Description
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 19, 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
Outline
- High Cardiometabolic Risk in Severe Mental Illness (SMI)
- Impact of Antipsychotic Medications
- Disparities in Monitoring and Treatment
- Recommendations and Future Directions
Target Audience
Psychiatrist, Physician (Non-psychiatrist), Physician Assistant, Nurse/Nurse Practitioner, Pharmacist, Peer Specialist
Instructional Level
Advanced
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
After completing the evaluation, participants will have the opportunity to claim their hours of participation and download the appropriate certificate. Physicians may obtain an official CME certificate, other healthcare professionals may receive a CE certificate (as applicable), and all other attendees may generate a certificate of participation. Each certificate will reflect the event date and total hours earned.
Continuing Education Credit
In support of improving patient care, American Psychiatric Association (APA) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physicians
The APA designates this live event for a maximum of 1.00 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 Association (APA) designates this activity for 1.00 Nursing contact hours. Nurses should only claim credit commensurate with the extent of their participation in the activity.
Faculty and Planner Disclosures
The American Psychiatric Association adheres to the ACCME's Standards for Integrity and Independence in Accredited 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.
Faculty
- 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.
Program 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
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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+
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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)
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