Cardiometabolic health risks, lifestyle behaviours and quality of life in people diagnosed with early psychosis – A cross‐sectional study
Authors: Meepring Soontareeporn , Gray Richard , Li Yan , Ho Grace , Chien Wai‐Tong , Bressington Daniel 
Published: December 2021

Accessible summary

What is known on the subject?

People diagnosed with schizophrenia have poor cardiometabolic health, with elevated 10‐year cardiovascular disease risk (CVD‐R) scores and low quality of life (QOL).

There is a lack of understanding about CVD‐R scores in people diagnosed with early psychosis and no studies have quantified CVD‐R using the QRISK®3 calculator in this client group.

Establishing potential relationships between modifiable lifestyle behaviours/treatment characteristics with CVD‐R or QOL may identify targets for early intervention.

What the paper adds to existing knowledge?

This is the first study to quantify the individual 10‐year CVD‐R of people diagnosed with early psychosis utilising the QRISK®3 calculator.

This is also the first study to investigate relationships between QOL and CVD‐R and lifestyle factors in a cohort of Thai people diagnosed with early psychosis.

We observed low levels of physical health‐related QOL and high levels of CVR‐R despite participants reporting relatively positive lifestyle behaviours.

What are the implications for practice?

The cardiometabolic health state of this client group warrants as much attention as for those with an enduring severe mental illness; early preventative interventions are warranted.

It may be useful to routinely quantify the CVD‐R of people diagnosed with early psychosis using the QRISK®3 calculator, even in the absence of immediate concerns about lifestyle behaviours.

Mental health nurses should utilise evidence‐based approaches such as increasing activity levels, dietary counselling and behaviour change interventions to mitigate poor physical health in this client group.

Introduction

People diagnosed with schizophrenia have poor cardiometabolic health, with elevated 10‐year cardiovascular disease risk (CVD‐R) scores and poor quality of life (QOL). There is lack of understanding of these issues in early psychosis.

Aims

To quantify CVD‐R in people diagnosed with early psychosis and profile their obesity prevalence, lifestyle behaviours and QOL. Secondary aim was to explore associations between lifestyle behaviours/treatment characteristics and CVD‐R/QOL.

Method

Baseline data from 81 RCT participants were used to profile cardiometabolic health risks (QRISK®3, BMI and waist circumference). Participants self‐reported lifestyle behaviours and QOL. Relationships between modifiable treatment/lifestyle factors and QOL/CVD‐R were explored.

Results

Participants’ relative risk for CVD over 10 years was 1.93 times higher than healthy counterparts; 39% also had an obese BMI and physical QOL was poor. No significant associations were observed between CVD‐R or QOL with treatment characteristics and lifestyle factors.

Discussion

Despite positive lifestyle behaviours, participants had elevated CVD‐R scores and poor physical health‐related QOL. Quantifying CVD‐R with QRISK®3 may highlight the need for health promotion interventions.

Implications for practice

Mental health professionals should be aware that elevated CVD‐R exists in the context of relatively healthy lifestyle behaviours and utilise evidence‐based interventions to address these issues.