title: Metabolic abnormalities in an early psychosis service: a retrospective, naturalistic cross-sectional study.
abstract: OBJECTIVE
  There is an increasing recognition of the impact of weight gain on the development of metabolic abnormalities in young people receiving atypical antipsychotic drugs for first-episode psychosis. This study examined the prevalence of such abnormalities in a specialist early-intervention community mental health team.
  
  
  METHODS
  A retrospective case record audit of 85 patients 16-27 years old attending the Early Psychosis Service between October 2006 and June 2008, who had at least one metabolic measure defined as: weight, body mass index (BMI), waist circumference, blood pressure, and fasting blood glucose and lipids. Metabolic syndrome identified by the International Diabetes Federation (IDF) criteria.
  
  
  RESULTS
  Fifty-five percent of males and 42% of females were overweight or obese at a median treatment duration of 8 months. Duration of antipsychotic therapy was associated with higher BMI (r = 0.28, P < 0.01). More than 40% of the total sample had high waist circumference. Of the 64 subjects with complete metabolic data, eight (12.5%) met full IDF criteria for metabolic syndrome, and another 21 (32.8%) had either increased waist with one metabolic abnormality or normal waist and two metabolic abnormalities.
  
  
  CONCLUSIONS
  Over a third of young patients being treated for their first episode of psychosis either had metabolic syndrome or showed metabolic abnormalities. Treatment duration related to higher BMI and greater prevalence of metabolic syndrome. Detection of metabolic complications after treatment instigation in patients with first-episode psychosis will permit early intervention with lifestyle or drug interventions in those at risk of significant physical health morbidity.
authors.affiliation: Early Psychosis Programme, Bondi Centre, South Eastern Sydney Local Health Network, School of Psychiatry, University of New South Wales, Sydney, Australia. jackie.curtis@sesiahs.health.nsw.gov.au
authors.forename: Jackie
authors.initials: J
authors.lastname: Curtis
authors.forename: Catherine
authors.initials: C
authors.lastname: Henry
authors.forename: Andrew
authors.initials: A
authors.lastname: Watkins
authors.forename: Hannah
authors.initials: H
authors.lastname: Newall
authors.forename: Katherine
authors.initials: K
authors.lastname: Samaras
authors.forename: Philip B
authors.initials: PB
authors.lastname: Ward
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015992:Body Mass Index; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000139:chemically induced / Q000150:complications / Q000453:epidemiology*; D050177:Overweight / Q000139:chemically induced / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D011618:Psychotic Disorders / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D012189:Retrospective Studies; D055105:Waist Circumference; D015430:Weight Gain
chemical_list: D014150:Antipsychotic Agents