Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-26T07:59:17.171Z Has data issue: false hasContentIssue false

High prevalence of risk factors for physical illness in a long-stay psychiatric unit

Published online by Cambridge University Press:  13 June 2014

Sinead O'Brien
Affiliation:
St Anne's Day Hospital, Roxboro Road, Limerick
Enda Devitt
Affiliation:
Western Area GP Training Scheme
Mohamed Ahmed
Affiliation:
St Brigid's Hospital, Ballinasloe, Co. Galway
Colm McDonald
Affiliation:
Department of Psychiatry, Clinical Science Institute, National University of Ireland, Galway, Ireland

Abstract

Objective: The aim of this study was to determine the prevalence of risk factors for physical illness in a long stay psychiatric unit, where all care (both psychiatric and physical) is provided by the psychiatric team.

Method: All patients in the long-stay ward had a full physical examination including calculation of BMI. All patients had blood sampling including FBC, U&E, LFTs, TFTs, lipid profile (total cholesterol, triglycerides, HDL and LDL), glucose, HbA1c, and prolactin. ATP111 criteria were used to determine the presence of the metabolic syndrome.

Results: We found the mean number of comorbid medical diagnosis was 2.7. The prevalence of metabolic syndrome was 40.7% (44.4% of females and 24.1% of males). The prevalence of obesity was 51%, and 51% also had a total cholesterols in excess of 5.0mmol/l. Prolactin was elevated in two-thirds of female patients.

Conclusion: We conclude that the annual physical examination is of limited value in long-stay psychiatric unit. The high prevalence of physical illness and physical risk factors warrants primary care involvement in screening and treatment of long-stay psychiatric patients.

Type
Brief Reports
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Barraclough, EC, Harris, B. Excess mortality of mental disorder. Br J Psychiatry 1998; 173: 1153.Google Scholar
2.Cormac, I, Martin, D, Ferriter, M. Improving the physical health of long-stay psychiatric patients. Adv Psychiatr Treat 2004; 10: 107–15.CrossRefGoogle Scholar
3.Brown, S, Barraclough, B, Inskip, H. Cause of the excess mortality in schizophrenia. Br J Psychiatry 2000; 177: 212–7.CrossRefGoogle ScholarPubMed
4.Newman, SC, Bland, RC. Mortality in a cohort of patients with schizophrenia: a record linkage study. Can. J Psychiatry 1991; 36: 239–45.Google Scholar
5.Dinan, TG. The physical consequences of depressive illness. BMJ 1999; 318: 826.CrossRefGoogle ScholarPubMed
6.Van Schrojenstein Lantman-De Valk, HMJ, Metsemakers, JFM, Haveman, JM. Health problems in people with intellectual disability in general practice: a comparative study. Fam Pract 2000; 17:405–7.CrossRefGoogle ScholarPubMed
7.Marder, SRet al.Physical health monitoring with schizophrenia. Am J Psychiatry 2004; 161: 1334–49.CrossRefGoogle ScholarPubMed
8.Jeste, DV, Gladsjo, J, Lindamar, LA, Lacro, JP. Medical comorbidity in schizophrenia. Schizophr Bull 1996;22: 413–20.CrossRefGoogle ScholarPubMed
9.Osby, U, Correia, N, Brandt, L, Ekbom, A, Sparen, P. Mortality and causes of death in schizophrenia in Stockholm county Sweden. Schizophr Res 2000; 45: 21–8.CrossRefGoogle ScholarPubMed
10.Rozanski, A, Blumenthal, JA, Kaplan, J. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation 1999; 99: 2192–217.CrossRefGoogle ScholarPubMed
11.Penninx, BWet al.Depression and cardiac mortality: results from a community based longitudinal study. Arch Gen Psychiatry 2001; 58: 221–7.CrossRefGoogle ScholarPubMed
12.McEvoy, JPet al.Prevalence of the metabolic syndrome in patients with schizophrenia: Baseline results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III. Schizophr Res 2005; 80: 1932.CrossRefGoogle ScholarPubMed
13.Alexander, CM, Landsman, PB, Teutsch, SM, Haffner, SM. Third National Health and Nutrition Examination Survey (NHANES); National Cholesterol Education Programme (NCEP). NCEP defined metabolic syndrome, diabetes, and prevalence of coronary heart disease among NHANES III participants age 50 years and older. Diabetes 2003; 52: 1210–4.CrossRefGoogle ScholarPubMed
14.Expert Panel on Detection and Evaluation and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 2001; 285: 2486–97.CrossRefGoogle Scholar
15.Villegas, R, Perry, IJ, Creagh, D, Hinchion, R, O'Halloran, D. Prevalence of the metabolic syndrome in middle-aged men and women. Diabetes Care 2003; 26: 3198–9.CrossRefGoogle ScholarPubMed
16.Mehta, SK, Holliday, C, Hayuk, L. Effect of regular exercise after third decade on doppler derived left ventricular filling. Am J Cardiol 2004; 94; 1595–7.CrossRefGoogle ScholarPubMed
17.Woods, SW. Chlorpromazine equivalent doses for the newer atypical antipsychotics. J Clin Psychiatry 2003; 64: 663–7.CrossRefGoogle ScholarPubMed
18.Basu, R, Chengappa, KN, John, V. The prevalence of the metabolic syndrome in patients with schizoaffective disorder-bipolar type. Bipolar Disord 2004; 6:314–8.CrossRefGoogle Scholar
19.Ford, ES, Giles, WH, Dietz, WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002; 287: 356–9.CrossRefGoogle ScholarPubMed
20.West, R, McNeill, A, Raw, M. Smoking cessation guidelines for health professionals: an update. Thorax 2000; 55: 987–9.CrossRefGoogle ScholarPubMed
21.Homel, P, Casey, D, Allison, D. Changes in body mass index for individuals with and without schizophrenia, 1987-1996. Schizophr Res 2002; 55: 277–84.CrossRefGoogle ScholarPubMed
22.Meaney, AM, Smith, S, Howes, OD, O'Brien, OD, Murray, RM, O'Keane, V. Br J Psychiatry 2004; 184: 503508.CrossRefGoogle Scholar
23.Ness, G. The limited value of the annual physical health examination in long-term secure care. Psychiatric Bull 2001; 25: 154–5.CrossRefGoogle Scholar