People with chronic schizophrenia die on average 10-15 years sooner than the general population, mostly due to physical comorbidity. While sociodemographic, chronic lifestyle and iatrogenic factors are important contributors to this comorbidity, a growing body of research is beginning to suggest that early signs of cardiometabolic dysfunction may be present from the onset of psychosis in some young adults, and may even be detectable before the onset of psychosis. Given that primary prevention is the best means to prevent the onset of more chronic and severe cardiometabolic phenotypes such as CVD, there is clear need to be able to identify young adults with psychosis who are most at risk of future adverse cardiometabolic outcomes, such that the most intensive interventions can be directed in an informed way to attenuate the risk or even prevent those adverse outcomes from occurring.In this talk, Ben will first outline some recent advances in our understanding of the association between cardiometabolic and schizophrenia spectrum disorders. He will then introduce the field of cardiometabolic risk prediction, and highlight how existing tools developed for older general population adults are unlikely to be suitable for young people with psychosis. Finally, he will discuss the current state of play and the future of the Psychosis Metabolic Risk Calculator (PsyMetRiC), a novel clinically useful cardiometabolic risk prediction algorithm tailored for young people with psychosis, which has been developed and externally validated using data from three psychosis early intervention services in the UK.