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Cholesterol and triglyceride levels in first-episode psychosis: systematic review and meta-analysis

  • Toby Pillinger (a1), Katherine Beck (a1), Brendon Stubbs (a1) and Oliver D. Howes (a2)



The extent of metabolic and lipid changes in first-episode psychosis (FEP) is unclear.


To investigate whether individuals with FEP and no or minimal antipsychotic exposure show lipid and adipocytokine abnormalities compared with healthy controls.


We conducted a meta-analysis of studies examining lipid and adipocytokine parameters in individuals with FEP and no or minimal antipsychotic exposure v. a healthy control group. Studies reported fasting total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and leptin levels.


Of 2070 citations retrieved, 20 case–control studies met inclusion criteria including 1167 patients and 1184 controls. Total cholesterol and LDL cholesterol levels were significantly decreased in patients v. controls, corresponding to an absolute reduction of 0.26mmol/L and 0.15mmol/L respectively. Triglyceride levels were significantly increased in the patient group, corresponding to an absolute increase of 0.08 mmol/L However, HDL cholesterol and leptin levels were not altered in patients v. controls.


Total and LDL cholesterol levels are reduced in FEP, indicating that hypercholesterolaemia in patients with chronic disorder is secondary and potentially modifiable. In contrast, triglycerides are elevated in FEP. Hypertriglyceridaemia is a feature of type 2 diabetes mellitus, therefore this finding adds to the evidence for glucose dysregulation in this cohort. These findings support early intervention targeting nutrition, physical activity and appropriate antipsychotic prescription.

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This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) licence.

Corresponding author

Dr Toby Pillinger, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK. Email:


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Declaration of interest

O.D.H. has received investigator-initiated research funding from and/or participated in advisory/ speaker meetings organised by Astra-Zeneca, Autifony, BMS, Eli Lilly, Heptares, Janssen, Lundbeck, Lyden-Delta, Otsuka, Servier, Sunovion, Rand and Roche.



