BACKGROUND: Excess mortality in psychotic disorders is largely due to preventable cardiometabolic morbidity. Efforts to evaluate the link between the psychosis spectrum and cardiometabolic health have been confounded by early-life adversity (ELA) and biased sampling. This population-based study examined prospective associations between psychosis-spectrum status and cardiometabolic biomarkers at age 44-45, adjusting for ELA. STUDY DESIGN: We analyzed data from the 2002/03 biomedical sweep of the British National Child Development Study (n = 9377; age 44-45). Psychosis-spectrum status (exposure; n = 171) was defined using repeated screening across adulthood (ages 23 to 44-45), including self-reported diagnoses, antipsychotic medication use, or professional help-seeking for hallucinations. Cardiometabolic biomarkers at age 44-45 (outcomes) were compared between individuals on the psychosis spectrum and psychosis-free controls (comparator; n = 2448). Analyses were conducted using unimputed and multiply imputed datasets (n = 7391-9298), adjusting for 24 indicators of ELA. STUDY RESULTS: In both unimputed/imputed analyses, individuals on the psychosis spectrum had significantly worse cardiometabolic profiles. Adjusted results showed elevated abdominal obesity (exp(b), 1.404; 95% CI, 1.177-1.676; P < .001), higher glycated hemoglobin (B = 0.321; 95% CI, 0.089-0.553; P = .008), lower high-density lipoprotein cholesterol (B = -4.472; 95% CI, -7.782 to -1.162; P = .009), and increased fibrinogen (B = 4.542; 95% CI, 0.939-8.144; P = .015) compared to controls. CONCLUSIONS: Overcoming early-life confounders and biases that limited prior research, our study demonstrates a robust, independent association between psychosis-spectrum status and cardiometabolic dysfunction at age 44-45. These findings underscore the urgent need for comprehensive screening, treatment, and monitoring of cardiometabolic morbidity in psychosis, guided by a life-course perspective.
Kravariti et al. (Thu,) studied this question.