Patients with schizophrenia spectrum disorders and other severe mental illness (SMI) have exceedingly high rates of metabolic comorbidity including obesity, dyslipidemia, and type 2 diabetes, all of which contribute to the high rates of cardiovascular mortality and morbidity seen among this patient population. The underlying causes are complex, including contribution of endogenous (i.e. genetics) and exogenous factors such as lifestyle, reduced access to physical care. In addition, antipsychotic (AP) medications, which most patients need to take for the duration of a chronic, often lifelong illness are associated with serious metabolic adverse effects. These include weight gain, dyslipidemia, and increased risk of type 2 diabetes. Particularly, first-episode patients with SMIs represent the most vulnerable individuals to these adverse effects, which appear to occur across all currently available agents in this population.
The complexities in underlying causes of metabolic comorbidity in SMI dictate that interventions may need to be tailored in this group. For example, while lifestyle interventions are recommended to treat metabolic comorbidity, data questioning efficacy and cost-effectiveness present barriers to use and scalability. Given contributing effects of APs to metabolic comorbidity, lowering the dose of the offending agent, or an AP switch may be unique considerations in SMI. Similarly, because mechanisms of AP-induced metabolic side-effects are complex, many agents that do not have regulatory body approval for chronic management of obesity have been studied in this population. In contrast, some of the currently approved weight loss agents in the general population may have possible effects on mental health symptoms or comorbidities.
Format
Recorded webinar, non-interactive, self-paced distance learning activity with post-test.
This presentation was recorded on September 15, 2022.
Learning Objectives
- Describe the underlying causes for high cardiometabolic comorbidity in severe mental illness, including contributing effects of psychotropic treatments
- List the disparities in care which exist in this population
- Gain a general knowledge of approaches to managing metabolic comorbidity in severe mental illness
Target Audience
Nurse/Nurse Practitioner, Pharmacist, Physician (Non-psychiatrist), Physician Assistant, Peer Specialist/Peer Support
Instructional Level
Intermediate
Estimate Time to Complete
Estimated Duration: 1.0 hour
Program Start Date: September 19, 2022
Program End Date: September 19, 2025
After completing the course, engage with colleagues in the mental health field through SMI Adviser's Webinar Roundtable Topics discussion board. This is an easy way to network and share ideas with other clinicians who participate in this webinar. Access through the discussion tab.
How to Earn Credit
Participants who wish to earn AMA PRA Category 1 Credit™, nursing continuing professional development contact hours (NCPD, formerly CNE), CE credit for psychologists, CE credit for social workers, or a certificate of participation may do so by viewing the live presentation and completing the evaluation. Participants claiming CE credit for psychologists and those claiming CE credit for Social workers, must have full attendance to claim credit. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians), NCPD (nurses), CE certificate (psychologists), CE certificate (social workers) or certificate of participation (other disciplines) showing the event date and hours earned.
Continuing Education Credit
Physicians
The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The APA designates this live event for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nurses/Nurse Practitioners
The American Psychiatric Nurses Association is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.
Faculty and Planner Disclosures
The American Psychiatric Association adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Medical Education. Any individuals in a position to control the content of a CME activity — including faculty, planners, reviewers or others — are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.
Instructor
- Margaret Hahn, PhD, MD, FRCPC is Associate Professor of Adult Psychiatry and Health Systems at the University of Toronto. Dr. Hahn's research interests lie in translational work focused on the complex interplay between mental illness, antipsychotic treatments, and cardiometabolic risk, with a special interest in diabetes. Given the early accrual of metabolic risk leading to a 20% reduction in life expectancy for patients with schizophrenia, she has an interest in early episode individuals and prevention strategies. She currently is the principal investigator on a clinical trial examining a pharmacological intervention for younger patients with psychosis and glucose abnormalities. She co-leads the Mental Health and Metabolic Clinic at the CAMH, which specializes in metabolic monitoring, and interventions for metabolic risk factors in individuals with serious mental illness. From a translational perspective, Dr. Hahn oversees a basic science laboratory that studies underlying mechanisms of antipsychotic-related metabolic disturbances and their attenuation. Dr. Hahn receives consultant fees from Alkermes.
Planners
- Teri Brister, PhD, LPC, National Alliance on Mental Illness. Reports no financial relationships with commercial interests.
- John Torous, MD, Beth Israel Deaconess Medical Center. Reports no financial relationships with commercial interests.
- Donna Rolin, PhD, APRN, University of Texas at Austin. Dr. Rolin has no financial relationships to disclose.
Accessibility for Participants with Disabilities
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Technical Requirements
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