Evidence map›Paper›PMID 41863368›Full record

SynthesisSchizophrenia bulletin2026

Short-, Medium-, and Long-Term Cardiometabolic Outcomes in First-Episode Psychosis: A Systematic Review and Meta-analysis.

Anna Zierotin, Jennifer Murphy, Anja Stano, Michael John Norton, David R Cotter, Mary Cannon, Karen O'Connor, Brian O'Donoghue, Mary Clarke

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Schizophrenia bulletin, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Anna ZierotinSchool of Medicine, College of Health and Agricultural Sciences, University College Dublin, Dublin 4, D04 V1W8, Ireland.ORCID 0009-0002-6200-6726
Jennifer MurphyDepartment of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, DO2 YN77, Ireland.
Anja StanoMax Planck Institute for Human Development, Center for Environmental Neuroscience, 14195 Berlin, Germany.
Michael John NortonRecovery and Engagement Lead, Office of Mental Health Engagement and Recovery, HSE, Dublin, D20 HK69, Ireland.ORCID 0000-0002-7420-9339
David R CotterDepartment of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, DO2 YN77, Ireland.
Mary CannonDepartment of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, DO2 YN77, Ireland.
Karen O'ConnorRISE Early Intervention in Psychosis Service, South Lee Mental Health Service, Cork, T12 YR2P, Ireland.
Brian O'DonoghueSchool of Medicine, College of Health and Agricultural Sciences, University College Dublin, Dublin 4, D04 V1W8, Ireland.ORCID 0000-0001-6240-6952
Mary ClarkeSchool of Medicine, College of Health and Agricultural Sciences, University College Dublin, Dublin 4, D04 V1W8, Ireland.

Funding

FutureNeuro Research Ireland Centre for Translational Brain ScienceHealth Research Board Psychosis Ireland Structured Training and Research CDA 2021-0005Taighde Éireann - Research Ireland 21/RC/10294_P2
6 · The paper itself

Abstract

backgroundIndividuals with first-episode psychosis (FEP) experience increased cardiometabolic risks, contributing to reduced life expectancy. While metabolic disturbances are well described in chronic schizophrenia, their trajectory from first presentation, before or with minimal antipsychotic exposure, through to long-term follow-up remains incompletely characterized.

objectiveTo synthesize evidence on progression of cardiometabolic outcomes in FEP cohorts from before initiation of antipsychotic medication to up to 10 years of follow-up. STUDY

designFollowing PRISMA and MOOSE guidelines (PROSPERO: CRD42023431072), Medline, Embase, PsycInfo, and CINAHL+ were searched to July 2025 for studies of FEP cohorts with ≤28 days of antipsychotic exposure at baseline. Outcomes included weight, glucose, lipids, blood pressure, metabolic syndrome (MetS), diabetes, and cardiovascular disease (CVD). Random-effects meta-analyses were stratified by follow-up duration. As post-baseline exposure was not quantified, follow-up estimates reflect outcomes under routine care. STUDY

resultsFrom 2601 unique articles, 82 studies were included. Obesity and MetS prevalence increased from 5.4% and 8.5%, respectively at baseline, to 26.6% and 18.2% at 1-3 years, whereas type 2 diabetes increased from 0.5% to 5.0% by >5 years. Lipid abnormalities emerged early, while blood pressure changes were minimal, and CVD hospitalization prevalence was 1.4% at 5-10 years. Weight increased by +2.5 kg at 4-8 weeks and + 13.4 kg at >5 years, with parallel increases in BMI and waist circumference.

conclusionsCardiometabolic deterioration begins within weeks of FEP onset and accumulates over time, indicating the need for early prevention, sustained monitoring, integrated metabolic care, and patient education throughout the course of care.

Indexed as

Antipsychotic AgentsCardiovascular DiseasesMetabolic SyndromeObesityPsychotic DisordersSchizophreniaHumansAntipsychotic Agentscardiovascular healthlongitudinalmetabolic dysregulationmultimorbidityphysical health comorbidity

Identifiers

PMID41863368
PMCPMC13005113

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.