The case for monitoring metabolic and inflammatory elevated risk groups in young people with emerging mental disorders

We investigated the prevalence of elevated metabolic and inflammatory risk groups in youth seeking care for emerging mental disorders. Among 124 participants (27.3±5.9 years), we analysed fasting insulin (FI), fasting blood glucose (FBG), homeostasis model assessment of insulin resistance (HOMA2-IR), and C-reactive Protein (CRP). FI (≥10mU/L) and CRP (≥1mg/L) were used to categorise metabolic- or inflammatory-risk groups, and demographic/clinical features were compared. Inflammatory risk was common (58% [n=73] with elevated CRP), as was metabolic risk (38% [n=47] with elevated FI). Notably, 25% (n=31) had elevated HOMA2-IR, while only 7% (n=9) had abnormal FBG. Elevated-risk groups had poorer mental and physical health, and the inflammatory-risk group comprised more youth with major mood disorders. Elevated metabolic and inflammatory dysfunction is common in youth with emerging mental disorders and associated with poorer clinical features. Early detection and monitoring of these markers in early intervention mental health services is needed.