Short-, Medium-, and Long-Term Cardiometabolic Outcomes in First-Episode Psychosis: A Systematic Review and...

Area of Science:

• Psychiatry
• Cardiology
• Metabolic Medicine

Background:

• First-episode psychosis (FEP) is associated with elevated cardiometabolic risks, impacting life expectancy.
• Metabolic disturbances in FEP are not fully understood, especially their progression from initial presentation.
• Understanding this trajectory is vital for early intervention strategies.

Purpose of the Study:

• To systematically review the progression of cardiometabolic outcomes in FEP cohorts.
• To analyze data from before antipsychotic initiation up to 10 years of follow-up.
• To inform clinical practice regarding metabolic health in early psychosis.

Main Methods:

• Systematic review and meta-analysis following PRISMA and MOOSE guidelines.
• Searched Medline, Embase, PsycInfo, and CINAHL+ for studies on FEP with minimal antipsychotic exposure.
• Included outcomes: weight, glucose, lipids, blood pressure, metabolic syndrome, diabetes, and cardiovascular disease.

Main Results:

• Obesity and metabolic syndrome prevalence increased significantly from baseline to 1-3 years.
• Type 2 diabetes incidence rose by >5 years; lipid abnormalities appeared early.
• Weight gain was substantial, with parallel increases in BMI and waist circumference over time.

Conclusions:

• Cardiometabolic health deteriorates rapidly in the early stages of psychosis.
• Integrated metabolic care, patient education, and sustained monitoring are essential.
• Early prevention strategies are critical for improving long-term outcomes in FEP.