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First-episode Psychosis, Physical Health Comorbidities, Metabolic Health, Cardiovascular Health, Respiratory Health, Cancer
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Zierotin A, Murphy J, O'Donoghue B et al. The short-, medium-, and long-term prevalence of physical health comorbidities in first-episode psychosis: a systematic review and meta-analysis protocol [version 2; peer review: 3 approved]. HRB Open Res 2025, 6:75 (https://doi.org/10.12688/hrbopenres.13810.2)
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Study Protocol
Revised
The short-, medium-, and long-term prevalence of physical health comorbidities in first-episode psychosis: a systematic review and meta-analysis protocol
[version 2; peer review: 3 approved]
PUBLISHED 08 Jan 2025
OPEN PEER REVIEW
REVIEWER STATUS
Abstract
Corresponding author:
Anna Zierotin
Competing interests:
No competing interests were disclosed.
Grant information:
Health Research Board [CDA 2021-005, Psychosis Ireland Structured Training Program].
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Copyright:
© 2025 Zierotin A et al.
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
How to cite: Zierotin A, Murphy J, O'Donoghue B et al. The short-, medium-, and long-term prevalence of physical health comorbidities in first-episode psychosis: a systematic review and meta-analysis protocol [version 2; peer review: 3 approved]. HRB Open Res 2025, 6:75 (https://doi.org/10.12688/hrbopenres.13810.2)
First published: 07 Dec 2023, 6:75 (https://doi.org/10.12688/hrbopenres.13810.1)
Latest published: 08 Jan 2025, 6:75 (https://doi.org/10.12688/hrbopenres.13810.2)
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Revised Amendments from Version 1
In this updated protocol, we now explicitly acknowledge that some individuals with first-episode psychosis (FEP) may have pre-existing physical long-term conditions (LTCs). We have clarified that our primary focus remains on short-, medium-, and long-term prevalence of physical LTCs post-FEP, but we will record whether these comorbidities developed prior to or following FEP diagnosis. We refined the eligibility criteria by removing the blanket exclusion of organic psychotic disorders and personality disorders, allowing for a broader representation of real-world clinical populations. We also clarified that non-FEP studies will be excluded unless data specific to FEP participants are provided.
Additionally, we revised the title to highlight the intended meta-analysis. The abstract now briefly mentions potential limitations (e.g., diagnostic heterogeneity). We established a cut-off of fewer than 10 participants to define case series, specified procedures for handling missing or unresponsive data, and introduced a supplementary table (PICOS) detailing inclusion and exclusion criteria. We will collect chlorpromazine-equivalent dosages where available, and we have also expanded our planned subgroup analyses to include social deprivation and parental mental health. We now provide more detail on patient and public involvement (PPI), specifying how an expert-by-experience co-author contributed to the protocol design. Finally, we explained how diagnostic criteria (ICD-10 vs. ICD-11) will be managed and revised the Discussion to address limitations regarding sampling, diagnostic inconsistencies, and potential overrepresentation of studies from high-income countries. Minor edits were made throughout for consistent terminology, abbreviation use, and clarity.
See the authors' detailed response to the review by Luigi Francesco Saccaro
See the authors' detailed response to the review by A Dregan
Introduction
Individuals with psychosis face an increased risk of various physical health conditions, including cardiovascular diseases, respiratory disorders, metabolic disorders, and cancer (De Hert et al., 2011; Leucht et al., 2007). The increased incidence of physical comorbidities, especially cardiovascular diseases, contributes to a significant burden of physical illness and premature mortality, with individuals with psychosis experiencing a reduced life expectancy of approximately 10–20 years compared to the general population (Firth et al., 2019). A higher prevalence of lifestyle risk factors such as smoking, poor nutrition, and disrupted sleep patterns in people with psychosis contribute to these health risks (Firth et al., 2019). Additionally, shared risk factors, including non-white ethnicity and social deprivation, contribute to distinct multimorbidity patterns in psychosis (Lawrence & Kisely, 2010; Rodrigues et al., 2021). Recent research has also reported the genetic risk for schizophrenia to be associated with cardiac structural changes that can worsen cardiac outcomes (Pillinger et al., 2023). This connection further emphasises the complex interplay between genetic and lifestyle factors in shaping the health outcomes of those with psychosis.
