Holistic assessment of patients with chronic mental disorders who attend a metabolic clinic in Sligo Town catchment area.
Chronic mental illness
Metabolic
Physical health
Quality of life
Journal
Irish journal of medical science
ISSN: 1863-4362
Titre abrégé: Ir J Med Sci
Pays: Ireland
ID NLM: 7806864
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
received:
26
02
2022
accepted:
14
01
2023
medline:
28
9
2023
pubmed:
7
2
2023
entrez:
6
2
2023
Statut:
ppublish
Résumé
People with serious mental illness exhibit higher morbidity and mortality rates of chronic diseases than the general population. The aim of this study was to establish a dedicated clinic for patients with chronic mental illness to monitor physical health and quality of life in accordance with best practice guidelines. Patients were invited to attend the clinic. The following areas were examined: personal and family history of cardiovascular disease, diet, exercise, and 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. 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. A statistically significant improvement was found for the psychological domain of the WHOQOL-BREF and the HoNOs, particularly at third assessment. (β = 4.64, Wald x 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.
Sections du résumé
BACKGROUND
BACKGROUND
People with serious mental illness exhibit higher morbidity and mortality rates of chronic diseases than the general population.
AIMS
OBJECTIVE
The aim of this study was to establish a dedicated clinic for patients with chronic mental illness to monitor physical health and quality of life in accordance with best practice guidelines.
METHODS
METHODS
Patients were invited to attend the clinic. The following areas were examined: personal and family history of cardiovascular disease, diet, exercise, and 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
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. A statistically significant improvement was found for the psychological domain of the WHOQOL-BREF and the HoNOs, particularly at third assessment. (β = 4.64, Wald x
CONCLUSION
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.
Identifiants
pubmed: 36745285
doi: 10.1007/s11845-023-03284-y
pii: 10.1007/s11845-023-03284-y
pmc: PMC9901375
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2323-2329Informations de copyright
© 2023. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.
Références
De Hert M, Correll CU, Bobes J et al (2011) Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry 10(1):52
Cunningham C, Riano NS, Mangurian C (2018) Screening for metabolic syndrome in people with severe mental illness. J Clin Outcomes Manag 25(1)
Peña A, DeJongh B, Haas M et al (2018) Overcoming barriers to monitoring patients taking second-generation antipsychotics. Ment Health Clin 8(2):49–55
doi: 10.9740/mhc.2018.03.049
pubmed: 29955545
pmcid: 6007736
De Hert M, Mazereel V, Detraux J et al (2021) Prioritizing COVID-19 vaccination for people with severe mental illness. World Psychiatry 20(1):54
doi: 10.1002/wps.20826
pubmed: 33131217
Hennekens CH, Hennekens AR, Hollar D et al (2005) Schizophrenia and increased risks of cardiovascular disease. Am Heart J 150(6):1115–1121
doi: 10.1016/j.ahj.2005.02.007
pubmed: 16338246
Holt RIG, Abdelrahman T, Hirsch M et al (2010) The prevalence of undiagnosed metabolic abnormalities in people with serious mental illness. J Psychopharmacol 24(6):867–873
doi: 10.1177/0269881109102788
pubmed: 19304868
Mitchell AJ, Vancampfort D, Sweers K et al (2013) Prevalence of metabolic syndrome and metabolic abnormalities in schizophrenia and related disorders—a systematic review and meta-analysis. Schizophr Bull 39(2):306–318
doi: 10.1093/schbul/sbr148
pubmed: 22207632
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
Waln O, Jankovic J (2013) An update on tardive dyskinesia: from phenomenology to treatment. Tremor Other Hyperkinet Mov 3
Faurbye A, Rasch PJ, Petersen PB et al (1964) Neurological symptoms in pharmagotherapy of psychoses. Acta Psychiatr Scand 40(1):10–27
doi: 10.1111/j.1600-0447.1964.tb05731.x
pubmed: 14217630
Cornett EM, Novitch M, Kaye AD et al (2017) Medication-induced tardive dyskinesia: a review and update. Ochsner Journal 17(2):162–174
pubmed: 28638290
pmcid: 5472076
Carbon M, Hsieh CH, Kane JM et al (2017) Tardive dyskinesia prevalence in the period of second-generation antipsychotic use: a meta-analysis. J Clin Psychiatry 78(3):20738
doi: 10.4088/JCP.16r10832
McEvoy J, Gandhi SK, Rizio AA et al (2019) Effect of tardive dyskinesia on quality of life in patients with bipolar disorder, major depressive disorder, and schizophrenia. Qual Life Res 28(12):3303–3312
doi: 10.1007/s11136-019-02269-8
pubmed: 31435866
pmcid: 6863950
Usman M, Saleem F, McCafferty B et al (2022) Establishing a dedicated metabolic clinic for patients with chronic mental illness. Ir J Psychol Med 1–2. Advance online publication. https://doi.org/10.1017/ipm.2022.18
Gill M, McCauley M (2016) Establishing a physical health monitoring service for patients on depot antipsychotic medication. Eur Psychiatry 33(S1):S564–S564
doi: 10.1016/j.eurpsy.2016.01.2089
Bomboy KT, Graber JS, Wallis EP (2021) Improved prescriber adherence to guidelines on antipsychotic medication management through increased access to metabolic monitoring forms. J Am Psychiatr Nurses Assoc 27(2):162–168
doi: 10.1177/1078390320906196
pubmed: 32054390
Menzies V, Farrell SP (2002) Schizophrenia, tardive dyskinesia, and the abnormal involuntary movement scale (AIMS). J Am Psychiatr Nurses Assoc 8(2):51–56
doi: 10.1067/mpn.2002.124918
Wing JK, Beevor AS, Curtis RH et al (1998) Health of the Nation Outcome Scales (HoNOS): research and development. Br J Psychiatry 172(1):11–18
doi: 10.1192/bjp.172.1.11
pubmed: 9534825
Whoqol Group (1998) Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med 28(3):551–558
doi: 10.1017/S0033291798006667
Ali RA, Jalal Z, Paudyal V (2020) Barriers to monitoring and management of cardiovascular and metabolic health of patients prescribed antipsychotic drugs: a systematic review. BMC Psychiatry 20(1):1–15
doi: 10.1186/s12888-020-02990-6
Leucht S, Cipriani A, Spineli L et al (2013) Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. Lancet 382(9896):951–962
doi: 10.1016/S0140-6736(13)60733-3
pubmed: 23810019
de Bartolomeis A, Fagiolini A, Vaggi M et al (2016) Targets, attitudes, and goals of psychiatrists treating patients with schizophrenia: key outcome drivers, role of quality of life, and place of long-acting antipsychotics. Neuropsychiatr Dis Treat 12:99
pubmed: 26811682
pmcid: 4714729
Connell J, Brazier J, O’Cathain A et al (2012) Quality of life of people with mental health problems: a synthesis of qualitative research. Health Qual Life Outcomes 10(1):1–16
doi: 10.1186/1477-7525-10-138