Cardiometabolic risk factors in people with psychotic disorders: the second Australian national survey of psychosis.
Abstract
OBJECTIVE: To determine the prevalence of cardiometabolic risk factors in Australian adults with a psychotic disorder. METHOD: Data were collected during the interview phase of the second Australian survey of psychosis, a population-based survey of Australians aged 18 to 64 years with a psychotic disorder. Body mass index, waist circumference and blood pressure were measured. Participants were asked about diagnoses of relevant medical conditions, medications, smoking and physical activity. Fasting blood samples were analysed for glucose, high-density lipoprotein cholesterol, total cholesterol and triglycerides. The prevalence of metabolic syndrome was determined using the harmonized criteria developed by the International Diabetes Federation and other bodies. RESULTS: A total of 1087 men (60%) and 738 women (40%) participated. Their mean age was 38.36 (SD 11.16) years; 773 (42%) were aged 18-34 years and 1052 (58%) 35-64 years. Three-quarters were overweight or obese and 82% had abdominal obesity. Almost half were hypertensive. Two-thirds were current smokers and 81% had a lifetime history of smoking. Levels of physical activity were very low. About 30% reported a diagnosis of hypertension or high cholesterol, 20% knew they had diabetes or high blood sugar and 18% had cardiovascular disease. Half of those with self-reported hypertension were taking antihypertensive drugs, and about 40% with hypercholesterolemia or hyperglycaemia were receiving medication for these conditions. Seventy per cent (N = 1286) of participants provided fasting blood samples. Abnormal levels of high-density lipoprotein cholesterol and triglycerides were each found in almost half of participants and almost one-third had elevated fasting glucose. More than half of participants (54.8%) met criteria for metabolic syndrome. CONCLUSIONS: Australians living with psychosis have high rates of cardiometabolic risk factors. There are a number of obvious targets for prevention and treatment, including obesity (especially in women), smoking (more prevalent in men), hypertension, hyperlipidaemia and sedentary lifestyle.
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CVD diagnoses have previously been validated in THIN with positive predictive values (PPVs) greater than 90%.
“CVD diagnoses have previously been validated in THIN with positive predictive values (PPVs) greater than 90%.46,47”
From Mortality gap for people with bipolar disorder and schizophrenia: UK-based cohort study 2000–2014 (2017) · cites this paper as [47]
The exposure groups (bipolar disorder and schizophrenia) and the outcomes (mortality, CVD deaths, CVD, suicide and self-harm) have been well validated.
“The exposure groups (bipolar disorder and schizophrenia)44,45 and the outcomes (mortality, CVD deaths, CVD, suicide and self-harm)46,47,50,51 have been well validated.”
From Mortality gap for people with bipolar disorder and schizophrenia: UK-based cohort study 2000–2014 (2017) · cites this paper as [47]
Patients with mental illness are more likely to be overweight and have higher rates of cardiometabolic disease compared with the general population.
“Patients with mental illness are also more likely to be overweight and have higher rates of cardiometabolic disease compared with the general population (Galletly et al. 2012).”
From A call to action: Exercise as treatment for patients with mental illness (2015) · cites this paper as Galletly et al. 2012
Psychiatric populations are already at an elevated risk of cardiovascular, metabolic or respiratory dysfunction compared with the general population, independent of medication influences.
“Independent of influences from medication, psychiatric populations are already at an elevated risk of cardiovascular, metabolic or respiratory dysfunction than the general population (Galletly et al., 2012; Vancampfort et al., 2013)”
From Aerobic Exercise as a Tool to Improve Hippocampal Plasticity and Function in Humans: Practical Implications for Mental Health Treatment (2016) · cites this paper as Galletly et al., 2012
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Cardiometabolic Risk in First Episode Psychosis Patients
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Cognition in schizophrenia improves with treatment of severe obstructive sleep apnoea: A pilot study
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Cardio-metabolic risk in individuals prescribed long-acting injectable antipsychotic medication
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Premature death in schizophrenia: bridging the gap
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What Physical Health Means to Me: Perspectives of People with Mental Illness
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Why don’t people diagnosed with schizophrenia spectrum disorders (SSDs) get enough exercise?
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Psychosis and cardiovascular disease: Is diet the missing link?
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A Practical Approach to Avoiding Cardiovascular Adverse Effects of Psychoactive Medications
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Non-dipping nocturnal blood pressure and psychosis parameters in Parkinson disease
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Inequalities in the Incidence of Psychotic Disorders Among Racial and Ethnic Groups
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Obesity in a forensic and rehabilitation psychiatric service: a missed opportunity?
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Physical health monitoring for people with schizophrenia
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Where to for Australian mental health services? Promoting self-efficacy
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Higher Body-Mass Index and Lower Gray Matter Volumes in First Episode of Psychosis
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- Authors
- Galletly, C. A., Foley, D. L., Waterreus, A., Watts, G. F., Castle, D. J., McGrath, J. J., Mackinnon, A., & Morgan, V. A.
- Affiliations
- Ramsay Health Care (Australia) (AU)
- The University of Melbourne (AU)
- The University of Western Australia (AU)
- The University of Queensland (AU)
- ORCID
- Venue
- Australian & New Zealand Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2012-07-03
- Volume
- 46
- Issue
- 8
- Pages
- 753-761
- ISSN
- 0004-8674 (ISSN-L)
- 1440-1614
- OpenAlex
- W1989168334
- Cited by
- 203
- References
- 34
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 12 · 2023: 6 · 2022: 6 · 2021: 8 · 2020: 16 · 2019: 14 · 2018: 19 · 2017: 22 · 2016: 25 · 2015: 26 · 2014: 19 · 2013: 17 · 2012: 5
- FWCI
- 15.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Australian & New Zealand Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Funders
- Ramsay Health Care
- 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 › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- psychosis, cardiometabolic risk factors, metabolic syndrome, obesity, abdominal obesity, hypertension, hyperlipidemia, hyperglycemia, smoking, physical inactivity, sedentary lifestyle, cardiovascular disease, Australian adults
- MeSH terms
- Adult, Australia, Blood Glucose, Blood Pressure, Female, Health Surveys, Humans, Lipids, Male, Middle Aged, Motor Activity, Psychotic Disorders, Risk Factors, Smoking, Body Mass Index, Prevalence, Metabolic Syndrome, Health Status Disparities, Waist Circumference
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