Metabolic syndrome, encompassing dyslipidaemia, hypertension, impaired glucose regulation, and central obesity, is prevalent in up to 69% of those with chronic schizophrenia (Vancampfort et al., 2015). Although antipsychotic use may contribute to these metabolic changes, altered glucose homeostasis is already observed in antipsychotic-naïve individuals with first-episode psychosis (FEP), suggesting that metabolic disturbances emerge from the onset of psychosis (Pillinger et al., 2017a; Pillinger et al., 2017b).
Research has indicated that two-thirds of individuals with FEP will experience metabolic changes, such as impaired glucose and lipid metabolism, as well as weight gain exceeding 7% during the initial 12 months of treatment (Alvarez-Jiménez et al., 2008; Coentre et al., 2022). These metabolic changes lead to a greater risk of cardiovascular disease, stroke, and type 2 diabetes later in life, which underlines the importance of early intervention and the need for attention to physical health changes from the initial diagnosis of psychosis. Moreover, individuals with schizophrenia face a higher risk of respiratory conditions such as chronic obstructive pulmonary disease (COPD) and pneumonia (Suetani et al., 2021), which might be linked to increased active and passive smoke exposure (Hunter et al., 2020; Lally et al., 2019), childhood exposure to air pollution (Antonsen et al., 2020; Schraufnagel et al., 2019) and socioeconomic factors (Rocha et al., 2020; Sariaslan et al., 2016).
Research on the incidence of cancer in people with psychosis has been mixed, with earlier studies concluding a generally lower cancer incidence in this population (Ananth & Burnstein, 1977) and more recent reviews finding an increased risk of certain cancer types but a decrease for others (Wootten et al., 2022; Xu et al., 2017; Zhuo & Triplett, 2018). The inconsistencies between earlier and more recent studies may partially reflect the evolving practices in diagnosing and reporting cancer among those with psychosis, emphasising the importance of updating previous findings with more contemporary health data.
Despite several systematic reviews establishing the increased prevalence of physical health disorders in individuals with psychosis (Leucht et al., 2007; Oud & Meyboom-de Jong, 2009; Suetani et al., 2021; Vancampfort et al., 2013), these reviews often report pooled prevalence data from individuals with chronic psychosis and FEP, or only report FEP baseline outcomes, limiting our understanding of the evolution of physical health outcomes in FEP. Therefore, by focusing specifically on FEP cohorts, this review aims to understand the progression of physical health comorbidities from the onset to the later stages of psychosis. It also considers that certain comorbid conditions may have been present prior to FEP diagnosis and can be exacerbated by FEP or subsequent antipsychotic treatment.
Given the limited number of longitudinal FEP cohort studies reporting physical health outcomes (Suetani et al., 2021; Vancampfort et al., 2013; Wootten et al., 2022), this review will also synthesise evidence from antipsychotic intervention studies. Antipsychotic intervention studies often conduct baseline and follow-up physical health monitoring, providing data on health outcomes, particularly metabolic health. Given that antipsychotic medication commonly constitutes first-line treatment in FEP, including these studies will allow us to capture more data about the development of physical health outcomes. While we acknowledge that clinical trials may not generalise to the broader FEP population due to specific inclusion and exclusion criteria, we aim to analyse outcomes separately and then provide a comprehensive pooled analysis.
Review questions
The primary objective of this review is to systematically examine the existing evidence relating to the short-, medium- and long-term period prevalence of cardiovascular, metabolic, cancer and respiratory comorbidities in individuals with FEP.
1. What is the short-, medium- and long-term period prevalence of cardiovascular, metabolic, cancer and respiratory comorbidities in individuals with FEP?
2. To what extent do antipsychotic medications moderate or mediate the association between FEP and these physical comorbidities?
3. Does the prevalence of cardiovascular, metabolic, cancer and respiratory comorbidities vary with certain demographic factors such as age, sex, or ethnicity among individuals with FEP?
Methods
Study registration
The study was registered in PROSPERO, the International Prospective Register of Systematic Reviews (CRD42023431072; 17/06/2023). This protocol follows the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols; Moher et al., 2015; Zierotin et al., 2023) guidelines. The review will be conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 2020 statement (Page et al., 2021) and the Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines (Stroup et al., 2000).
