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Screen to Intervene; establishing a dedicated metabolic clinic for patients with chronic mental illness in an Irish Metal Health Service

Published online by Cambridge University Press:  01 September 2022

M. Usman ,
F. Saleem ,
B. Mccafferty ,
J.H.P. Tan ,
M. Zubir  and
D. Adamis
M. Usman*
Affiliation:
St James’s Hospital Dublin, Liaison Psychiatry For Elderly, Dublin, Ireland
F. Saleem
Affiliation:
Mayo University Hospital, Psychiatry, Castlebar, Ireland
B. Mccafferty
Affiliation:
Bayview Family Practice, Bundoran, Donegal., General Practice, Bundoran, Ireland
J.H.P. Tan
Affiliation:
Maudsley Hospital, Psychiatry, South London & Maudsley Nhs Foundation Trust, London, United Kingdom
M. Zubir
Affiliation:
The Rotunda Hospital, Specialist Perinatal Mental Health Service, Dublin, Ireland
D. Adamis
Affiliation:
Sligo Leitrim Mental Health Services, St. Columba’s Hospital,, Psychiatry, Sligo, Ireland
*
*Corresponding author.

Abstract

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Introduction

People with serious mental illness exhibit higher morbidity and mortality rates of chronic diseases than the general population.

Objectives

The aim of this study was to establish a dedicated clinic for patients with chronic mental illness to monitor physical health in accordance with best practice guidelines.

Methods

Patients were invited to attend the metabolic clinic. The following areas were examined: Personal and family history of cardiovascular disease, diet, exercise, smoking. Mental state examination, waist circumference, BP, pulse, ECG and BMI. Laboratory tests including U+E, LFTs, HbA1c, Lipid profile and other tests as appropriate such as serum lithium. AIMS scale, HoNOS and WHOQOL-BREF scales as additional indicators of global health.

Results

A total of 80 patients attended during 3.5 years of clinic. Mean age was 54.9 years (SD:13.81) at first contact and 45% were females. Mean years in the service was 19.66 (SD:11.54) and mean number of previous hospital admissions was 4.4 (SD:5.63). Metabolic syndrome was present in 42% at first assessment and 20% had at least one new physical abnormality identified during the clinic. A statistically significant difference was found for the psychological domain of the WHOQOL-BREF and the HoNOs particularly at third assessment. (β=4.64, Wald x2=7.38, df:1, p=0.007, CI:1.3-8.1, β=-.889, Wald x2=4.08, df:1, p=0.043, CI: -1.752 to-.026) respectively.

Conclusions

The results show a high prevalence of physical health conditions in this cohort, some of which represent a new diagnosis. This implicates better allocation of existing resources for screening and early detection, and potential to run joint clinics with primary care.

Disclosure

No significant relationships.

Keywords

Metabolicchronic mental illnessphysical health
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S198 - S199
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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