The clinical and behavioral cardiometabolic risk of children and young people on mental health inpatient units: A systematic review and meta-analysis

Abstract

Objective Serious mental illness is associated with physical health comorbidities, however most research has focused on adults. We aimed to synthesise existing literature on clinical and behavioral cardiometabolic risk factors of young people on mental health inpatient units. Methods A systematic review and meta-analysis was conducted, using electronic searches of PsycINFO, EMBASE, AMED, Cochrane Central Register of Controlled Trials, and Ovid MEDLINE. Eligible studies included child/adolescent mental health inpatient units for <25 years, reporting clinical/behavioral cardiometabolic risk factors. Studies containing adult samples, case-studies, or eating disorder populations were excluded. The main clinical outcome was weight, and main behavioral outcome was tobacco use. Results Thirty-nine studies were identified (n = 809,185). Pooled prevalence rates of young people who were overweight (BMI > 25) was 32.4% (95% CI 26.1%–39.5%; n = 2789), and who were obese (BMI > 30) was 15.5% (95% CI 4.5%–41.6%; n = 2612). Pooled prevalence rates for tobacco use was 51.5% (95% CI 32.2–70.2; N = 804,018). Early signs of metabolic risk were observed; elevated blood cholesterol, presence of physical health conditions, and behavioral risk factors (e.g. physical inactivity). Conclusions This review highlights the vulnerability of young people admitted to inpatient units and emphasises the opportunity to efficiently monitor, treat and intervene to target physical and mental health.

Applications of Artificial Intelligence to Popularize Legal Knowledge and Publicize the Impact on Adolescents' Mental Health Status

“…To summarize available research on medical and psychological metabolic abnormalities among adolescent mental health inpatients. They executed the meta-analysis ( 12 ). A convenience sample strategy was used to deliver an online survey among kids and teenagers ( 13 ).…”

Exercise interventions in child and adolescent mental health care: An overview of the evidence and recommendations for implementation

“…These physical health problems often go undetected and therefore untreated (Eapen & John, 2011). Furthermore, CYP with mental health disorders are at increased risk for engaging in behaviors which are detrimental to their physical health, such as tobacco smoking, alcohol consumption, unhealthy diet, and physical inactivity, compared with their peers (Carney et al, 2016(Carney et al, , 2021Eapen & John, 2011). Relatedly, CYP with mental health disorders also experience significantly more barriers to living a healthy, active lifestyle, than CYP without (Carney, Cotter, et al, 2017;Firth et al, 2016;Rosenbaum et al, 2016).…”

“…This involves targeting wide-reaching community-based child and adolescent mental health services, using public health initiatives, as well as looking at those providing specialist inpatient care to people already exhibiting signs of ill-health or already prescribed psychotropic medications with substantial metabolic side-effects (Carney et al, 2021;Eapen & John, 2011;Galling & Correll, 2015) 3. Accredited exercise professionals should be used to deliver interventions, where possible.…”

“…Young people with mental health conditions exhibit signs of poor physical health from the early stages of diagnosis/treatment of mental illness. There is evidence to suggest that CYP within the early stages of mental health disorders, and even those who are at-risk (or in "prodromal" stages), have significantly poorer physical health compared with their peers (Carney et al, 2016(Carney et al, , 2021Galling & Correll, 2015). Cardiometabolic risk factors such as increased weight and prevalence of obesity, metabolic diseases, and other co-morbid physical health conditions (such as dyslipidemia and hypertension) are all observed in CYP with a range of mental health disorders.…”

Accessing and engaging with primary health care services following discharge from forensic secure services: the perspectives of service users and mental health practitioners

“…Moreover, the common co-occurrence of SMI and substance use can leave individuals with serious mental illness at increased risk of infectious diseases (Hughes et al, 2016). A systematic review by Carney et al (2021) similarly found relatively poor physical health among young people in inpatient units compared to the general population. Behavioural risk factors for physical health conditions can also vary by mental health diagnosis (Firth et al, 2019).…”