Eligibility criteria
This review will include research reporting on the relationship between FEP and cardiovascular, metabolic, cancer and respiratory health outcomes. Since some participants may have pre-existing comorbidities prior to FEP, the data extraction will consider whether these conditions emerged prior to or following FEP diagnosis. Two study types will be included: 1) observational longitudinal studies investigating physical health outcomes in a FEP cohort and 2) antipsychotic intervention studies reporting the incidence of physical health outcomes in antipsychotic-naïve individuals with FEP, with no more than 28 days of antipsychotic exposure. Studies that primarily focus on non-FEP populations, such as those with severe anxiety or mood disorders will be excluded. If mixed samples (for example, severe mental illness groups) are used, we will attempt to extract the data specific to people with psychosis. If data extraction is not possible, we will contact the authors twice within a one-month period to request the data for individuals with psychosis. If multiple reports of the same study are identified, the most complete report will be included.
We will exclude single case studies and case series, specifically defining studies with fewer than 10 participants as case series. We will also exclude studies that did not measure physical health outcomes or only measured physical health at baseline. There will be no restrictions regarding language or publication period. There will be no restrictions regarding language or publication period. Studies will be selected for inclusion in the systematic review according to the following population and outcome criteria. For an overview of the eligibility criteria see Table 1 (PICOS-based inclusion and exclusion criteria).
Table 1. This table lists the search terms, and Boolean operators used to identify studies on psychotic disorders and their associations with cardiovascular, metabolic, respiratory and cancer outcomes.
The keywords are grouped by database (Medline, PsycINFO, EMBASE, CINAHL+) to illustrate the tailored search strategies used for each database.
Population
The population includes individuals with a first-episode diagnosis of psychosis, either clinician-diagnosed, confirmed through medical records, or enrolled in a clinical program dedicated to psychosis (for example, Early Intervention in Psychosis). First-episode psychosis is defined as first treatment contact (inpatient or outpatient) regardless of the duration of untreated illness. There are no restrictions regarding the age of participants. For studies to be eligible for inclusion, individuals with FEP should have no more than 28 days of antipsychotic drug exposure at the minimal effective dose, as recommended by the Maudsley clinical guidelines (Owen et al., 2014). If a study includes a subset with longer exposure, we will not automatically exclude it but will document the proportion and, if feasible, conduct sensitivity analyses to examine any impact on overall findings.
Outcomes
The primary outcome is the prevalence or incidence of metabolic, cardiovascular, cancer or respiratory outcomes in individuals with FEP. Physical health outcomes must be confirmed by a clinician, enrolment in a clinical program dedicated to the physical illness, medical records, or primarily according to International Classification of Diseases (ICD)-10 criteria. However, for interpretation consistency and considering recent updates, any ambiguities in outcomes will be assessed against the ICD-11 criteria. Eligible studies must report the prevalence/incidence of these health outcomes at a specified follow-up time point post the initial psychosis diagnosis, meaning the studies should specify the duration from the first diagnosis of psychosis to the time when these physical health outcomes were reported. There are no restrictions regarding the study time frame. In the context of this review, the terms “short-”, “medium-” and “long-term prevalence” refer to the occurrence of cardiovascular, metabolic, cancer, and respiratory comorbidities in individuals diagnosed with FEP over specific time intervals post-diagnosis. Specifically, “short-term prevalence” assesses these comorbidities from >0–12 months following an FEP diagnosis, “medium-term prevalence” spans from 13–36 months post-diagnosis, and “long-term prevalence” encompasses both 37–60 months post-diagnosis and periods exceeding 5 years. The secondary outcome of interest concerns the impact of demographic and study variables, such as age, sex, ethnicity and study year, as well as antipsychotic medication on the prevalence of cardiovascular, metabolic, cancer and respiratory comorbidities.
Information sources
The following databases will be searched from inception for publications: Medline, Embase, PsycInfo, and CINAHL+. Grey literature, including ClinicalTrials gov.uk, OpenGrey, WHO International Clinical Trials Registry Platform, Current Controlled Trials, United States National Institute of Health Trials Registry, and the Irish Health Repository, will be searched. The searches will be re-run prior to the final analysis.
Search strategy
The literature search strategy will use Medical Subject Headings (MeSH) and text words related to first-episode psychosis, metabolic, cardiovascular, cancer and respiratory outcomes. The search terms for the physical disorders are adapted from previous publications on similar topics (Leucht et al., 2007; Onyeka et al., 2019). The search strategy was produced with the help of a librarian and follows the below structure:
First-episode psychosis terms AND metabolic outcomes OR cardiovascular outcomes OR cancer terms OR respiratory outcomes
The full search strategy can be found in Table 1.
