Kendrick T
Division of General Practice and Primary Care, St george's Hospital Medical School, London.
Br J Psychiatry. 1996 Dec;169(6):733-9. doi: 10.1192/bjp.169.6.733.
In the past, psychiatric in-patients suffered increased cardiovascular and respiratory mortality. The present study investigated whether increased risks persist among patients in the community and are being addressed in general practice.
A survey of 101 long-term mentally ill adults in 16 general practices in the South Thames (West) Region.
Twenty-six patients were found to be obese (body mass index > 30 kg/m2), 53 were current smokers and 11 were hypertensive (mean systolic blood pressure > 160 mmHg or mean diastolic blood pressure > 100 mmHg, or both). Twenty-one reported daily cough and sputum, 24 shortness of breath, 11 wheezing and seven chest pain on exertion. These rates were significantly higher than population rates in a contemporary national survey. Nearly all the risk factors were recorded in the general practice records but few attempts to intervene were apparent.
Long-term mentally ill patients remain at increased risk of cardiovascular and respiratory problems in the community. Primary care teams should make special efforts to tackle risk factors among this group.
过去,精神科住院患者的心血管和呼吸系统死亡率有所上升。本研究调查了社区患者中增加的风险是否仍然存在,以及全科医疗是否正在解决这些问题。
对南泰晤士(西部)地区16家全科诊所的101名长期患有精神疾病的成年人进行了一项调查。
发现26名患者肥胖(体重指数>30kg/m²),53名患者目前吸烟,11名患者患有高血压(平均收缩压>160mmHg或平均舒张压>100mmHg,或两者兼有)。21名患者报告每天咳嗽和咳痰,24名患者呼吸急促,11名患者喘息,7名患者运动时胸痛。这些比率明显高于当代全国调查中的人群比率。几乎所有风险因素都记录在全科医疗记录中,但几乎没有明显的干预措施。
长期患有精神疾病的患者在社区中患心血管和呼吸系统问题的风险仍然增加。基层医疗团队应特别努力解决该群体中的风险因素。