Theme: Comorbidity

Project Description

People with severe mental illness (SMI) die 15–20 years earlier than the general population, and cardiometabolic disease is a major cause. This is usually blamed on psychiatric medication, lifestyle and poorer access to physical healthcare after illness begins. Yet emerging evidence shows that metabolic problems, such as insulin resistance, may already be present before psychosis develops. If so, physical and mental health may start to diverge much earlier than we think, and there is a window to act.

This project asks when metabolic dysfunction emerges in young people in contact with mental health services, and whether it comes before psychosis and other SMI. Using large-scale electronic health records from people aged 12–25, the fellow will map metabolic health over time, test whether early abnormalities signal later illness, and identify who could benefit most from earlier assessment and care. The goal is not only to predict risk, but to show how routinely recorded information could support targeted prevention. The work will take account of medication exposure, gaps in testing and access to care, and inequalities across ethnic and socioeconomic groups. A mixed-methods approach, co-produced with young people, families and clinicians, will ensure findings are meaningful and usable in practice.

The project suits healthcare professionals from any background, including psychiatry, general practice, nursing, pharmacy, dietetics and other allied health professions, with an interest in the physical health of people with mental illness. No prior experience of large datasets is needed.

The fellow will be supervised across the Universities of Oxford and Birmingham, joining leading groups in psychiatry, primary care and metabolic health, with links to NHS and industry data partners. They will gain skills in epidemiology, longitudinal analysis, mixed methods and research communication, and build networks that support future clinical academic fellowships and research leadership.