Study selection
Studies will be deduplicated in Endnote and uploaded to Rayyan for screening. Two reviewers will independently undertake the screening process in two rounds: the first round will involve title and abstract screening, and the second round will focus on full-text screening. A third reviewer will resolve any discrepancies between the reviewers at each stage. We will check for overlapping cohorts by examining recruitment site, time frame, and researcher groups. If multiple publications arise from the same study population, we will include the most comprehensive data set.
Data extraction
Two reviewers will extract data independently according to a pre-piloted Microsoft Excel form. Discrepancies will be identified and resolved through discussion (with a third reviewer where necessary). Where study data is not reported (e.g., conference abstracts), authors will be contacted up to two times within a one-month period to request relevant data. If authors remain unresponsive, we will either proceed with analyses excluding the missing data or, if the absence critically impairs the study’s utility, exclude that study from meta-analyses and note it in sensitivity analyses. We will also collect data on average chlorpromazine equivalents or another standardized antipsychotic dosage measure when reported, to facilitate cross-study comparisons.
The extracted information will include authors, title, publication year, country, study design, data collection timeframe, setting, recruitment, inclusion/exclusion criteria, the number of participants, age, sex, ethnicity, psychosis diagnosis type, method of diagnosing, medication status, year of follow-up, method of diagnosing physical outcomes, prevalence/incidence estimates at baseline and at >0–12 months, or 13–36 months, or 37–60 months, or after more than 5 years after a FEP diagnosis, percentage smoking, comorbid mental disorders/substance abuse disorders, social deprivation measures, parental mental health history, covariates adjusted for, control group/comparator data, funding sources/conflicts of interest, and additional information. In the case of missing data, study investigators will be contacted for unreported data or additional details. Selected articles will be stored and managed using EndNote X9 Reference Manager Library.
Risk of bias in individual studies
Two reviewers will independently assess the risk of bias in included studies using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Studies Reporting Prevalence Data (Munn et al., 2015). Disagreements between reviewers will be resolved by discussion with a third reviewer. This tool will help assess study quality based on criteria such as sample representativeness, reliability of outcome measurement, and appropriateness of statistical analysis. The results of this appraisal will inform sensitivity analyses, where we may exclude high-risk studies to assess their impact on pooled estimates.
Strategy of data synthesis
A narrative synthesis will be used to synthesise and summarise the findings and to explore relationships in the data. If two or more studies are available, a random-effects meta-analysis of prevalence with 95% confidence and prediction intervals will be calculated for studies investigating outcomes within the same disease category (metabolic, cardiovascular, cancer or respiratory outcomes) at >0–12 months, at 13–36 months, at 37–60 months, and after more than 5 years after a FEP diagnosis (e.g., one meta-analysis on FEP cohort studies at 13–36 month follow up reporting the prevalence of respiratory outcomes). We will also conduct meta-analyses on the prevalence of specific physical health outcomes that are reported on in two or more studies at 0–12 months, at 13–36 months, at 37–60 months, and after more than 5 years.
Heterogeneity between prevalence estimates will be assessed using the I2 statistic, Tau-squared, and prediction intervals. We will also generate Forest plots for the prevalence estimates and their 95% CI of the individual studies and pooled estimates. Forest plots will be examined visually, looking for potential outliers. We will conduct sensitivity analyses based on study quality and exclude studies at high risk of bias. Publication bias will be assessed with a funnel plot and the Begg and Egger tests.
Analysis of subgroups
Sensitivity analyses will be conducted for associations supported by previous literature or convincing evidence. The following factors will be considered: study design, study year, studies that adjusted for age/sex, studies that adjusted for smoking at baseline, studies that adjusted for BMI or obesity at baseline, studies that adjusted for physical activity levels at baseline; studies that adjusted for the presence of co-occurring mental disorders at baseline; studies that adjusted for exposure to childhood maltreatment at baseline; studies that adjusted for use of psychotropic medications/substances; studies sponsored by a pharmaceutical company, and studies that adjusted for general medical burden at baseline. We will also include additional variables such as social deprivation status and parental mental health history if reported.
