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Testing the Transportability of the Psychosis Metabolic Risk Calculator in Canada (Quebec): International External
Sébastien Brodeur1,2,3,4, Olivier Corbeil2,4,5, Laurent Béchard2,4,5
1Department of Psychiatry and Neuroscience, Faculty of Medicine, Laval University, Quebec, G1V 0A6, Canada.
Schizophrenia Bulletin
|October 27, 2025
Summary
The Psychosis Metabolic Risk Calculator (PsyMetRiC) shows promise for predicting cardiometabolic risk in young adults with first-episode psychosis (FEP). This validation in North America suggests potential for early intervention to improve long-term physical health outcomes.
Area of Science:
- Psychiatry
- Cardiology
- Metabolic Health
Background:
- Cardiometabolic morbidity is a major cause of premature mortality in individuals with psychotic disorders.
- This risk is detectable early, even at psychosis onset.
- No accurate risk prediction tool currently exists for young people experiencing first-episode psychosis (FEP).
Purpose of the Study:
- To externally validate the Psychosis Metabolic Risk Calculator (PsyMetRiC) in a North American population.
- To assess the accuracy and clinical usefulness of PsyMetRiC for predicting metabolic syndrome (MetS) in FEP patients.
- To refine the PsyMetRiC tool for better representation of North American demographics.
Main Methods:
- External validation of the UK-developed PsyMetRiC tool using data from a Canadian FEP clinic.
- PsyMetRiC includes penalized logistic regression models with and without biochemical predictors.
- Performance was evaluated using discrimination (C-statistic), calibration, and decision curve analysis in patients aged 16-35 with over 12 months follow-up.
Main Results:
- The Canadian cohort (N=559) had higher BMI and lower lipid profiles compared to the UK cohort.
- PsyMetRiC demonstrated acceptable discrimination (full model C=0.74).
- Slight performance improvements were observed after updating the race and ethnicity predictor for the North American population.
Conclusions:
- This study provides the first external validation of PsyMetRiC in a North American sample.
- PsyMetRiC shows potential as a tool for early cardiometabolic risk detection in FEP.
- Further research is needed prior to routine clinical implementation to guide personalized treatments.
