Department of Health Sciences, University of York, UK.
Department of Psychology, University of Crete, Greece.
Br J Psychiatry. 2023 Apr;222(4):160-166. doi: 10.1192/bjp.2022.143.
People with severe mental ill health (SMI) experience some of the largest health inequalities of any sector within society. For these inequalities to be reduced, an understanding of the behavioural determinants of health in this population is needed.
Utilising data from the Closing the Gap Health Study, we aimed to assess the extent to which people with SMI report health-risk factors and behaviours, their interest in modifying them, and the factors associated with being motivated to modify these behaviours.
Adult (≥18 years old) participants were recruited via primary and secondary care in the English National Health Service. To be eligible, participants needed to have a documented diagnosis of schizophrenia, psychotic disorders or bipolar disorder. Data were collected by survey on demographics, general physical health, diet, physical activity, alcohol, smoking and body mass index.
Between April 2016 and March 2020, = 9914 participants were recruited. Among people with SMI, high rates of obesity (37.5%), infrequent physical activity (62.0%), not meeting current guidelines (≥5) for the consumption of fruit and vegetables (85.0%) and smoking (42.2%) were observed. However, most participants were motivated to reduce health-risk behaviours. Perceiving the importance of health-promoting behaviours, being of poorer general health and being female were significantly associated with being motivated to modify health-risk behaviours.
Despite experiencing poor physical and mental health outcomes compared with the general population, and contrary to popular misconceptions, people with SMI perceive health as important and are motivated to make behavioural changes to improve health.
患有严重精神疾病的人（SMI）在社会的任何部门中都经历着最大的健康不平等。为了减少这些不平等，需要了解该人群中健康行为的决定因素。
利用Closing the Gap Health Study 的数据，我们旨在评估患有 SMI 的人报告健康风险因素和行为的程度，他们对改变这些行为的兴趣，以及与改变这些行为的动机相关的因素。
通过英格兰国民保健制度的初级和二级保健，招募成年（≥18 岁）参与者。参与者需要有记录在案的精神分裂症、精神病性障碍或双相情感障碍的诊断才能符合条件。通过调查收集人口统计学、一般身体健康、饮食、身体活动、酒精、吸烟和体重指数的数据。
2016 年 4 月至 2020 年 3 月期间，共招募了 9914 名参与者。在患有 SMI 的人中，肥胖（37.5%）、不经常进行身体活动（62.0%）、不遵守当前水果和蔬菜（85.0%）和吸烟（42.2%）的消费指南的比例很高。然而，大多数参与者都有减少健康风险行为的动机。感知健康促进行为的重要性、总体健康状况较差和女性是与改变健康风险行为的动机显著相关的因素。
尽管与一般人群相比，患有 SMI 的人经历了较差的身心健康结果，而且与普遍的误解相反，他们认为健康很重要，并愿意做出行为改变以改善健康。