A meta-regression analysis of moderators of interest will be conducted if there are more than 10 studies available on one specific illness (e.g., Metabolic syndrome) at one of the pre-specified time periods:
(a) Mean age
(b) Ethnicity
(c) Sex
(d) % smokers
(e) % taking antipsychotic medication
(f) % alcohol or substance use disorder
(g) Study year
(h) Social deprivation status
(i) Parental mental health history
Public and patient involvement and dissemination plans
One of the co-authors has lived experience of FEP and serves as an expert by experience, having actively contributed to formulating the protocol and shaping the research question. They will also be involved in interpreting the findings and co-creating dissemination materials. The completed review will be submitted to a leading journal in this field. Drawing from the insights of the review, we plan to create a recovery education module, informed by both the study findings and PPI feedback, to further support and inform patient groups. To make our findings accessible and comprehensible to a broader audience, a lay summary will be added to the review and disseminated to interested patient groups, with the continuous involvement of PPI to ensure its clarity and relevance.
Study status
The systematic review is currently at the stage of data extraction. Database searching and screening have been completed.
Discussion
Individuals with FEP experience significant health disparities, demonstrated by increased rates of premature mortality and a variety of physical comorbidities (Firth et al., 2019). This systematic review seeks to consolidate the existing knowledge on the prevalence of physical health comorbidities among this group.
An important focus of our review is the health trajectory from FEP onset to subsequent stages. Past reviews often group FEP with chronic psychosis, potentially masking the trajectory of physical health comorbidities (Leucht et al., 2007; Oud & Meyboom-de Jong, 2009). Our review dissects the prevalence of cardiovascular, metabolic, cancer, and respiratory comorbidities across varying post-diagnosis durations to provide a detailed health outlook for this cohort. We also consider pre-existing conditions physical health conditions, thus highlighting potential bi-directionality between FEP and physical multimorbidities. A key component of our review evaluates the influence of demographic variables on prevalence rates. Understanding these demographic nuances can aid in public service planning and preparedness, ensuring communities are better equipped to address these challenges. By only including studies with antipsychotic-naïve individuals with FEP, we aim to achieve a better appreciation of the baseline physical health changes after entering mental health services.
We also anticipate certain limitations in our review. The reported prevalence rates may not accurately represent the true prevalence of specific physical health disorders among individuals with FEP. Prior research has indicated that conditions like cancer tend to be diagnosed at more advanced stages compared to the general population (Wootten et al., 2022). Additionally, diagnostic overshadowing could further lead to underreporting physical health issues (Molloy et al., 2023; Shefer et al., 2014). We acknowledge that excluding personality disorders may limit the generalizability of our findings to individuals on the broader psychosis spectrum. Additionally, diagnostic differences (e.g., ICD-10 vs. ICD-11) and variation in how outcomes are measured may introduce heterogeneity in prevalence estimates, which we aim to address via subgroup or sensitivity analyses. We also note that many included studies are likely to be conducted in high-income countries, which can reduce the representativeness of the results in low- and middle-income contexts. Despite these potential limitations, the findings of this review will provide insights that can inform clinical practice and early intervention strategies
The findings can inform targeted interventions and timely management of metabolic, cardiovascular, respiratory, and oncologic risks, as well as highlight the need for embedding structured physical health assessments and integrated care strategies into early intervention services for FEP, informing. Future longitudinal research should evaluate the effectiveness of these approaches while examining genetic, lifestyle, and socioeconomic mechanisms underlying disparities in physical health outcomes.
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Zierotin A, Murphy J, O'Donoghue B et al. The short-, medium-, and long-term prevalence of physical health comorbidities in first-episode psychosis: a systematic review and meta-analysis protocol [version 2; peer review: 3 approved]. HRB Open Res 2025, 6:75 (https://doi.org/10.12688/hrbopenres.13810.2)
NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article.
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ApprovedThe paper is scientifically sound in its current form and only minor, if any, improvements are suggested
Approved with reservations
A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
Not approvedFundamental flaws in the paper seriously undermine the findings and conclusions
Version 2
VERSION 2
PUBLISHED 08 Jan 2025
Revised
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How to cite this report:
Dregan A. Reviewer Report For: The short-, medium-, and long-term prevalence of physical health comorbidities in first-episode psychosis: a systematic review and meta-analysis protocol [version 2; peer review: 3 approved]. HRB Open Res 2025, 6:75 (https://doi.org/10.21956/hrbopenres.15441.r44661)
The direct URL for this report is:
https://hrbopenresearch.org/articles/6-75/v2#referee-response-44661
https://hrbopenresearch.org/articles/6-75/v2#referee-response-44661
NOTE: it is important to ensure the information in square brackets after the title is included in this citation.
