Specialist Clinic Dedicated to Chronic Mental Illness and Metabolic Monitoring

Abstract

Introduction

People with serious mental illness exhibit higher morbidity and mortality rates of chronic disease than the general population. A significant proportion of premature deaths has been related to modifiable cardiovascular risk factors and may be related to medications taken for mental illness.

Objectives

Establish a clinic for a cohort of patients with chronic mental illness dedicated to monitoring physical health focusing on modifiable risk factors.

Methods

Patients with chronic mental illness taking psychotropic medications long term were invited to attend clinic.

The following areas were examined: History focusing on current mental state, cardiovascular history assessing diet, exercise, personal and family history of cardiovascular disease, Exam including waist circumference, BP, pulse, ECG and calculation of BMI. Laboratory tests including HbA1c, Lipid profile, and other tests as appropriate such as serum lithium. Examination for tardive dyskinesia (Abnormal Involuntary Movement Scale (AIMS)), outcomes, (Health of the Nation outcome scale (HoNos)) and quality of life (WHOQOL-Bref) were performed also performed as additional indicators of global health.

Results

Sample consisting of 47 patients. Mean age 56.1 (SD: 13.6) males 27 (60%). Mean years of illness 23.1(SD:12.2). Mean HoNos 2.7 (SD 2.5). Four cases prolonged QTc, 5 HbA1c > 6% (2 no prior record of elevation); 18 abnormal lipid profiles, (12 no prior record of elevation); 4 blood pressure readings ≥ 140/90, 3 no prior diagnosis of hypertension; 18 BMI > 25.

Conclusions

This is a newly established clinic. Preliminary results have highlighted modifiable risk factors some of which may represent new diagnoses. Close liaison with General Practice is of importance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.