Pathophysiological mechanisms of increased cardiometabolic risk in people with schizophrenia and other severe mental illnesses
Abstract
Patients with schizophrenia have increased mortality and morbidity compared with the general population. These patients have a 20-year shorter lifespan than peers without schizophrenia, mainly due to premature cardiovascular disease, suicide, and cancer. Patients with severe mental illness are at increased risk for cardiovascular disease related to increased incidence of diabetes, hypertension, smoking, poor diet, obesity, dyslipidaemia, metabolic syndrome, low physical activity, and side-effects of antipsychotic drugs. Some second-generation antipsychotics (eg, clozapine, olanzapine, quetiapine, and risperidone) are associated with an increased risk of weight gain and obesity, impaired glucose tolerance and new-onset diabetes, hyperlipidaemia, and cardiovascular disease. The mechanisms by which schizophrenia and patients with severe mental illness are susceptible to cardiometabolic disorders are complex and include lifestyle risks and direct and indirect effects of antipsychotic drugs. An understanding of these risks might lead to effective interventions for prevention and treatment of cardiometabolic disorders in schizophrenia and severe mental illness.
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Profound metabolic side effects, including weight gain, increased chance of diabetes, hyperlipidemia, and high blood pressure, are also common with risperidone and aripiprazole.
“Profound metabolic side effects, including weight gain, increased chance of diabetes, hyperlipidemia, and high blood pressure, are also common with risperidone and aripiprazole [139–141].”
From Pharmacological treatment in autism: a proposal for guidelines on common co-occurring psychiatric symptoms (2025) · cites this paper as [140]
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- Authors
- Henderson, D. C., Vincenzi, B., Andrea, N. V., Ulloa, M., & Copeland, P. M.
- Affiliations
- Harvard University (US)
- Massachusetts General Hospital (US)
- ORCID
- Henderson, David C
- Venue
- The Lancet Psychiatry
- Publisher
- Elsevier BV
- Published
- 2015-05
- Volume
- 2
- Issue
- 5
- Pages
- 452-464
- ISSN
- 2215-0366 (ISSN-L)
- OpenAlex
- W2092025665
- Cited by
- 288
- References
- 12
- Citations by year
- 2026: 19 · 2025: 29 · 2024: 29 · 2023: 28 · 2022: 17 · 2021: 32 · 2020: 36 · 2019: 28 · 2018: 24 · 2017: 21 · 2016: 20 · 2015: 5
- FWCI
- 3.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
- Keywords
- schizophrenia, severe mental illness, cardiometabolic risk, cardiovascular disease, metabolic syndrome, atypical antipsychotics, antipsychotic adverse effects, obesity, diabetes mellitus, dyslipidemia, premature mortality, lifestyle risk factors, pathophysiological mechanisms
- MeSH terms
- Mental Disorders, Cardiovascular Diseases, Humans, Risk Factors, Schizophrenia, Severity of Illness Index
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