A special article published in today’s (1 October 2012) The
Psychiatrist argues that clinicians should not dismiss
problems such as weight gain and obesity in young patients being
treated for psychosis.
The paper highlights that of
the 7,500 people who develop a psychosis in England each year, many
face a future compromised by poor physical health in addition to
psychological difficulties. Antipsychotic drugs often lead to rapid
weight gain and increases in cholesterol, compromising the
patient’s broader health and well being.
The authors argue that to
ignore the potentially serious cardiac and metabolic consequences
of these younger patients could be to condone health
Men with a diagnosis of
psychosis live 20 years less than the general population, while
women with the diagnosis live 15 years less, with evidence that
this ‘mortality gap’ may be widening.
The authors say: “Behind
this ‘scandal of premature mortality’ lies a reality that mental
and physical disorders frequently co-exist, often intertwined with
social exclusion and restricted opportunity, bringing with it all
the problems of disadvantage.”
The article highlights the
context of a dramatic rise in obesity and type 2 diabetes in young
people and states: “Given the rapid demographic shift in patterns
of obesity, the impact on weight gain for young people with
psychosis may be disproportionately greater, adding more evidence
to our concern that we are witnessing an epidemic within an
The authors argue that
although the relative importance of genetics, demographics and
antipsychotic medication is unclear, it is certain is that young
people acquire cardiovascular risk factors very quickly in the
early phase of psychosis.
They argue for a more
preventive approach towards treatment for young people as well as
greater choice for patients in their treatment options.
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Sue Bailey, Clare Gerada, Helen Lester, David Shiers. The cardiovascular health of young people with severe mental illness: addressing an epidemic within an epidemic. The Psychiatrist, 1 October 2012