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Individuals with eating disorders have significantly elevated mortality rates, with the highest rates occurring in those with AN. The mortality rates for BN and EDNOS are similar. The study found age at assessment to be a significant predictor of mortality for patients with AN. Further research is needed to identify predictors of mortality in patients with BN and EDNOS.

Objective:  To quantify the risk of developing dementia in those with mild cognitive impairment (MCI).Method:  Meta‐analysis of inception cohort studies.Results:  Forty‐one robust cohort studies were identified. To avoid heterogeneity clinical studies, population studies and clinical trials were analysed separately. Using Mayo defined MCI at baseline and adjusting for sample size, the cumulative proportion who progressed to dementia, to Alzheimer’s disease (AD) and to vascular dementia (VaD) was 39.2%, 33.6% and 6.2%, respectively in specialist settings and 21.9%, 28.9% and 5.2%, respectively in population studies. The adjusted annual conversion rate (ACR) from Mayo defined MCI to dementia, AD and VaD was 9.6%, 8.1% and 1.9%, respectively in specialist clinical settings and 4.9%, 6.8% and 1.6% in community studies. Figures from non‐Mayo defined MCI and clinical trials are also reported.Conclusion:  The ACR is approximately 5–10% and most people with MCI will not progress to dementia even after 10 years of follow‐up.

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Individuals with schizophrenia have high levels of medical comorbidity and cardiovascular risk factors. The presence of 3 or more specific factors is indicative of metabolic syndrome, which is a significant influence upon future morbidity and mortality. We aimed to clarify the prevalence and predictors of metabolic syndrome (MetS) in adults with schizophrenia and related disorders, accounting for subgroup differences. A PRISMA systematic search, appraisal, and meta-analysis were conducted of 126 analyses in 77 publications (n = 25,692). The overall rate of MetS was 32.5% (95% CI = 30.1%-35.0%), and there were only minor differences according to the different definitions of MetS, treatment setting (inpatient vs outpatient), by country of origin and no appreciable difference between males and females. Older age had a modest influence on the rate of MetS (adjusted R(2) = .20; P < .0001), but the strongest influence was of illness duration (adjusted R(2) = .35; P < .0001). At a study level, waist size was most useful in predicting high rate of MetS with a sensitivity of 79.4% and a specificity of 78.8%. Sensitivity and specificity of high blood pressure, high triglycerides, high glucose and low high-density lipoprotein, and age (>38 y) are shown in supplementary appendix 2 online. Regarding prescribed antipsychotic medication, highest rates were seen in those prescribed clozapine (51.9%) and lowest rates of MetS in those who were unmedicated (20.2%). Present findings strongly support the notion that patients with schizophrenia should be considered a high-risk group. Patients with schizophrenia should receive regular monitoring and adequate treatment of cardio-metabolic risk factors.

ObjectiveTo investigate if people with subjective memory complaints (SMC) but no objective deficits are at increased risk of developing mild cognitive impairment (MCI) and dementia. MethodsMajor electronic databases were searched till 03/2014 and a meta-analysis was conducted using inception cohort studies. ResultsAcross 28 studies there were 29,723 unique individuals (14,714 with SMC and 15,009 without SMC) (mean 71.6 years) followed on average for 4.8 years through to dementia. The annual conversion rate (ACR) of SMC to dementia was 2.33% (95% CI = 1.93% -2.78%) a relative risk (RR) of 2.07 (95% CI = 1.76 to 2.44) compared to those without SMC (n=15,009). From 11 studies the ACR of developing MCI was 6.67% (95% CI = 4.70 -8.95%).In long-term studies over 5 years, 14.5% (9.67 -19.1%) of people with SMC developed dementia and 26.6% (95% CI =15.3-39.7) went on to develop MCI. The ACR from SMC to dementia and MCI were comparable in community and non-community settings. ConclusionOlder people with SMC but no objective complaints are twice as likely to develop dementia as individuals without SMC. Approximately 2.3% and 6.6% of older people with SMC will progress to dementia and MCI per year. Summations •Among people with SMC but without objective complaints, the annual conversion rate (ACR) to MCI is 6.6%, whilst it is 2.3% to dementia, compared to 1% in those without SMC• Over about 5 years, 24.4% of those with SMC will develop MCI, whilst 10.9% will convert to dementia, compared to 4.6% in those without SMC. 4• Overall, the risk of developing dementia is double in those with SMC compared to those without SMC.• Considerations• It was not possible to stratify the results according to type of dementia or the diagnosis method.• A wide range of definitions were used to capture SMC and it was not possible to conduct subgroup analysis to determine if this influenced the results.• Most of the analysis had high heterogeneity and there was evidence of publication bias in some of the analyses.

Metabolic syndrome (MetS) and its components are highly predictive of cardiovascular diseases. The primary aim of this systematic review and meta-analysis was to assess the prevalence of MetS and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder, comparing subjects with different disorders and taking into account demographic variables and psychotropic medication use. The secondary aim was to compare the MetS prevalence in persons with any of the selected disorders versus matched general population controls. The pooled MetS prevalence in people with severe mental illness was 32.6% (95% CI: 30.8%-34.4%; N 5 198; n 5 52,678). Relative risk meta-analyses established that there was no significant difference in MetS prevalence in studies directly comparing schizophrenia versus bipolar disorder, and in those directly comparing bipolar disorder versus major depressive disorder. Only two studies directly compared people with schizophrenia and major depressive disorder, precluding meta-analytic calculations. Older age and a higher body mass index were significant moderators in the final demographic regression model (z 5 23.6, p 5 0.0003, r 2 5 0.19). People treated with all individual antipsychotic medications had a significantly (p<0.001) higher MetS risk compared to antipsychotic-na€ ıve participants. MetS risk was significantly higher with clozapine and olanzapine (except vs. clozapine) than other antipsychotics, and significantly lower with aripiprazole than other antipsychotics (except vs. amisulpride). Compared with matched general population controls, people with severe mental illness had a significantly increased risk for MetS (RR 5 1.58; 95% CI: 1.35-1.86; p<0.001) and all its components, except for hypertension (p 5 0.07). These data suggest that the risk for MetS is similarly elevated in the diagnostic subgroups of severe mental illness. Routine screening and multidisciplinary management of medical and behavioral conditions is needed in these patients. Risks of individual antipsychotics should be considered when making treatment choices.Key words: Metabolic syndrome, severe mental illness, schizophrenia, bipolar disorder, major depressive disorder, antipsychotics (World Psychiatry 2015;14:339-347) People with severe mental illness (SMI), including schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder (MDD), experience a twothree times higher mortality rate than the general population (1,2). This mortality gap translates into a 10-20 year shortened life expectancy (3,4) and appears to be widening (5). About 60% of the excess mortality observed in SMI is due to physical comorbidities, predominantly cardiovascular diseases (CVD) (6). Factors predisposing people with SMI to CVD include antipsychotic medication and unhealthy lifestyles (7) as well as their reduced likelihood to receive standard levels of medical care (8-12).To assist clinicians in identifying and treating patients at an increased risk...

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