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长期精神科住院部患者的心脏代谢危险因素、身体活动与精神状态

Cardiometabolic risk factors, physical activity and psychiatric status in patients in long-term psychiatric inpatient departments.

作者信息

Ringen Petter Andreas, Faerden Ann, Antonsen Bjørnar, Falk Ragnhild S, Mamen Asgeir, Rognli Eline B, Solberg Dag K, Andreassen Ole A, Martinsen Egil W

机构信息

a Division of Mental Health and Addiction , Oslo University Hospital , Oslo , Norway.

b NORMENT, KG Jebsen Centre, Oslo University Hospital , Oslo , Norway.

出版信息

Nord J Psychiatry. 2018 May;72(4):296-302. doi: 10.1080/08039488.2018.1449012. Epub 2018 Mar 9.

Abstract

PURPOSE

Cardiovascular diseases are a major cause for the markedly reduced life expectancy in people with severe mental illness (SMI). Hospital departments should provide adequate prevention of cardiometabolic risk by optimizing prevention and treatment. Characteristics of cardiometabolic risk factors in inpatients are still not well known. We aimed to describe the status of cardiometabolic risk factors in inpatients with SMI and identify associations with psychiatric status and treatment.

METHODS

A cross sectional descriptive study of inpatients with SMI from long term psychosis treatment wards in South Eastern Norway was performed. Comprehensive assessments of cardiometabolic risk factors, physical activity, lifestyle habits, symptoms, life satisfaction and treatment were made. Associations and potential prognostic factors were analyzed using linear and logistic regressions.

RESULTS

A total of 83 patients were included in the study, but many individual datasets were incomplete. Over half of the subjects had unhealthy eating habits. Obesity (class 1-3) was found in 44%, 23% had elevated fasting triglycerides, 26% had elevated blood pressure and 78% smoked daily. Low levels of physical activity were significantly associated with higher levels of depression (p = .007). A nominal increase in cardiometabolic risk factors was found for olanzapine and clozapine users.

CONCLUSION

Inpatients in long term psychosis treatment wards have alarmingly high cardiometabolic risk. Level of physical activity was associated with both psychiatric and somatic health. Focus on lifestyle and somatic health should be an integral part of the treatment for hospitalized SMI patients.

摘要

目的

心血管疾病是导致重症精神疾病(SMI)患者预期寿命显著缩短的主要原因。医院科室应通过优化预防和治疗措施,充分预防心脏代谢风险。住院患者心脏代谢危险因素的特征仍未完全明确。我们旨在描述SMI住院患者心脏代谢危险因素的状况,并确定其与精神状态和治疗的关联。

方法

对挪威东南部长期精神病治疗病房的SMI住院患者进行了横断面描述性研究。对心脏代谢危险因素、身体活动、生活习惯、症状、生活满意度和治疗进行了全面评估。使用线性和逻辑回归分析关联和潜在的预后因素。

结果

共有83名患者纳入研究,但许多个体数据集不完整。超过一半的受试者有不健康的饮食习惯。44%的人存在肥胖(1-3级),23%的人空腹甘油三酯升高,26%的人血压升高,78%的人每天吸烟。低水平的身体活动与较高水平的抑郁显著相关(p = 0.007)。使用奥氮平和氯氮平的患者心脏代谢危险因素有明显增加。

结论

长期精神病治疗病房的住院患者心脏代谢风险高得惊人。身体活动水平与精神和躯体健康均相关。关注生活方式和躯体健康应成为住院SMI患者治疗的一个组成部分。

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