Does severe mental illness predispose to cardiovascular and metabolic disease via an unfavourable adipose storage profile?

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Individuals with severe mental illness (SMI, including schizophrenia, bipolar disorder, and major depressive disorder) have increased rates and risk of cardiovascular and metabolic diseases (CMD, including obesity, type 2 diabetes and cardiovascular diseases), compared to the general population. Socioeconomic and lifestyle factors as well as psychotropic medication and genetic variation all contribute to this excess. Recent studies have provided evidence of shared biology, however the mechanisms linking SMI and CMD remain to be fully elucidated. This is necessary so that appropriate clinical risk management can be undertaken in these patients. Many genetic variants contributing to SMI and to obesity phenotypes have been identified. Obesity-associated genetic variants have been classified by their effects on BMI (reflecting total obesity) and WHR (reflecting central obesity), as having neutral, increasing (CMD-coupled) and decreasing (CMD-uncoupled)