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Psychosis Metabolic Risk Calculator

Understand early.Act together.Live healthier.

We built PsyMetRiC, a regulated clinical prediction tool, to estimate the risk of clinically significant weight gain, metabolic syndrome and type 2 diabetes in people aged 16 to 35 with psychosis. PsyMetRiC was co-produced with people with lived experience of psychosis, carers and health professionals. PsyMetRiC has been validated using data from over 25,000 people with early psychosis in the UK, and has been separately validated in 9 countries across four continents.

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MHRA Class I Medical Device For people with early psychosis aged 16 to 35 years Uses routine clinical data Suitable for secondary mental health services and primary care

Why it matters

Physical health is often sidelined when prevention matters most

Psychosis occurs most often in early adulthood, and signs of cardiometabolic risk can appear from its onset. Yet physical healthcare in this group is too often reactive, waiting for physical health problems to emerge before offering treatment. PsyMetRiC changes that, giving patients and health professionals a shared understanding of risk and enabling collaborative decision-making around prevention.

15 years

shorter life expectancy on average for people with severe mental illness, largely from preventable physical health problems, including obesity, diabetes and heart disease

Firth et al., 2019
£2bn+

a year in NHS healthcare costs for people with severe mental illness in England

Ride et al., 2019
3 in 10

people on the SMI register did not receive all six physical health checks in 2023/24

NHS England, 2024

How it works

From routine data to a plan agreed together

We designed PsyMetRiC to fit into the care young people already receive in early intervention in psychosis services.

A health professional measuring blood pressure
1

Enter routine information

Most teams already record these details. A partial model works without blood results.

AgeSexEthnicityBMIBlood pressureSmokingAntipsychoticAntidepressantFamily history of cardiometabolic disorders HDL cholesterolTriglyceridesHbA1c

Dashed items are used by the full model only.

A young woman and a health professional looking at a tablet together
2

See a personal physical health risk estimate

Physical health risk across three time horizons that young people and health professionals said matter most.

A young woman and a health professional talking, seated side by side
3

Agree prevention together

Clear visuals help the young person and health professional understand the physical health risk and agree the next step, such as health behaviour support, a medication review or closer monitoring.

Prevention in everyday life

Understand early. Act together. Live healthier.

A person checking heart rate on a smartwatch
Understand earlySee physical health risk before problems emerge, using information teams already record.
A clipboard surrounded by hand weights, an exercise band and apples
Act togetherAgree a prevention plan that fits everyday life, from activity to nutrition and medication review.
A young woman resting on a running track with a water bottle
Live healthierSmall, realistic steps that young people choose for themselves, with support from their team.
PsyMetRiC screen: how physical health risk changes over time for a mock case, 18% at 10 years and 52% at 20 years, with the likely range shaded
Real PsyMetRiC screen. Mock case used in clinical teaching, not a real person.

Shared understanding of physical health risk

Physical health risk you can understand together

Most clinical prediction tools stop at a number. We co-produced PsyMetRiC with young people, carers and health professionals so that both sides of the conversation understand the result. This focus on shared understanding has rarely been done before, and we believe it gives young people more say in their own care.

Uncertaintya likely range, not false precision
Change over timehow physical health risk may rise in the years ahead
What drives itthe factors pushing the risk score higher, and pulling it lower
A similar individualcompare physical health risk with someone of a similar background but different physical health risk factors
Metabolic agean easy way into the conversation

See it in the tool

How a young person sees their physical health risk, and how it compares with others

A short walk-through of the real PsyMetRiC screens for one mock case: the diabetes risk score, its uncertainty, how it changes over time, a crowd of 1,000 people with a similar profile, what drives the score, and a comparison with a similar person.

Screens from the PsyMetRiC tool, June 2026 version. Mock case used in clinical teaching; not a real person and not medical advice.

Who it is for

One tool, four conversations

Mental health teams and GPs

Protect physical health from the first consultation, without adding to your workload

  • Early: see metabolic risk before physical health problems emerge
  • Long term: agree a collaborative prevention plan that prioritises physical as well as mental health
  • Light touch: inputs can be pre-filled from the electronic health record
Try the toolBook a team demo
25,850

people in the development and validation data, with separate validation in 9 countries across four continents.

Named in the Lester resource (NICE endorsed), alongside RCPsych, BAP and INTEGRATE guidance.

Evidence and trust

Built for this group, tested beyond it

A researcher working at a computer
25,850young people in the development and validation data, from primary and secondary care records in England
9 countries across 4 continentsPsyMetRiC is extensively tested around the world
A trusted medical devicePsyMetRiC is a regulated medical device with the MHRA
16 to 35designed for the age group where general tools are least accurate
The Lester Positive Cardiometabolic Health ResourcePsyMetRiC forms part of the NHS England co-produced Lester Positive Cardiometabolic Health Resource
In useapproved for use in Birmingham and Solihull Mental Health NHS Foundation Trust

Built for the years when psychosis often begins

We built PsyMetRiC for individuals aged 16 to 35, the age range when psychosis tends to emerge in most people. Three in four people with schizophrenia first show symptoms by age 35.

Age at first symptoms of schizophrenia, from a meta-analysis of 192 studies (Solmi et al., 2022).

Publications

2026Transition into a clinically available tool Cardiometabolic prediction models for young people with psychosis spectrum disorders in the UK (PsyMetRiC 2.0): a retrospective, multicohort clinical prediction model study Perry, B.I. et al. The Lancet Psychiatry, 13(4), pp. 291 to 303. 2026Lived experience contribution Lived experience perspectives on the development of a Psychosis Metabolic Risk Calculator (PsyMetRiC) The Lancet Psychiatry. Written with the PsyMetRiC Lived Experience Advisory Panel (LEAP). 2022International validation example Validation of PsyMetRiC in young people with psychosis, with site-specific recalibration in two European cohorts Perry, B.I. et al. The Lancet Regional Health Europe, 22, 100493. 2021Early beginnings Development and external validation of the Psychosis Metabolic Risk Calculator (PsyMetRiC) Perry, B.I. et al. The Lancet Psychiatry, 8(7), pp. 589 to 598.

Latest

Event
Live demo for early intervention teamsA 45-minute walk-through of the tool with a worked case.
 News
LiveWell clinic coming soonPreventive lifestyle support for young people in early intervention in psychosis services.
 Research
PsyMetRiC 2.0 published in The Lancet PsychiatryUpdated models for cardiometabolic outcomes in young people with psychosis.
All events and news

Our partners

Working together for physical health in early psychosis

University of Birmingham

We are the PsyMetRiC Operating Division, part of University of Birmingham Enterprise.

Oxford Health NHS Foundation TrustNHS deployment partner
Birmingham and Solihull Mental Health NHS Foundation TrustClinical use and LiveWell
b13.aiTechnology partner
McPin FoundationLived experience research
Centre for Mental HealthPolicy and research