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1 Beary, M, Hodgson, R, Wildgust, HJ. A critical review of major mortality risk factors for all-cause mortality in first-episode schizophrenia: clinical and research implications. J Psychopharmacol 2012; 26: 5261.
2 Crump, C, Winkleby, MA, Sundquist, K, Sundquist, J. Comorbidities and mortality in persons with schizophrenia: a Swedish national cohort study. Am J Psychiatry 2013; 170: 324–33.
3 Hoang, U, Goldacre, MJ, Stewart, R. Avoidable mortality in people with schizophrenia or bipolar disorder in England. Acta Psychiatr Scand 2013; 127: 195201.
4 Laursen, TM, Nordentoft, M, Mortensen, PB. Excess early mortality in schizophrenia. Annu Rev Clin Psychol 2014; 10: 425–48.
5 Brown, S, Kim, M, Mitchell, C, Inskip, H. Twenty-five year mortality of a community cohort with schizophrenia. Br J Psychiatry 2010; 196: 116–21.
6 Osby, U, Correia, N, Brandt, L, Ekbom, A, Sparen, P. Mortality and causes of death in schizophrenia in Stockholm county, Sweden. Schizophr Res 2000; 45: 21–8.
7 Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285: 2486–97.
8 Grundy, SM, Cleeman, JI, Daniels, SR, Donato, KA, Eckel, RH, Franklin, BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112: 2735–52.
9 Alberti, KG, Zimmet, P, Shaw, J, IDF Epidemiology Task Force Consensus Group. The metabolic syndrome – a new worldwide definition. Lancet 2005; 366: 1059–62.
10 World Health Organization. Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications: Report of a WHO Consultation. Part 1: Diagnosis and Classification of Diabetes Mellitus. WHO, 1999.
11 Malhotra, N, Graver, S, Chakrabarti, S, Kulhara, P. Metabolic syndrome in schizophrenia. Indian J Psychol Med 2013; 35: 227–40.
12 Papanastasiou, E. The prevalence and mechanisms of metabolic syndrome in schizophrenia: a review. Ther Adv Psychopharmacol 2013; 3: 3351.
13 Vancampfort, D, Stubbs, B, Mitchell, AJ, De Hert, M, Wampers, M, Ward, PB, et al. Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis. World Psychiatry 2015; 14: 339–47.
14 Vancampfort, D, Wampers, M, Mitchell, AJ, Correll, CU, De Herdt, A, Probst, M, et al. A meta-analysis of cardio-metabolic abnormalities in drug naive, first-episode and multi-episode patients with schizophrenia versus general population controls. World Psychiatry 2013; 12: 240–50.
15 Chen, DC, Du, XD, Yin, GZ, Yang, KB, Nie, Y, Wang, N, et al. Impaired glucose tolerance in first-episode drug-naive patients with schizophrenia: relationships with clinical phenotypes and cognitive deficits. Psychol Med 2016; 46: 3219–30.
16 Chen, S, Broqueres-You, D, Yang, G, Wang, Z, Li, Y, Yang, F, et al. Male sex may be associated with higher metabolic risk in first-episode schizophrenia patients: a preliminary study. Asian J Psychiatr 2016; 21: 2530.
17 Verma, SK, Subramaniam, M, Liew, A, Poon, LY. Metabolic risk factors in drug-naive patients with first-episode psychosis. J Clin Psychiatry 2009; 70: 9971000.
18 Ryan, MC, Collins, P, Thakore, JH. Impaired fasting glucose tolerance in first-episode, drug-naive patients with schizophrenia. Am J Psychiatry 2003; 160: 284–9.
19 Saddichha, S, Manjunatha, N, Ameen, S, Akhtar, S. Metabolic syndrome in first episode schizophrenia – a randomized double-blind controlled, short-term prospective study. Schizophr Res 2008; 101: 266–72.
20 Misiak, B, Laczmanski, L, Sloka, NK, Szmida, E, Piotrowski, P, Loska, O, et al. Metabolic dysregulation in first-episode schizophrenia patients with respect to genetic variation in one-carbon metabolism. Psychiatry Res 2016; 238: 607.
