Increased health risks, premature death linked to patients with psychosis

Patients diagnosed with psychosis are at high risk for developing health issues that could lead to premature death early on in their mental illness, according to a new study published in JAMA Psychiatry.

Researchers found that increased risks of heart disease and metabolic issues, such high blood sugar, in first episode psychosis patients are due to a combination of three things:

• Mental illness,
• Unhealthy lifestyle behaviors; and
• Antipsychotic medications that can accelerate health risks.

The study included results from the Recovery After an Initial Schizophrenia Episode project, which was developed by the National Institute of Mental Health to examine first episode psychosis before and after treatment is offered in community-based settings.

Participating in the study were approximately 400 patients between ages 15 and 40 with first episode psychosis, and the average age was 24. All patients undergoing treatment had significant health concerns including excess weight, smoking and metabolic issues.

Although the frequency of obesity was similar to the general population when compared by age, smoking and metabolic syndrome were much more common. Furthermore, frequencies of dyslipidemia and pre-hypertension were as high as rates found in people 15 to 20 years older.

Most notably, treatment with antipsychotic medication was linked to an increased risk of metabolic syndrome, which can lead to future cardiovascular illness.

According to Christoph Correll, MD, the study’s lead author, a combined physical and mental healthcare approach is needed to improve treatment and prevention.

Specifically, the researchers found that in order to improve patient health and also reduce costs, clinicians must not only educate patients on healthy lifestyle behaviors, but they must also carry out early interventions, improve routine monitoring of physical health, treat patients using lower-risk antipsychotics and encourage participation in smoking cessation programs.