Weight change following diagnosis with psychosis: a retrospective cohort study in Greater Manchester, UK
Abstract Introduction Weight gain in the months/years after diagnosis/treatment of severe enduring mental illness (SMI) is a major predictor of future diabetes, dysmetabolic profile and increased risk of cardiometabolic diseases. There is limited data on the longer-term profile of weight change in p...
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-01-01
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| Series: | Annals of General Psychiatry |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12991-023-00485-8 |
| _version_ | 1797362991270723584 |
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| author | Adrian Heald Chris Daly John Julian Warner-Levy Richard Williams Cheyenne Meehan Mark Livingston Toby Pillinger Lamiece Hussain Joseph Firth |
| author_facet | Adrian Heald Chris Daly John Julian Warner-Levy Richard Williams Cheyenne Meehan Mark Livingston Toby Pillinger Lamiece Hussain Joseph Firth |
| author_sort | Adrian Heald |
| collection | DOAJ |
| description | Abstract Introduction Weight gain in the months/years after diagnosis/treatment of severe enduring mental illness (SMI) is a major predictor of future diabetes, dysmetabolic profile and increased risk of cardiometabolic diseases. There is limited data on the longer-term profile of weight change in people with a history of SMI and how this may differ between individuals. We here report a retrospective study on weight change over the 5 years following an SMI diagnosis in Greater Manchester UK, an ethnically and culturally diverse community, with particular focus on comparing non-affective psychosis (NAP) vs affective psychosis (AP) diagnoses. Methods We undertook an anonymised search in the Greater Manchester Care Record (GMCR). We reviewed the health records of anyone who had been diagnosed for the first time with first episode psychosis, schizophrenia, schizoaffective disorder, delusional disorder (non-affective psychosis = NAP) or affective psychosis (AP). We analysed body mass index (BMI) change in the 5-year period following the first prescription of antipsychotic medication. All individuals had taken an antipsychotic agent for at least 3 months. The 5-year follow-up point was anywhere between 2003 and 2023. Results We identified 9125 people with the diagnoses above. NAP (n = 5618; 37.3% female) mean age 49.9 years; AP (n = 4131; 60.5% female) mean age 48.7 years. 27.0% of NAP were of non-White ethnicity vs 17.8% of AP individuals. A higher proportion of people diagnosed with NAP were in the highest quintile of social disadvantage 52.4% vs 39.5% for AP. There were no significant differences in baseline BMI profile. In a subsample with HbA1c data (n = 2103), mean HbA1c was higher in NAP at baseline (40.4 mmol/mol in NAP vs 36.7 mmol/mol for AP). At 5-year follow-up, there was similarity in both the overall % of individuals in the obese ≥ 30 kg/m2 category (39.8% NAP vs 39.7% AP), and % progressing from a normal healthy BMI transitioned to obese/overweight BMI (53.6% of NAP vs 55.6% with AP). 43.7% of those NAP with normal BMI remained at a healthy BMI vs 42.7% with AP. At 5-year follow-up for NAP, 83.1% of those with BMI ≥ 30 kg/m2 stayed in this category vs 81.5% of AP. Conclusion The results of this real-world longitudinal cohort study suggest that the changes in BMI with treatment of non-affective psychosis vs bipolar disorder are not significantly different, while 43% maintain a healthy weight in the first 5 years following antipsychotic prescription. |
| first_indexed | 2024-03-08T16:15:09Z |
| format | Article |
| id | doaj.art-4f1ebc139ed5449ca89336395f0d601c |
| institution | Directory Open Access Journal |
| issn | 1744-859X |
| language | English |
| last_indexed | 2024-03-08T16:15:09Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Annals of General Psychiatry |