Reviewer Report 23 Jan 2025
A Dregan,
King's College London, London, England, UK
Approved
VIEWS 1
I am satisfied with the authors responses to my earlier concerns
... Continue reading
CITE
HOW TO CITE THIS REPORT
Dregan A. Reviewer Report For: The short-, medium-, and long-term prevalence of physical health comorbidities in first-episode psychosis: a systematic review and meta-analysis protocol [version 2; peer review: 3 approved]. HRB Open Res 2025, 6:75 (https://doi.org/10.21956/hrbopenres.15441.r44661)
The direct URL for this report is:
https://hrbopenresearch.org/articles/6-75/v2#referee-response-44661
https://hrbopenresearch.org/articles/6-75/v2#referee-response-44661
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
Views
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How to cite this report:
Waterreus A. Reviewer Report For: The short-, medium-, and long-term prevalence of physical health comorbidities in first-episode psychosis: a systematic review and meta-analysis protocol [version 2; peer review: 3 approved]. HRB Open Res 2025, 6:75 (https://doi.org/10.21956/hrbopenres.15441.r44805)
The direct URL for this report is:
https://hrbopenresearch.org/articles/6-75/v2#referee-response-44805
https://hrbopenresearch.org/articles/6-75/v2#referee-response-44805
NOTE: it is important to ensure the information in square brackets after the title is included in this citation.
Reviewer Report 23 Jan 2025
Approved
VIEWS 1
Thank you for asking me to review this revised study protocol for a systematic review and meta-analysis investigating the prevalence of physical health co-morbities over time in people in their first episode of psychosis.
This document clearly outlines the ... Continue reading
This document clearly outlines the ... Continue reading
CITE
HOW TO CITE THIS REPORT
Waterreus A. Reviewer Report For: The short-, medium-, and long-term prevalence of physical health comorbidities in first-episode psychosis: a systematic review and meta-analysis protocol [version 2; peer review: 3 approved]. HRB Open Res 2025, 6:75 (https://doi.org/10.21956/hrbopenres.15441.r44805)
The direct URL for this report is:
https://hrbopenresearch.org/articles/6-75/v2#referee-response-44805
https://hrbopenresearch.org/articles/6-75/v2#referee-response-44805
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
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Saccaro LF. Reviewer Report For: The short-, medium-, and long-term prevalence of physical health comorbidities in first-episode psychosis: a systematic review and meta-analysis protocol [version 2; peer review: 3 approved]. HRB Open Res 2025, 6:75 (https://doi.org/10.21956/hrbopenres.15441.r44660)
The direct URL for this report is:
https://hrbopenresearch.org/articles/6-75/v2#referee-response-44660
https://hrbopenresearch.org/articles/6-75/v2#referee-response-44660
NOTE: it is important to ensure the information in square brackets after the title is included in this citation.
Reviewer Report 10 Jan 2025
Approved
VIEWS 2
The authors have addressed all comments appropriately, and I look
... Continue reading
CITE
HOW TO CITE THIS REPORT
Saccaro LF. Reviewer Report For: The short-, medium-, and long-term prevalence of physical health comorbidities in first-episode psychosis: a systematic review and meta-analysis protocol [version 2; peer review: 3 approved]. HRB Open Res 2025, 6:75 (https://doi.org/10.21956/hrbopenres.15441.r44660)
The direct URL for this report is:
https://hrbopenresearch.org/articles/6-75/v2#referee-response-44660
https://hrbopenresearch.org/articles/6-75/v2#referee-response-44660
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
Version 1
VERSION 1
PUBLISHED 07 Dec 2023
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How to cite this report:
Saccaro LF. Reviewer Report For: The short-, medium-, and long-term prevalence of physical health comorbidities in first-episode psychosis: a systematic review and meta-analysis protocol [version 2; peer review: 3 approved]. HRB Open Res 2025, 6:75 (https://doi.org/10.21956/hrbopenres.15114.r43606)
The direct URL for this report is:
https://hrbopenresearch.org/articles/6-75/v1#referee-response-43606
https://hrbopenresearch.org/articles/6-75/v1#referee-response-43606
NOTE: it is important to ensure the information in square brackets after the title is included in this citation.