21 Perry, BI, Mcintosh, G, Weich, S, Singh, S, Rees, K. The association between first-episode psychosis and abnormal glycaemic control: systematic review and meta-analysis. Lancet Psychiatry 2016; 3: 1049–58.
22 Moher, D, Liberati, A, Tetzlaff, J, Altman, DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 2009; 62: 1006–12.
23 Stroup, DF, Berlin, JA, Morton, SC, Olkin, I, Williamson, GD, Rennie, D, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 2000; 283: 2008–12.
24 Gurillo, P, Jauhar, S, Murray, RM, MacCabe, JH. Does tobacco use cause psychosis? Systematic review and meta-analysis. Lancet Psychiatry 2015; 2: 718–25.
25 Pillinger, T, Beck, K, Gobjila, C, Donocik, JG, Jauhar, S, Howes, OD. Impaired glucose homeostasis in first-episode schizophrenia: a systematic review and meta-analysis. JAMA Psychiatry 2017; 74: 261–9.
26 Mitchell, AJ, Vancampfort, D, De Herdt, A, Yu, W, De Hert, M. Is the prevalence of metabolic syndrome and metabolic abnormalities increased in early schizophrenia? A comparative meta-analysis of first episode, untreated and treated patients. Schizophr Bull 2013; 39: 295305.
27 Miller, TJ, McGlashan, TH, Woods, SW, Stein, K, Driesen, N, Corcoran, CM, et al. Symptom assessment in schizophrenic prodromal states. Psychiatr Q 1999; 70: 273–87.
28 Yung, AR, Yuen, HP, McGorry, PD, Phillips, LJ, Kelly, D, Dell'Olio, M, et al. Mapping the onset of psychosis: the Comprehensive Assessment of At-Risk Mental States. Aust NZ J Psychiatry 2005; 39: 964–71.
29 Breitborde, NJ, Srihari, VH, Woods, SW. Review of the operational definition for first-episode psychosis. Early Interv Psychiatry 2009; 3: 259–65.
30 Stang, A. Critical evaluation of the Newcastle–Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 2010; 25: 603–5.
31 Kratz, A, Lewandrowski, KB. Case records of the Massachusetts General Hospital, Weekly clinicopathological exercises. Normal reference laboratory values. N Engl J Med 1998; 339: 1063–72.
32 Bowden, J, Tierney, JF, Copas, AJ, Burdett, S. Quantifying, displaying and accounting for heterogeneity in the meta-analysis of RCTs using standard and generalised Q statistics. BMC Med Res Methodol 2011; 11: 41.
33 Higgins, JP, Thompson, SG, Deeks, JJ, Altman, DG. Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557–60.
34 Egger, M, Zellweger-Zahner, T, Schneider, M, Junker, C, Lengeler, C, Antes, G. Language bias in randomised controlled trials published in English and German. Lancet 1997; 350: 326–9.
35 Higgins, JPT, Green, S. Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Collaboration, 2008.
36 Durrington, P. Dyslipidaemia. Lancet 2003; 362: 717–31.
37 Mozaffarian, D, Benjamin, EJ, Go, AS, Arnett, DK, Blaha, MJ, Cushman, M, et al. Heart disease and stroke statistics – 2015 update: a report from the American Heart Association. Circulation 2015; 131: e29322.
38 Petrikis, P, Tigas, S, Tzallas, AT, Papadopoulos, I, Skapinakis, P, Mavreas, V. Parameters of glucose and lipid metabolism at the fasted state in drug-naive first-episode patients with psychosis: evidence for insulin resistance. Psychiatry Res 2015; 229: 901–4.
39 Enez Darcin, A, Yalcin Cavus, S, Dilbaz, N, Kaya, H, Dogan, E. Metabolic syndrome in drug-naive and drug-free patients with schizophrenia and in their siblings. Schizophr Res 2015; 166: 201–6.
40 Dasgupta, A, Singh, OP, Rout, JK, Saha, T, Mandal, S. Insulin resistance and metabolic profile in antipsychotic naive schizophrenia patients. Prog Neuropsychopharmacol Biol Psychiatry 2010; 34: 1202–7.
41 Arranz, B, Rosel, P, Ramirez, N, Duenas, R, Fernandez, P, Sanchez, JM, et al. Insulin resistance and increased leptin concentrations in noncompliant schizophrenia patients but not in antipsychotic-naive first-episode schizophrenia patients. J Clin Psychiatry 2004; 65: 1335–42.
