title: Bridging the gap from evidence to policy and practice: reducing the progression to metabolic syndrome for children and adolescents on antipsychotic medication.
abstract: OBJECTIVE
  For children and adolescents, the adverse effects from antipsychotic medicines exaggerate the already considerable burden of having a serious mental illness. Many of these young people face a future not only limited by stigmatizing psychiatric illness but also a life restricted and shortened by physical ill-health, particularly cardiovascular disease and type-2 diabetes. This review focuses on bridging the current gap between available evidence and practice guidelines and policies.
  
  
  METHODS
  Following an extensive literature search, key papers focusing on the evidence of the nature and occurrence of metabolic morbidity in children and adolescents following the use of antipsychotic medication were included.
  
  
  RESULTS
  There is growing evidence to suggest that some of the key antecedents of metabolic syndrome occur soon after diagnosis and initiation of antipsychotic medication, and they accumulate over time.
  
  
  CONCLUSIONS
  While guidelines and policies around the monitoring of metabolic syndrome in children and adolescents with mental illness receiving antipsychotic medication are limited, an opportunity lies in altering the trajectory towards cardiovascular disease and type-2 diabetes by early recognition and intervention to reduce cardiometabolic risk rather than waiting until disease end-points are reached later in life.
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, Australia. v.eapen@unsw.edu.au
authors.forename: Valsamma
authors.initials: V
authors.lastname: Eapen
authors.forename: David
authors.initials: D
authors.lastname: Shiers
authors.forename: Jackie
authors.initials: J
authors.lastname: Curtis
mesh_terms: D000293:Adolescent; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced* / Q000517:prevention & control; D018450:Disease Progression; D006801:Humans; D024821:Metabolic Syndrome / Q000139:chemically induced* / Q000517:prevention & control; D009765:Obesity / Q000139:chemically induced* / Q000517:prevention & control; D011618:Psychotic Disorders / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents