The prevalence of undiagnosed metabolic abnormalities in people with serious mental illness
The prevalence of undiagnosed metabolic abnormalities in people with serious mental illness
The prevalence of metabolic syndrome is increased 2–3-fold in people with serious mental illness (SMI). Monitoring of physical health in these individuals is poor, despite clear guidance from the National Institute of Health and Clinical Excellence. The aim of this study was to assess the proportion of people with SMI who had been screened for metabolic abnormalities within the previous year and in a further study to assess the prevalence of undiagnosed metabolic abnormalities in people who had not been screened. The notes and computer records of 100 patients with SMI from community and in-patient settings were evaluated. In a subsequent study, the prevalence of metabolic syndrome was assessed in 71 previously unscreened patients. The study was carried out at the psychiatric in-patient and out-patient units in Southampton and Winchester. The frequency of screening and prevalence of the metabolic syndrome as defined by the International Diabetes Federation (IDF) were assessed. There was documented evidence that the following cardiovascular risk factors had been measured in the previous year: blood pressure (32%), glucose (16%), lipids (9%) and weight (2%). In the metabolic abnormalities study, 41 of 71 (58%) patients were found to fulfil the IDF criteria for the metabolic syndrome. Two had previously undiagnosed diabetes. Twelve percent of patients had a greater than 20% risk of a cardiovascular event within the next 10 years. Despite clear guidance and a high prevalence of undiagnosed metabolic syndrome, screening rates for metabolic abnormalities in people with SMI remain low. Improved screening of metabolic complications should lead to better identification and treatment of this clinical problem.
bipolar illness, diabetes, insulin resistance, metabolic syndrome, schizophrenia, screening
Holt, R.I.G.
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Abdelrahman, T.
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Hirsch, M.
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Dhesi, Z.
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George, T.
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Blincoe, T.
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Peveler, R.C.
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Holt, R.I.G.
d54202e1-fcf6-4a17-a320-9f32d7024393
Abdelrahman, T.
51f0068d-62aa-4397-bc24-523be01d84fc
Hirsch, M.
c2099166-8726-47f2-9fed-631278642cd8
Dhesi, Z.
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George, T.
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Blincoe, T.
ab23cd16-a41a-4ca3-8b7a-689181a4a0cc
Peveler, R.C.
93198224-78d9-4c1f-9c07-fdecfa69cf96
Holt, R.I.G., Abdelrahman, T., Hirsch, M., Dhesi, Z., George, T., Blincoe, T. and Peveler, R.C.
(2009)
The prevalence of undiagnosed metabolic abnormalities in people with serious mental illness.
Journal of Psychopharmacology.
(doi:10.1177/0269881109102788).
(In Press)
Abstract
The prevalence of metabolic syndrome is increased 2–3-fold in people with serious mental illness (SMI). Monitoring of physical health in these individuals is poor, despite clear guidance from the National Institute of Health and Clinical Excellence. The aim of this study was to assess the proportion of people with SMI who had been screened for metabolic abnormalities within the previous year and in a further study to assess the prevalence of undiagnosed metabolic abnormalities in people who had not been screened. The notes and computer records of 100 patients with SMI from community and in-patient settings were evaluated. In a subsequent study, the prevalence of metabolic syndrome was assessed in 71 previously unscreened patients. The study was carried out at the psychiatric in-patient and out-patient units in Southampton and Winchester. The frequency of screening and prevalence of the metabolic syndrome as defined by the International Diabetes Federation (IDF) were assessed. There was documented evidence that the following cardiovascular risk factors had been measured in the previous year: blood pressure (32%), glucose (16%), lipids (9%) and weight (2%). In the metabolic abnormalities study, 41 of 71 (58%) patients were found to fulfil the IDF criteria for the metabolic syndrome. Two had previously undiagnosed diabetes. Twelve percent of patients had a greater than 20% risk of a cardiovascular event within the next 10 years. Despite clear guidance and a high prevalence of undiagnosed metabolic syndrome, screening rates for metabolic abnormalities in people with SMI remain low. Improved screening of metabolic complications should lead to better identification and treatment of this clinical problem.
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Accepted/In Press date: 2009
Keywords:
bipolar illness, diabetes, insulin resistance, metabolic syndrome, schizophrenia, screening
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Local EPrints ID: 148365
URI: http://eprints.soton.ac.uk/id/eprint/148365
ISSN: 0269-8811
PURE UUID: 407cfa31-4c2f-4f61-83b6-357891ba77de
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Date deposited: 28 Apr 2010 08:54
Last modified: 14 Mar 2024 02:45
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Author:
T. Abdelrahman
Author:
M. Hirsch
Author:
Z. Dhesi
Author:
T. George
Author:
T. Blincoe
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