Longford Westmeath Mental Health Service, St Loman's Hospital, Mullingar, N91 N4XC, Ireland.
Cambridge/Peterborough Foundation Trust NHS, Cambridge, UK.
Ir J Med Sci. 2023 Oct;192(5):2323-2329. doi: 10.1007/s11845-023-03284-y. Epub 2023 Feb 6.
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 = 7.38, df:1, p = 0.007, CI:1.3-8.1, β = - .889, Wald x = 4.08, df:1, p = 0.043, CI: - 1.752 to - .026) respectively.
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.
患有严重精神疾病的人比一般人群表现出更高的慢性病发病率和死亡率。
本研究旨在根据最佳实践指南为慢性精神疾病患者设立专门的诊所，监测其身体健康和生活质量。
邀请患者参加诊所。检查以下方面：心血管疾病的个人和家族史、饮食、运动和吸烟情况。精神状态检查、腰围、血压、脉搏、心电图和 BMI。实验室检查包括 U + E、LFTs、HbA1c、血脂谱和其他适当的检查，如血清锂。AIMS 量表、HoNOS 和 WHOQOL-BREF 量表作为整体健康的额外指标。
在 3.5 年的诊所期间，共有 80 名患者就诊。首次接触时的平均年龄为 54.9 岁（标准差：13.81），女性占 45%。服务年限平均为 19.66 年（标准差：11.54），平均住院次数为 4.4 次（标准差：5.63）。首次评估时，代谢综合征的患病率为 42%。在第三次评估时，发现 WHOQOL-BREF 的心理领域和 HoNOs 有统计学意义上的显著改善。（β=4.64，Wald x=7.38，df:1，p=0.007，CI：1.3-8.1，β=-0.889，Wald x=4.08，df:1，p=0.043，CI：-1.752 至-0.026）。
结果表明，该队列中存在较高的身体健康状况，其中一些代表新的诊断。这意味着需要更好地分配现有资源进行筛查和早期发现，并有可能与初级保健联合开设联合诊所。
