Public Release: 

Cardiovascular risk factors extremely high in people with psychosis

King's College London

Extremely high levels of cardiovascular risk factors have been found in people with established psychosis, with central obesity evident in over 80 per cent of participants, in a study by researchers from the NIHR Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust (SLaM) and King's College London.

In the largest study of its kind in the UK, drawing on a sample of more than 400 outpatients with psychosis, it was discovered that nearly half of the sample were obese (48 per cent), with a body mass index (BMI) of 30 or more. Additionally, nearly all women and most men had a waist circumference above the International Diabetes Federation's (IDF) threshold for central obesity. According to this measure 83 per cent of patients were centrally obese: 95 per cent of females and 74 per cent of males. Central obesity refers to excessive fat around the stomach and abdomen, to the extent that it is likely to have a negative impact on health.

The majority of participants tested (57 per cent) met the IDF's criteria for metabolic syndrome, which is a cluster of biochemical and physiological abnormalities associated with the development of heart disease, stroke and type-2 diabetes. A fifth met the criteria for diabetes and 30 per cent showed a higher risk of going on to develop diabetes.

Although cardiovascular risk factors are common in psychosis, this UK study reports some of the highest rates worldwide, reinforcing the need to incorporate weight and cardiovascular risk assessment and management into the routine care of people with psychosis.

Data was collected as part of the NIHR-funded IMPaCT trial and the study took place within community mental health teams in five mental health NHS Trusts in urban and rural locations across England.

The study, published today in Psychological Medicine, also identified lifestyle choices likely to add to cardiovascular risk, with 62 per cent of the sample reported to be smokers, greatly in excess of the general UK population smoking rates of 20 per cent. Lack of exercise was also commonplace, with only 12 per cent of participants engaging in high intensity physical activity.

Dr Fiona Gaughran, senior author from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London, and the National Psychosis Unit at SLaM, said: 'We already know that diagnosis of a psychotic illness such as schizophrenia or bipolar disorder is associated with a reduced life expectancy of between 10 to 25 years. This mortality gap is largely due to natural causes, including cardiac disease. The worryingly high levels of cardiovascular risk shown in our study indicate that a much greater emphasis on physical activity is needed for those with severe mental illnesses, as well as a more significant focus on supporting attempts to quit smoking.

'While previous research has demonstrated that people gain weight on starting anti-psychotics, our study of people who have had psychosis for nearly 16 years on average found no difference in the rates of cardiovascular risk between the various different anti-psychotic medications. Research is urgently needed into the best ways to reduce existing cardiovascular risk in people with psychosis, prevent weight gain and promote healthy lifestyles in the early stages of the illness.'

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The research paper summarises independent research funded by the National Institute for Health Research (NIHR) under its IMPaCT Programme Grant (Reference Number RP-PG-0606-1049).

For further media information please contact Jack Stonebridge, Press Officer, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London jack.stonebridge@kcl.ac.uk/ (+44) 020 7848 5377

About King's College London: http://www.kcl.ac.uk

King's College London is one of the top 20 universities in the world (2014/15 QS World University Rankings) and among the oldest in England. King's has more than 26,500 students (of whom nearly 10,400 are graduate students) from some 150 countries worldwide, and nearly 6,900 staff. The university is in the second phase of a £1 billion redevelopment programme which is transforming its estate.

King's has an outstanding reputation for world-class teaching and cutting-edge research. In the 2014 Research Excellence Framework (REF) King's was ranked 6th nationally in the 'power' ranking, which takes into account both the quality and quantity of research activity, and 7th for quality according to Times Higher Education rankings. Eighty-four per cent of research at King's was deemed 'world-leading' or 'internationally excellent' (3* and 4*). The university is in the top seven UK universities for research earnings and has an overall annual income of more than £600 million.

King's has a particularly distinguished reputation in the humanities, law, the sciences (including a wide range of health areas such as psychiatry, medicine, nursing and dentistry) and social sciences including international affairs. It has played a major role in many of the advances that have shaped modern life, such as the discovery of the structure of DNA and research that led to the development of radio, television, mobile phones and radar.

King's College London and Guy's and St Thomas', King's College Hospital and South London and Maudsley NHS Foundation Trusts are part of King's Health Partners. King's Health Partners Academic Health Sciences Centre (AHSC) is a pioneering global collaboration between one of the world's leading research-led universities and three of London's most successful NHS Foundation Trusts, including leading teaching hospitals and comprehensive mental health services. For more information, visit: http://www.kingshealthpartners.org.

King's fundraising campaign - World questions|King's answers - created to address some of the most pressing challenges facing humanity has reached its £500 million target 18 months ahead of schedule. The university is now aiming to build on this success and raise a further £100 million by the end of 2015, to fund vital research, deliver innovative new treatments and to support scholarships. The campaign's five priority areas are neuroscience and mental health, leadership and society, cancer, global power and children's health. More information about the campaign is available at http://www.kcl.ac.uk/kingsanswers.

About National Institute for Health Research

The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (http://www.nihr.ac.uk).

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