| spelling | doaj.art-4f1ebc139ed5449ca89336395f0d601c2024-01-07T12:38:10ZengBMCAnnals of General Psychiatry1744-859X2024-01-012311710.1186/s12991-023-00485-8Weight change following diagnosis with psychosis: a retrospective cohort study in Greater Manchester, UKAdrian Heald0Chris Daly1John Julian Warner-Levy2Richard Williams3Cheyenne Meehan4Mark Livingston5Toby Pillinger6Lamiece Hussain7Joseph Firth8The School of Medicine and Manchester Academic Health Sciences Centre, Manchester UniversityGreater Manchester Mental Health, Prestwich HospitalDepartment of Endocrinology and Diabetes, Salford Royal HospitalDivision of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science CentreDepartment of Endocrinology and Diabetes, Salford Royal HospitalBlack CountryPathology ServicesInstitute of PsychiatryDivision of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science CentreDivision of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science CentreAbstract Introduction Weight gain in the months/years after diagnosis/treatment of severe enduring mental illness (SMI) is a major predictor of future diabetes, dysmetabolic profile and increased risk of cardiometabolic diseases. There is limited data on the longer-term profile of weight change in people with a history of SMI and how this may differ between individuals. We here report a retrospective study on weight change over the 5 years following an SMI diagnosis in Greater Manchester UK, an ethnically and culturally diverse community, with particular focus on comparing non-affective psychosis (NAP) vs affective psychosis (AP) diagnoses. Methods We undertook an anonymised search in the Greater Manchester Care Record (GMCR). We reviewed the health records of anyone who had been diagnosed for the first time with first episode psychosis, schizophrenia, schizoaffective disorder, delusional disorder (non-affective psychosis = NAP) or affective psychosis (AP). We analysed body mass index (BMI) change in the 5-year period following the first prescription of antipsychotic medication. All individuals had taken an antipsychotic agent for at least 3 months. The 5-year follow-up point was anywhere between 2003 and 2023. Results We identified 9125 people with the diagnoses above. NAP (n = 5618; 37.3% female) mean age 49.9 years; AP (n = 4131; 60.5% female) mean age 48.7 years. 27.0% of NAP were of non-White ethnicity vs 17.8% of AP individuals. A higher proportion of people diagnosed with NAP were in the highest quintile of social disadvantage 52.4% vs 39.5% for AP. There were no significant differences in baseline BMI profile. In a subsample with HbA1c data (n = 2103), mean HbA1c was higher in NAP at baseline (40.4 mmol/mol in NAP vs 36.7 mmol/mol for AP). At 5-year follow-up, there was similarity in both the overall % of individuals in the obese ≥ 30 kg/m2 category (39.8% NAP vs 39.7% AP), and % progressing from a normal healthy BMI transitioned to obese/overweight BMI (53.6% of NAP vs 55.6% with AP). 43.7% of those NAP with normal BMI remained at a healthy BMI vs 42.7% with AP. At 5-year follow-up for NAP, 83.1% of those with BMI ≥ 30 kg/m2 stayed in this category vs 81.5% of AP. Conclusion The results of this real-world longitudinal cohort study suggest that the changes in BMI with treatment of non-affective psychosis vs bipolar disorder are not significantly different, while 43% maintain a healthy weight in the first 5 years following antipsychotic prescription.https://doi.org/10.1186/s12991-023-00485-8Non-affective psychosisAffective psychosisLongitudinalWeight gainBMI |
| spellingShingle | Adrian Heald Chris Daly John Julian Warner-Levy Richard Williams Cheyenne Meehan Mark Livingston Toby Pillinger Lamiece Hussain Joseph Firth Weight change following diagnosis with psychosis: a retrospective cohort study in Greater Manchester, UK Annals of General Psychiatry Non-affective psychosis Affective psychosis Longitudinal Weight gain BMI |
| title | Weight change following diagnosis with psychosis: a retrospective cohort study in Greater Manchester, UK |
| title_full | Weight change following diagnosis with psychosis: a retrospective cohort study in Greater Manchester, UK |
| title_fullStr | Weight change following diagnosis with psychosis: a retrospective cohort study in Greater Manchester, UK |
| title_full_unstemmed | Weight change following diagnosis with psychosis: a retrospective cohort study in Greater Manchester, UK |
| title_short | Weight change following diagnosis with psychosis: a retrospective cohort study in Greater Manchester, UK |
| title_sort | weight change following diagnosis with psychosis a retrospective cohort study in greater manchester uk |
| topic | Non-affective psychosis Affective psychosis Longitudinal Weight gain BMI |
| url | https://doi.org/10.1186/s12991-023-00485-8 |
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