A new online tool that can predict the likelihood of young people with psychosis developing serious physical health conditions, such as obesity, diabetes and heart disease, is now available to healthcare professionals. according to a study published in The Lancet Psychiatry.
The tool, called PsyMetRiC, was developed by researchers at the University of Birmingham and is one of the first in psychiatry to receive official certification for use in real-world clinical settings in the UK.
The need for such a tool is urgent. On average, people with severe mental illness die 15 years younger than the rest of the population, largely because they are at much higher risk of developing physical health conditions that are preventable. Yet the standard tools that GPs use to assess these risks (for example, to decide who might need medication to protect their heart) were not designed with younger people or those with psychosis in mind, and don’t work accurately for this group.
Dr Benjamin Perry, Associate Clinical Professor of Psychiatry at the University of Birmingham, who led the development of PsyMetRiC, said: “Psychotic disorders are typically diagnosed when people are in their late teens and early twenties, and the impact on lifestyles can be profound. People with psychosis may be less able to eat healthy food, or exercise, and may be more likely to smoke. Additionally, antipsychotic medicines could have side effects making patients feel hungrier, or more sedate, contributing to weight gain. People with psychosis may also experience healthcare and other inequalities, preventing them from receiving the same standard of physical healthcare as the rest of the population.”
“Consequently, factors that predispose people to obesity, diabetes and heart disease, are detectable from the onset of psychosis, many years earlier than would be typical for the rest of the population.”
PsyMetRiC works by using basic information that is routinely recorded during clinical appointments to calculate a patient’s risk of significant weight gain within one year, metabolic syndrome (a combination of high blood pressure, weight gain, high cholesterol and high blood sugar) within six years, and type 2 diabetes within ten years. The algorithms behind it were built and tested using anonymised health data from more than 25,000 young people with psychosis in the UK, tracked over more than 20 years.
Crucially, the tool was shaped not just by clinicians but also by patients with lived experience of psychosis, to make sure the information it provides is meaningful and easy to understand. Dr Perry said: “The original PsyMetRiC study predicted metabolic syndrome. We received feedback that many clinicians aren’t aware of what that means, let alone patients. If PsyMetRiC is to change behaviour – both health professional and patient – then the outcomes need to be meaningful to both groups.”
The team also worked hard to ensure the tool would work fairly across different communities, including those from under-served backgrounds. As Dr Perry explained: “We were inspired by the work of the STANDING Together collaboration, led by Birmingham researchers including Dr Joseph Alderman and Professor Alastair Denniston, who highlighted such an important issue. If inequalities in society get baked into health datasets, then tools developed using those datasets may inherit those biases, potentially making things worse.”
The result is a web application that presents risk information in clear visual formats, helping to open up conversations between doctors and patients about what steps can be taken to reduce those risks.
Dr Perry said: “Input from the lived experience panel was critical to designing risk communication guides that are accessible and motivating for patients, showing how each risk factor contributes to an overall risk score, how this overall risk changes over time, and how interventions can reduce the overall risk.”
The ultimate goal is straightforward. Dr Perry said: “We are hoping to increase vigilance about the physical health risks for young people with psychosis, and expand the conversation between doctors and patients, so these risks are mitigated and premature mortality is reduced by earlier intervention and preventative measures.”
PsyMetRiC has already been tested in several countries including Spain, Switzerland, Finland, Canada, Australia and Hong Kong, with plans to extend to the United States. Healthcare professionals in the UK can sign up for a free account at the PsyMetRiC website.
Perry B, Osimo E, Si S et al. Cardiometabolic prediction models for young people with psychosis spectrum disorders in the UK (PsyMetRiC 2.0): a retrospective, multicohort clinical prediction model study. The Lancet Psychiatry, 2026; 13, 291-303