The heart of the matter: cardiometabolic care in youth with psychosis.
OBJECTIVE
Weight gain, obesity and metabolic disturbances in youth with psychosis are significant contributors to the health burden of people with psychosis, with a two- to threefold increase in rates compared with the general population and a 20% reduction in life expectancy. Several studies have now described cardiometabolic benefits of a range of interventions, including a structured diet and exercise programmes and metformin for patients receiving antipsychotic medications. Despite the development of Australian consensus guidelines and screening algorithms to detect such metabolic abnormalities, there is a lack of guidelines for clinicians to determine appropriate, timely, targeted prevention and intervention to manage these complications in the youth population.


METHODS
The Bondi Early Psychosis Programme targets young people (aged 15-25 years) experiencing their first episode of psychosis. This service has developed a model of metabolic screening and a treatment algorithm to provide clinicians with recommendations for targeted interventions.


RESULTS
Positive Cardiometabolic Health: an early intervention framework for patients on psychotropic medication describes a method for early detection, prevention and intervention strategies targeting antipsychotic-induced metabolic abnormalities and cardiovascular risk factors.


CONCLUSIONS
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.
Eastern Suburbs Mental Health Programme, Bondi Centre, Sydney, New South Wales, Australia. j.curtis@unsw.edu.au
Jackie
J
Curtis
Hannah D
HD
Newall
Katherine
K
Samaras
D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D061345:Early Medical Intervention; D005260:Female; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000150:complications* / Q000188:drug therapy / Q000628:therapy; D012307:Risk Factors; D015430:Weight Gain / Q000187:drug effects; D055815:Young Adult
D014150:Antipsychotic Agents