The heart of the matter: cardiometabolic care in youth with psychosis
The heart of the matter: cardiometabolic care in youth with psychosis
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DOI：
10.1111/j.1751-7893.2011.00315.x
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发表时间：
2012-08-01
影响因子：
2
通讯作者：
Samaras, Katherine
中科院分区：
文献类型：
--
作者：
Curtis, Jackie;Newall, Hannah D.;Samaras, Katherine
目的：青少年精神病患者的体重增加、肥胖和代谢紊乱是精神病患者健康负担的重要原因，其发生率比一般人群增加两到三倍，预期寿命减少 20%。现在有几项研究描述了一系列干预措施对心脏代谢的益处，包括结构化饮食和锻炼计划以及对接受抗精神病药物治疗的患者使用二甲双胍。尽管澳大利亚制定了共识指南和筛查算法来检测此类代谢异常，但临床医生仍缺乏指南来确定适当、及时、有针对性的预防和干预措施来管理青年人群中的这些并发症。方法：邦迪早期精神病项目针对经历首次精神病发作的年轻人（1525 岁）。该服务开发了代谢筛查模型和治疗算法，为临床医生提供有针对性的干预建议。结果：积极的心脏代谢健康：接受精神药物治疗的患者的早期干预框架描述了一种针对抗精神病药物引起的代谢异常和心血管危险因素的早期检测、预防和干预策略的方法。结论：虽然还需要进一步研究，但有足够的证据支持早期干预和预防策略，以改善首发精神病年轻人的身体健康结果。
Aim: Weight gain, obesity and metabolic disturbances in youth with psychosis are significant contributors to the health burden of people with psychosis, with a two- to threefold increase in rates compared with the general population and a 20% reduction in life expectancy. Several studies have now described cardiometabolic benefits of a range of interventions, including a structured diet and exercise programmes and metformin for patients receiving antipsychotic medications. Despite the development of Australian consensus guidelines and screening algorithms to detect such metabolic abnormalities, there is a lack of guidelines for clinicians to determine appropriate, timely, targeted prevention and intervention to manage these complications in the youth population. Methods: The Bondi Early Psychosis Programme targets young people (aged 1525 years) experiencing their first episode of psychosis. This service has developed a model of metabolic screening and a treatment algorithm to provide clinicians with recommendations for targeted interventions. Results: Positive Cardiometabolic Health: an early intervention framework for patients on psychotropic medication describes a method for early detection, prevention and intervention strategies targeting antipsychotic-induced metabolic abnormalities and cardiovascular risk factors. Conclusion: Although further research is required, there is sufficient evidence to support early intervention and prevention strategies to improve physical health outcomes in young people with first-episode psychosis.