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IMPROVING METABOLIC HEALTH IN MENTAL ILLNESS: A TRANSDIAGNOSTIC APPROACH

Mahavir Agarwal — Centre for Addiction and Mental Health, Canada

2026 ASCP Annual Meeting

Cardiometabolic comorbidities such as metabolic syndrome, type 2 diabetes, and cardiovascular disease are intrinsically 3-5 times more prevalent among patients with psychiatric illness compared to the general population. The etiology of metabolic disturbances in mental illness is multifactorial, arising from a complex interplay of intrinsic risk, lifestyle factors, reduced access to medical care, and iatrogenic causes such as psychotropic treatment side effects. Concerningly, modifiable cardiovascular risk factors are often under-screened and under-treated in the psychiatric context, further perpetuating the health disparity among these individuals. This symposium, co-chaired by Dr. Mahavir Agarwal (University of Toronto, Canada) and Dr. Benjamin Perry (University of Birmingham, United Kingdom), will present recent progress in the understanding, prediction, and management of metabolic dysfunction in various psychiatric disorders. The panel will emphasize the importance of adopting a transdiagnostic perspective for effective prevention and early intervention. Dr. Katharine Liang (University of Washington, USA) will examine risk factors that influence the strength and direction of the relationship between posttraumatic stress disorder and diabetes severity in trauma-exposed Black women with type 2 diabetes. She will focus on potential mediators such as age, smoking, glycemic control, body mass index, and medication use. The findings suggest that PTSD and diabetes may exacerbate each other, creating a cycle of worsening health, and that treating only one condition may be insufficient to reduce long-term risk. Dr. Benjamin Perry will present on the Psychosis Metabolic Risk Calculator (PsyMetRiC), a novel clinic-ready cardiometabolic prediction model for young people with psychosis spectrum disorders. This presentation will outline recent updates to the models, highlight improvements in predictive accuracy, and describe how PsyMetRiC can be used to identify individuals at highest risk for early cardiometabolic disease. Dr. Perry will discuss how integrating these tools into routine care may support individualized monitoring and targeted preventive strategies. Finally, Dr. Nicolette Stogios (Centre for Addiction and Mental Health (CAMH), Canada) will present data from a psychiatrist-led mental health and metabolism clinic aimed at improving the metabolic health of individuals treated with psychotropic medications. This study is the first to evaluate the impact of structured metabolic monitoring and targeted interventions on psychotropic-induced weight gain in individuals with intellectual and developmental disabilities (IDD). This work takes an important step to meet the needs of a vulnerable group often ignored in metabolic dysfunction prevention and management. Dr. Rebecca Hendrickson (University of Washington, USA) will serve as the discussant to review the implications of early identification and treatment of cardiometabolic risk in individuals with mental illness, as well as insights for future directions that can help propel the field forward. Collectively, this symposium will provide attendees with an updated understanding of metabolic risk across psychiatric populations and will identify actionable strategies to improve long-term physical health outcomes for individuals living with mental illness or treated with psychotropic medications. The symposium unites researchers from Canada, the United States, and the United Kingdom, including women scientists (Drs. Liang, Stogios, and Hendrickson), early career investigators (Drs. Liang and Stogios), and clinicians (Drs. Liang, Perry, Agarwal, and Hendrickson).

Learning Objective 1: Identify key factors that contribute to elevated cardiometabolic risk across psychiatric populations and describe how emerging prediction tools, including PsyMetRiC, can support individualized risk stratification and early intervention.

Learning Objective 2: Learn practical strategies to monitor and manage metabolic side effects of psychotropic medications, including in high-risk groups such as people with posttraumatic stress disorder or intellectual and/or developmental disabilities.

References

  1. Stogios N, PrasannaKumar A, Mehra K, Hahn MK, Agarwal SM. Risk Factors and Management Strategies for Antipsychotic-Induced Weight Gain: A Prescriptive Review for Clinicians. Focus. 2025;23(4).
  2. Perry BI, Osimo EF, Upthegrove R, Mallikarjun PK, et al. Development and external validation of the Psychosis Metabolic Risk Calculator (PsyMetRiC): a cardiometabolic risk prediction algorithm for young people with psychosis. Lancet Psychiatry. 2021 Jul;8(7):589598.