42 Basoglu, C, Oner, O, Gunes, C, Semiz, UB, Ates, AM, Algul, A, et al. Plasma orexin A, ghrelin, cholecystokinin, visfatin, leptin and agouti-related protein levels during 6-week olanzapine treatment in first-episode male patients with psychosis. Int Clin Psychopharmacol 2010; 25: 165–71.
43 Kirkpatrick, B, Garcia-Rizo, C, Tang, K, Fernandez-Egea, E, Bernardo, M. Cholesterol and triglycerides in antipsychotic-naive patients with nonaffective psychosis. Psychiatry Res 2010; 178: 559–61.
44 Spelman, LM, Walsh, PI, Sharifi, N, Collins, P, Thakore, JH. Impaired glucose tolerance in first-episode drug-naive patients with schizophrenia. Diabet Med 2007; 24: 481–5.
45 Wang, HC, Yang, YK, Chen, PS, Lee, IH, Yeh, TL, Lu, RB. Increased plasma leptin in antipsychotic-naive females with schizophrenia, but not in males. Neuropsychobiology 2007; 56: 213–5.
46 Sengupta, S, Parrilla-Escobar, MA, Klink, R, Fathalli, F, Ying Kin, N, Stip, E, et al. Are metabolic indices different between drug-naive first-episode psychosis patients and healthy controls? Schizophr Res 2008; 102: 329–36.
47 Venkatasubramanian, G, Chittiprol, S, Neelakantachar, N, Shetty, TK, Gangadhar, BN. A longitudinal study on the impact of antipsychotic treatment on serum leptin in schizophrenia. Clin Neuropharmacol 2010; 33: 288–92.
48 Wu, X, Huang, Z, Wu, R, Zhong, Z, Wei, Q, Wang, H, et al. The comparison of glycometabolism parameters and lipid profiles between drug-naive, first-episode schizophrenia patients and healthy controls. Schizophr Res 2013; 150: 157–62.
49 Kavzoglu, SO, Hariri, AG. Intracellular Adhesion Molecule (ICAM-1), Vascular Cell Adhesion Molecule (VCAM-1) and E-Selectin levels in first episode schizophrenic patients. Klin Psikofarmakol B 2013; 23: 205–14.
50 Sarandol, A, Sarandol, E, Acikgoz, HE, Eker, SS, Akkaya, C, Dirican, M. First-episode psychosis is associated with oxidative stress: effects of short-term antipsychotic treatment. Psychiatry Clin Neurosci 2015; 69: 699707.
51 Srihari, VH, Phutane, VH, Ozkan, B, Chwastiak, L, Ratliff, JC, Woods, SW, et al. Cardiovascular mortality in schizophrenia: defining a critical period for prevention. Schizophr Res 2013; 146: 64–8.
52 Perk, J, De Backer, G, Gohlke, H, Graham, I, Reiner, Z, Verschuren, M, et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J 2012; 33: 1635–701.
53 Cholesterol Treatment Trialists Collaboration, Mihaylova, B, Emberson, J, Blackwell, L, Keech, A, Simes, J, et al. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet 2012; 380: 581–90.
54 Greenhalgh, AM, Gonzalez-Bianco, L, Garcia-Rizo, C, Fernandez-Egea, E, Miller, B, Arroyo, MB, et al. Meta-analysis of glucose tolerance, insulin, and insulin resistance in antipsychotic-naive patients with nonaffective psychosis. Schizophr Res 2017; 179: 5763.
55 Lin, SX, Berlin, I, Younge, R, Jin, Z, Sibley, CT, Schreiner, P, et al. Does elevated plasma triglyceride level independently predict impaired fasting glucose?: the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care 2013; 36: 342–7.
56 Tirosh, A, Shai, I, Bitzur, R, Kochba, I, Tekes-Manova, D, Israeli, E, et al. Changes in triglyceride levels over time and risk of type 2 diabetes in young men. Diabetes Care 2008; 31: 2032–7.
57 Stubbs, B, Firth, J, Berry, A, Schuch, FB, Rosenbaum, S, Gaughran, F, et al. How much physical activity do people with schizophrenia engage in? A systematic review, comparative meta-analysis and meta-regression. Schizophr Res 2016; 176: 431–40.
