title: Cardiovascular risk factors and metabolic syndrome in people with established psychotic illnesses: baseline data from the IMPaCT randomized controlled trial.
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.
  
  
  METHODS
  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.
authors.affiliation: Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience (IoPPN),King's College London,London,UK.
authors.forename: P
authors.initials: P
authors.lastname: Gardner-Sood
authors.affiliation: Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience (IoPPN),King's College London,London,UK.
authors.forename: J
authors.initials: J
authors.lastname: Lally
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience (IoPPN),King's College London,London,UK.
authors.forename: S
authors.initials: S
authors.lastname: Smith
authors.affiliation: Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience (IoPPN),King's College London,London,UK.
authors.forename: Z
authors.initials: Z
authors.lastname: Atakan
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience (IoPPN),King's College London,London,UK.
authors.forename: K
authors.initials: K
authors.lastname: Ismail
authors.affiliation: School of Psychology,University of Sussex,Brighton and Early Intervention in Psychosis Service,Sussex Partnership NHS Foundation Trust,West Sussex,UK.
authors.forename: K E
authors.initials: KE
authors.lastname: Greenwood
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience (IoPPN),King's College London,London,UK.
authors.forename: A
authors.initials: A
authors.lastname: Keen
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience (IoPPN),King's College London,London,UK.
authors.forename: C
authors.initials: C
authors.lastname: O'Brien
authors.affiliation: NIHR Biomedical Research Centre - BioResource for Mental Health, Social, Genetic and Development Psychiatric Centre,London,UK.
authors.forename: O
authors.initials: O
authors.lastname: Onagbesan
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience (IoPPN),King's College London,London,UK.
authors.forename: C
authors.initials: C
authors.lastname: Fung
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience (IoPPN),King's College London,London,UK.
authors.forename: E
authors.initials: E
authors.lastname: Papanastasiou
authors.affiliation: Clinical Psychiatric Research Center, Lund University, Skåne, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Eberhard
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience (IoPPN),King's College London,London,UK.
authors.forename: J
authors.initials: J
authors.lastname: Eberherd
authors.affiliation: Centre for the Economics of Mental and Physical Health (CEMPH), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London,London,UK.
authors.forename: A
authors.initials: A
authors.lastname: Patel
authors.affiliation: Florence Nightingale Faculty of Nursing and Midwifery,King's College London,London,UK.
authors.forename: R
authors.initials: R
authors.lastname: Ohlsen
authors.affiliation: Department of Biostatistics,Institute of Psychiatry, Psychology and Neuroscience (IoPPN),King's College London,London,UK.
authors.forename: D
authors.initials: D
authors.lastname: Stahl
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience (IoPPN),King's College London,London,UK.
authors.forename: A
authors.initials: A
authors.lastname: David
authors.affiliation: Division of Ambulatory Care and Local Networks,King's College Hospital NHS Foundation Trust,London,UK.
authors.forename: D
authors.initials: D
authors.lastname: Hopkins
authors.affiliation: Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience (IoPPN),King's College London,London,UK.
authors.forename: R M
authors.initials: RM
authors.lastname: Murray
authors.affiliation: National Psychosis Service,South London and Maudsley NHS Foundation Trust,London,UK.
authors.forename: F
authors.initials: F
authors.lastname: Gaughran
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology*; D003155:Community Mental Health Centers; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000523:psychology*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population; D017678:Sex Distribution; D013222:State Medicine; D014505:Urban Population; D055815:Young Adult
chemical_list: D001569:Benzodiazepines
keywords: Metabolic syndrome; physical health; psychotic disorder; schizophrenia; severe mental illnesses