Risk factors associated with metabolic abnormalities in first-episode psychotic patients. A systematic review.

Background. Weight gain and metabolic abnormalities are frequent complications in first-episode psychosis (FEP) patients. Literature reviews on metabolic profile disturbances in FEP patients are however sparse and show several limitations. This review aims to fill this gap. Methods. We identified all studies exploring risk factors for metabolic profile disturbances in FEP patients. Research focused on studies assessing the involvement of biologic, psychologic and environmental factors in the pathogenesis and maintenance of changes in glycolipid metabolism in FEP patients. Study selection was performed by searches on Medline, matching a set of key words and selecting all papers published up to October 2011. Results. 37 studies were included. Literature analysis shows that FEP patients are particularly at risk for weight gain and changes in glycolipid metabolism. Major risk factors for metabolic disturbances include: increase in body weight and body mass index; abnormalities in laboratory findings; wrong lifestyle; use of antipsychotic drugs; genetic background. Conclusions. Clinical practice should be implemented with integrated care, in which psychiatric care should be strictly linked to medical care, and with early intervention programs on lifestyle habits for patients with FEP at the beginning of their psychopharmacological treatment.