58 Juutinen, J, Hakko, H, Meyer-Rochow, VB, Rasanen, P, Timonen, M, Study-70 Research Group. Body mass index (BMI) of drug-naive psychotic adolescents based on a population of adolescent psychiatric inpatients. Eur Psychiatry 2008; 23: 521–6.
59 Koivukangas, J, Tammelin, T, Kaakinen, M, Maki, P, Moilanen, I, Taanila, A, et al. Physical activity and fitness in adolescents at risk for psychosis within the Northern Finland 1986 Birth Cohort. Schizophr Res 2010; 116: 152–8.
60 Myles, N, Newall, H, Compton, MT, Curtis, J, Nielssen, O, Large, M. The age at onset of psychosis and tobacco use: a systematic meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2012; 47: 1243–50.
61 Earnest, CP, Artero, EG, Sui, X, Lee, DC, Church, TS, Blair, SN. Maximal estimated cardiorespiratory fitness, cardiometabolic risk factors, and metabolic syndrome in the aerobics center longitudinal study. Mayo Clin Proc 2013; 88: 259–70.
62 Langsted, A, Freiberg, JJ, Nordestgaard, BG. Fasting and nonfasting lipid levels: influence of normal food intake on lipids, lipoproteins, apolipoproteins, and cardiovascular risk prediction. Circulation 2008; 118: 2047–56.
63 Benetou, V, Chloptsios, Y, Zavitsanos, X, Karalis, D, Naska, A, Trichopoulou, A. Total cholesterol and HDL-cholesterol in relation to socioeconomic status in a sample of 11,645 Greek adults: the EPIC study in Greece. European Prospective Investigation into Nutrition and Cancer. Scand J Public Health 2000; 28: 260–5.
64 Nasrallah, HA, Meyer, JM, Goff, DC, McEvoy, JP, Davis, SM, Stroup, TS, et al. Low rates of treatment for hypertension, dyslipidemia and diabetes in schizophrenia: data from the CATIE schizophrenia trial sample at baseline. Schizophr Res 2006; 86: 1522.
65 Phutane, VH, Tek, C, Chwastiak, L, Ratliff, JC, Ozyuksel, B, Woods, SW, et al. Cardiovascular risk in a first-episode psychosis sample: a ‘critical period’ for prevention? Schizophr Res 2011; 127: 257–61.
66 Cholesterol and triglyceride concentrations in serum/plasma pairs. Clin Chem 1977; 23: 60–3.
67 Cloey, T, Bachorik, PS, Becker, D, Finney, C, Lowry, D, Sigmund, W. Reevaluation of serum-plasma differences in total cholesterol concentration, JAMA 1990; 263: 2788–9.
68 Pillinger, T, Beck, K, Gobjila, C, Donocik, JG, Jauhar, S, Howes, OD. Impaired glucose homeostasis in first-episode schizophrenia: a systematic review and meta-analysis. JAMA Psychiatry 2017; 74: 261–9.
69 Andreassen, OA, Djurovic, S, Thompson, WK, Schork, AJ, Kendler, KS, O'Donovan, MC, et al. Improved detection of common variants associated with schizophrenia by leveraging pleiotropy with cardiovascular-disease risk factors. Am J Hum Genet 2013; 92: 197209.
70 Liu, Y, Li, Z, Zhang, M, Deng, Y, Yi, Z, Shi, T. Exploring the pathogenetic association between schizophrenia and type 2 diabetes mellitus diseases based on pathway analysis. BMC Med Genomics 2013; 6 (suppl 1): S17.
71 Upthegrove, R, Manzanares-Teson, N, Barnes, NM. Cytokine function in medication-naive first episode psychosis: a systematic review and meta-analysis. Schizophr Res 2014; 155: 101–8.
72 Katsume, A, Saito, H, Yamada, Y, Yorozu, K, Ueda, O, Akamatsu, K, et al. Anti-interleukin 6 (IL-6) receptor antibody suppresses Castleman's disease like symptoms emerged in IL-6 transgenic mice. Cytokine 2002; 20: 304–11.
73 Myasoedova, E, Crowson, CS, Kremers, HM, Fitz-Gibbon, PD, Therneau, TM, Gabriel, SE. Total cholesterol and LDL levels decrease before rheumatoid arthritis. Ann Rheum Dis 2010; 69: 1310–4.
74 Nishimoto, N, Yoshizaki, K, Miyasaka, N, Yamamoto, K, Kawai, S, Takeuchi, T, et al. Treatment of rheumatoid arthritis with humanized anti-interleukin-6 receptor antibody – a multicenter, double-blind, placebo-controlled trial. Arthritis Rheum 2004; 50: 1761–9.
