The value of counting WHO-defined cardiovascular risk factors for death and disability in a national sample of adults with psychosis.
This study explored the prevalence and associations of eight WHO-defined CVD risk factors for death and disability in people with psychosis.



The study included 1156 people aged 18-64years, diagnosed with psychosis. The 2009 World Health Organisation (WHO) Global Health Risks Report was used as a framework to determine the prevalence and number of eight key risk factors for cardiovascular disease (CVD) in men and women with psychosis. Differences in the number and type of risk factors by age and gender were investigated. Multi-predictor analysis was performed to identify associations between demographic factors, psychiatric diagnosis and accumulative CVD risk factors.



Women had fewer CVD risk factors than men. The number of risk factors significantly decreased in association with single marital status, current employment and significantly increased with earning a higher income. People aged 35-49years and 50-64years had an average of 4 risk factors (SD 1.38 and 1.30); people aged 18-34years had an average of 3 risk factors (SD 1.30). Mean risk factors were higher in the middle age and older age groups (35-49years and 50-64years) compared with the younger age group (18-34years) (p<0.0001). Overweight/obesity, hypertension, high blood glucose/diabetes and high cholesterol were significantly more prevalent in older men and women.



People with psychosis have a high prevalence of individual and aggregate CVD risks. These were more common in men and rose with age, implying the necessity of close clinical monitoring. The most common risk factors should be targeted by lifestyle interventions.
Level 4, Eleanor Harrald Building, Royal Adelaide Hospital, University of Adelaide, Discipline of Psychiatry, Adelaide, SA, Australia, postcode: 5000. Electronic address: lisa.hahn@student.adelaide.edu.au.
Lisa Anne
LA
Hahn
Black Dog Institute, Sydney, NSW, Australia; Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia; University of New South Wales, Sydney, NSW, Australia. Electronic address: Andrew.Mackinnon@biostats.com.au.
Andrew
A
Mackinnon
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Australia. Electronic address: dfoley@unimelb.edu.au.
Debra L
DL
Foley
Neuropsychiatric Epidemiology Research Unit, School of Psychiatry & Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia. Electronic address: vera.morgan@uwa.edu.au.
Vera A
VA
Morgan
Neuropsychiatric Epidemiology Research Unit, School of Psychiatry & Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia. Electronic address: anna.waterreus@uwa.edu.au.
Anna
A
Waterreus
Cardiometabolic Clinic, Department of Cardiology, Royal Perth Hospital, School of Medicine and Pharmacology, The University of Western Australia, Crawley, WA, Australia. Electronic address: gerald.watts@uwa.edu.au.
Gerald F
GF
Watts
St Vincent's Hospital, Melbourne, VIC, Australia; Department of Psychiatry, The University of Melbourne, VIC, Australia. Electronic address: djcastle@unimelb.edu.au.
David J
DJ
Castle
Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia; Northern Adelaide Local Area Health Network, Adelaide, SA, Australia. Electronic address: Dennis.liu@health.sa.gov.au.
Dennis
D
Liu
Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia; Ramsay Health Care, Mental Health Services, Northern Adelaide Local Health Network, Adelaide, SA, Australia; Northern Adelaide Local Area Health Network, Adelaide, SA, Australia. Electronic address: cherrie.galletly@adelaide.edu.au.
Cherrie A
CA
Galletly
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003643:Death; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000401:mortality*; D012307:Risk Factors; D014944:World Health Organization; D055815:Young Adult
Cardiovascular disease; Morbidity; Mortality; Psychosis; Risk factors