The cardiovascular health of young people with severe mental illness: addressing an epidemic within an epidemic

Abstract

SummaryFor young people with emerging psychosis, early weight gain and its potential cardiac and metabolic consequences amplify worrying UK public health trends for young people in general. This paper will argue that if clinicians dismiss these changes as of secondary concern in psychiatric treatment for their young patients, they may be inadvertently condoning a first critical step on a path towards physical health inequalities. Greater recognition is needed for this patient population in their 20s and 30s, at ages not normally considered for active primary or secondary cardiovascular prevention, who are at high risk of dying prematurely. The early phase of psychosis presents an important treatment window for protecting cardiometabolic health.

Physical health and well‐being: Experiences and perspectives of young adult mental health consumers

“…They need to be provided clear and consistent information that enables them to understand and weigh up the benefits and risks of psychotropic treatment, so that treatment decisions can be negotiated and fit with their individual aspirations and values (Bailey et al . ; Murphy et al . ).…”

“…Bailey et al . () emphasize the particular concern that significant weight gain/obesity in this group can trigger the emergence of other cardiometabolic disturbances.…”

“…Physical comorbidities often develop in adolescence/early adulthood alongside risky health behaviours, the onset of mental illness, and the commencement of psychotropic medications (Bailey et al . ; McCloughen et al . ), then track through to older adulthood, together with adverse lifestyle factors and inadequate maintenance of physical health (McNamee et al .…”

“…Teenagers and early adults with mental illness live in a world exemplified by sedentary lifestyles and high‐calorie foods (Bailey et al . ), evidenced by a growing prevalence of type‐2 diabetes, excess weight disorders, and metabolic syndrome (Curtis et al . ; Yates et al .…”

Service Users’ Priorities and Preferences for Treatment of Psychosis: A User-Led Delphi Study

“…Although antipsychotic medication is helpful for some, it is ineffective for others and is associated with significant adverse effects that may outweigh perceived benefits and lead to discontinuation (5,6). It has been suggested that there is an excessive reliance on antipsychotic medication in the treatment of schizophrenia and related disorders and that there is "little or no choice offered to service users who meet criteria for such diagnoses, despite policies that actively promote patient-led care, collaborative decision-making and provision of choice" (7).…”