75 Dipasquale, S, Pariante, CM, Dazzan, P, Aguglia, E, McGuire, P, Mondelli, V. The dietary pattern of patients with schizophrenia: a systematic review. J Psychiatr Res 2013; 47: 197207.
76 Stubbs, B, Gardner-Sood, P, Smith, S, Ismail, K, Greenwood, K, Farmer, R, et al. Sedentary behaviour is associated with elevated C-reactive protein levels in people with psychosis. Schizophr Res 2015; 168: 461–4.
77 Koola, MM, McMahon, RP, Wehring, HJ, Liu, F, Mackowick, KM, Warren, KR, et al. Alcohol and cannabis use and mortality in people with schizophrenia and related psychotic disorders. J Psychiatr Res 2012; 46: 987–93.
78 Kurdyak, P, Vigod, S, Calzavara, A, Wodchis, WP. High mortality and low access to care following incident acute myocardial infarction in individuals with schizophrenia. Schizophr Res 2012; 142: 52–7.
79 Galling, B, Roldan, A, Nielsen, RE, Nielsen, J, Gerhard, T, Carbon, M, et al. Type 2 diabetes mellitus in youth exposed to antipsychotics: a systematic review and meta-analysis. JAMA Psychiatry 2016; 73: 247–59.
80 De Hert, M, Detraux, J, van Winkel, R, Yu, W, Correll, CU. Metabolic and cardiovascular adverse effects associated with antipsychotic drugs. Nat Rev Endocrinol 2011; 8: 114–26.
81 Heal, DJ, Gosden, J, Jackson, HC, Cheetham, SC, Smith, SL. Metabolic consequences of antipsychotic therapy: preclinical and clinical perspectives on diabetes, diabetic ketoacidosis, and obesity. Handb Exp Pharmacol 2012; 212: 135–64.
82 Howes, OD, Bhatnagar, A, Gaughran, FP, Amiel, SA, Murray, RM, Pilowsky, LS. A prospective study of impairment in glucose control caused by clozapine without changes in insulin resistance. Am J Psychiatry 2004; 161: 361–3.
83 Reynolds, GP, Zhang, ZJ, Zhang, XB. Association of antipsychotic drug-induced weight gain with a 5-HT2C receptor gene polymorphism. Lancet 2002; 359: 2086–7.
84 Kim, SF, Huang, AS, Snowman, AM, Teuscher, C, Snyder, SH. From the Cover: Antipsychotic drug-induced weight gain mediated by histamine H1 receptor-linked activation of hypothalamic AMP-kinase. Proc Natl Acad Sci USA 2007; 104: 3456–9.
85 Kinon, BJ, Kaiser, CJ, Ahmed, S, Rotelli, MD, Kollack-Walker, S. Association between early and rapid weight gain and change in weight over one year of olanzapine therapy in patients with schizophrenia and related disorders. J Clin Psychopharmacol 2005; 25: 255–8.
86 Stern, MP, Fatehi, P, Williams, K, Haffner, SM. Predicting future cardiovascular disease: do we need the oral glucose tolerance test? Diabetes Care 2002; 25: 1851–6.
87 Wilson, PW, Meigs, JB, Sullivan, L, Fox, CS, Nathan, DM, D'Agostino, RB. Prediction of incident diabetes mellitus in middle-aged adults: the Framingham Offspring Study. Arch Intern Med 2007; 167: 1068–74.
88 Schmidt, MI, Duncan, BB, Bang, H, Pankow, JS, Ballantyne, CM, Golden, SH, et al. Identifying individuals at high risk for diabetes: the Atherosclerosis Risk in Communities study. Diabetes Care 2005; 28: 2013–8.
89 Ginsberg, HN. Insulin resistance and cardiovascular disease. J Clin Invest 2000; 106: 453–8.
90 Cooper, SJ, Reynolds, GP, Barnes, T, England, E, Haddad, PM, et al. BAP guidelines on the management of weight gain, metabolic disturbances and cardiovascular risk associated with psychosis and antipsychotic drug treatment. J Psychopharmacol 2016; 30: 717–48.
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Cholesterol and triglyceride levels in first-episode psychosis: systematic review and meta-analysis

  • Toby Pillinger (a1), Katherine Beck (a1), Brendon Stubbs (a1) and Oliver D. Howes (a2)
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