Description
This course material was developed by SMI Adviser. Please be aware that some external resources and links referenced within this material may no longer be active or available.
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.
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
Estimated Time to Complete
Estimated Duration: 1.0 hours
Program Start Date: July 30, 2025
Program End Date: July 30, 2028
Ongoing Interdisciplinary Discussion Board
After completing the course, engage with colleagues in the mental health field through the 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™ or a certificate of participation may do so by viewing the live presentation and completing the evaluation. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) 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.
Faculty and Planner Disclosures
Instructors
- 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.
Accessibility for Participants with Disabilities
The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. Please contact the American Psychiatric Association at 202-559-3900, if you require assistance seven (7) business days prior to the start of a live webinar.
Technical Requirements
This internet-based CME activity is best experienced using any of the following:
- The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari
- Internet Explorer 11+
This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player.
Optimal System Configuration:
- Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version)
- Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version)
- Internet Connection: 1 Mbps or higher
Minimum Requirements:
- Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content
- Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content
For assistance: Contact educme@psych.org for questions about this activity | Contact support@smicaladviser.org for technical assistance