Socioeconomic Deprivation and Blood Lipid Levels in First-episode Psychosis: Implications for Cardiovascular Risk

Poster A6, Monday, October 8, 11:30 am - 1:00 pm, Essex Ballroom

Franz Veru1,2,3, Rho Aldanie2,3, Joober Ridha1,2,3, Malla Ashok1,2,3, Iyer Srividya1,2,3; 1McGill University, 2Prevention and Early Intervention Program for Psychosis PEPP-Montreal, 3Douglas Mental Health University Institute

Patients with psychosis-spectrum disorders (PSD) have increased rates of cardiovascular disease, which significantly contribute to their excessive rates of morbimortality. Moreover, a widening mortality gap between PSD patients and the rest of the population suggests that current pharmacological therapies –such as statins– have been ineffective. Recent conflicting meta-analytical evidence shows that first-episode psychosis (FEP) patients have lower blood lipid levels when compared to age-matched unaffected controls, implying lower cardiovascular risk. Other determinants of health might explain such high rates of cardiovascular disease. Since socioeconomic deprivation significantly predicts higher odds for cardiovascular disease and PSD, we sought to determine the influence of social and material deprivation on blood lipid levels in a FEP cohort. We tested the effects of neighborhood-level social and material deprivation (census data) on blood lipids, while controlling for age, sex, levels of physical anergia and exposure to medication in a hierarchical regression model. Social, but not material deprivation, predicted significantly lower levels of total cholesterol (low risk) but low HDL as well (high risk). While counterintuitive at first, similar results have been observed in animal models of psychological stress and lipid metabolism. These models suggest that stress functionally impairs the HDL-dependent reverse transport of cholesterol and hepatic clearance, which is independent of total cholesterol levels, thus promoting atherosclerosis by a different mechanism. The high levels of psychosocial stress observed in FEP patients could potentially explain why conventional cholesterol-lowering therapies have failed to have an impact on their cardiovascular morbimortality. Different preventive interventions might be needed.

Topic Area: Comorbid Conditions

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