eprintid: 10080630
rev_number: 20
eprint_status: archive
userid: 608
dir: disk0/10/08/06/30
datestamp: 2019-08-29 12:02:29
lastmod: 2021-09-17 22:31:46
status_changed: 2019-11-22 10:15:02
type: article
metadata_visibility: show
creators_name: Gaughran, F
creators_name: Stahl, D
creators_name: Stringer, D
creators_name: Hopkins, D
creators_name: Atakan, Z
creators_name: Greenwood, K
creators_name: Patel, A
creators_name: Smith, S
creators_name: Gardner-Sood, P
creators_name: Lally, J
creators_name: Heslin, M
creators_name: Stubbs, B
creators_name: Bonaccorso, S
creators_name: Kolliakou, A
creators_name: Howes, O
creators_name: Taylor, D
creators_name: Forti, MD
creators_name: David, AS
creators_name: Murray, RM
creators_name: Ismail, K
creators_name: IMPACT team, 
title: Effect of lifestyle, medication and ethnicity on cardiometabolic risk in the year following the first episode of psychosis: prospective cohort study
ispublished: inpress
divisions: UCL
divisions: B02
divisions: C07
divisions: D79
keywords: First episode psychosis; cardiometabolic risk; weight; glucose dysregulation; ethnicity
note: This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike licence (http://creativecommons.org/licenses/by-nc-sa/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the same Creative Commons licence is included and the original work is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use.
abstract: Background
The first episode of psychosis is a critical period in the emergence of cardiometabolic risk.

Aims
We set out to explore the influence of individual and lifestyle factors on cardiometabolic outcomes in early psychosis.

Method
This was a prospective cohort study of 293 UK adults presenting with first-episode psychosis investigating the influence of sociodemographics, lifestyle (physical activity, sedentary behaviour, nutrition, smoking, alcohol, substance use) and medication on cardiometabolic outcomes over the following 12 months.

Results
Rates of obesity and glucose dysregulation rose from 17.8% and 12%, respectively, at baseline to 23.7% and 23.7% at 1 year. Little change was seen over time in the 76.8% tobacco smoking rate or the quarter who were sedentary for over 10 h daily. We found no association between lifestyle at baseline or type of antipsychotic medication prescribed with either baseline or 1-year cardiometabolic outcomes. Median haemoglobin A1c (HbA1c) rose by 3.3 mmol/mol in participants from Black and minority ethnic (BME) groups, with little change observed in their White counterparts. At 12 months, one-third of those with BME heritage exceeded the threshold for prediabetes (HbA1c >39 mmol/mol).

Conclusions
Unhealthy lifestyle choices are prevalent in early psychosis and cardiometabolic risk worsens over the next year, creating an important window for prevention. We found no evidence, however, that preventative strategies should be preferentially directed based on lifestyle habits. Further work is needed to determine whether clinical strategies should allow for differential patterns of emergence of cardiometabolic risk in people of different ethnicities.
date: 2019-12
date_type: published
official_url: https://doi.org/10.1192/bjp.2019.159
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1679800
doi: 10.1192/bjp.2019.159
pii: S0007125019001594
lyricists_name: David, Anthony
lyricists_id: ADDAV87
actors_name: David, Anthony
actors_id: ADDAV87
actors_role: owner
full_text_status: public
publication: The British Journal of Psychiatry
volume: 215
number: 6
pagerange: 712-719
event_location: England
issn: 1472-1465
citation:        Gaughran, F;    Stahl, D;    Stringer, D;    Hopkins, D;    Atakan, Z;    Greenwood, K;    Patel, A;                                                         ... IMPACT team; + view all <#>        Gaughran, F;  Stahl, D;  Stringer, D;  Hopkins, D;  Atakan, Z;  Greenwood, K;  Patel, A;  Smith, S;  Gardner-Sood, P;  Lally, J;  Heslin, M;  Stubbs, B;  Bonaccorso, S;  Kolliakou, A;  Howes, O;  Taylor, D;  Forti, MD;  David, AS;  Murray, RM;  Ismail, K;  IMPACT team;   - view fewer <#>    (2019)    Effect of lifestyle, medication and ethnicity on cardiometabolic risk in the year following the first episode of psychosis: prospective cohort study.                   The British Journal of Psychiatry , 215  (6)   pp. 712-719.    10.1192/bjp.2019.159 <https://doi.org/10.1192/bjp.2019.159>.    (In press).    Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10080630/1/PUMP%20paper%20BJP.pdf