaughran, PO63, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, De Crespigny Park, London SE5 8AF, UK. (Email: Fiona.1.gaughran@kcl.ac.uk)

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