Reviewer Report 10 Dec 2024
Approved with Reservations
VIEWS 14
GENERAL COMMENTS
This well-designed, preregistered protocol clearly outlines a systematic review and meta-analysis investigating the short-, medium-, and long-term prevalence of metabolic, cardiovascular, respiratory, and oncologic comorbidities in antipsychotic-naïve or minimally exposed individuals with FEP, aiming to ... Continue reading
This well-designed, preregistered protocol clearly outlines a systematic review and meta-analysis investigating the short-, medium-, and long-term prevalence of metabolic, cardiovascular, respiratory, and oncologic comorbidities in antipsychotic-naïve or minimally exposed individuals with FEP, aiming to ... Continue reading
CITE
HOW TO CITE THIS REPORT
Saccaro LF. Reviewer Report For: The short-, medium-, and long-term prevalence of physical health comorbidities in first-episode psychosis: a systematic review and meta-analysis protocol [version 2; peer review: 3 approved]. HRB Open Res 2025, 6:75 (https://doi.org/10.21956/hrbopenres.15114.r43606)
The direct URL for this report is:
https://hrbopenresearch.org/articles/6-75/v1#referee-response-43606
https://hrbopenresearch.org/articles/6-75/v1#referee-response-43606
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
-
Author Response 08 Jan 2025Anna Zierotin, Department of Psychiatry, University College Dublin, Dublin, Ireland08 Jan 2025Author Response1. TITLE
The title is appropriate, but I suggest including a reference to the potential meta-analysis.
We thank the Reviewer for their comment. We have revised the manuscript title:
... Continue reading
COMMENTS ON THIS REPORT
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Author Response 08 Jan 2025Anna Zierotin, Department of Psychiatry, University College Dublin, Dublin, Ireland08 Jan 2025Author Response1. TITLE
The title is appropriate, but I suggest including a reference to the potential meta-analysis.
We thank the Reviewer for their comment. We have revised the manuscript title:
... Continue reading
Views
14
How to cite this report:
Dregan A. Reviewer Report For: The short-, medium-, and long-term prevalence of physical health comorbidities in first-episode psychosis: a systematic review and meta-analysis protocol [version 2; peer review: 3 approved]. HRB Open Res 2025, 6:75 (https://doi.org/10.21956/hrbopenres.15114.r38110)
The direct URL for this report is:
https://hrbopenresearch.org/articles/6-75/v1#referee-response-38110
https://hrbopenresearch.org/articles/6-75/v1#referee-response-38110
NOTE: it is important to ensure the information in square brackets after the title is included in this citation.
Reviewer Report 14 Mar 2024
A Dregan,
King's College London, London, England, UK
Approved with Reservations
VIEWS 14
The work represents the protocol of a proposed study to synthesize current evidence on the link between FEP and antipsychotic drugs with a restricted number of major physical long-term conditions.The questions are well detailed and clear, and the search strategy
... Continue reading
CITE
HOW TO CITE THIS REPORT
Dregan A. Reviewer Report For: The short-, medium-, and long-term prevalence of physical health comorbidities in first-episode psychosis: a systematic review and meta-analysis protocol [version 2; peer review: 3 approved]. HRB Open Res 2025, 6:75 (https://doi.org/10.21956/hrbopenres.15114.r38110)
The direct URL for this report is:
https://hrbopenresearch.org/articles/6-75/v1#referee-response-38110
https://hrbopenresearch.org/articles/6-75/v1#referee-response-38110
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
-
Author Response 08 Jan 2025Anna Zierotin, Department of Psychiatry, University College Dublin, Dublin, Ireland08 Jan 2025Author ResponseThe work represents the protocol of a proposed study to synthesize current evidence on the link between FEP and antipsychotic drugs with a restricted number of major physical long-term conditions. ... Continue reading
COMMENTS ON THIS REPORT
-
Author Response 08 Jan 2025Anna Zierotin, Department of Psychiatry, University College Dublin, Dublin, Ireland08 Jan 2025Author ResponseThe work represents the protocol of a proposed study to synthesize current evidence on the link between FEP and antipsychotic drugs with a restricted number of major physical long-term conditions. ... Continue reading
Alongside their report, reviewers assign a status to the article:
Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested
Approved with reservations -
A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions
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