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Watanabe Y, Otake M, Ono S, Ootake M, Murakami K, Kumagai K, Matsuzawa K, Kasahara H, Hori K, Someya T. Decreased oral function in Japanese inpatients with schizophrenia. Neuropsychopharmacol Rep 2024; 44:356-360. [PMID: 38602056 PMCID: PMC11144619 DOI: 10.1002/npr2.12443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 04/12/2024] Open
Abstract
AIM Oral function in patients with schizophrenia has not been well-characterized. To address this, we performed a cross-sectional study of oral function in Japanese inpatients with schizophrenia. METHODS We measured oral function, including occlusal force, tongue-lip motor function, tongue pressure, and masticatory function in 130 Japanese inpatients with schizophrenia. We then compared the frequency of clinical signs of oral hypofunction among 63 non-elderly and 67 elderly inpatients with schizophrenia, as well as data from 98 elderly control participants from a previous Japanese study. RESULTS The frequency of reduced occlusal force was significantly higher in the elderly inpatients (76.2%) than in the non-elderly inpatients (43.9%) and elderly controls (43.9%). The frequency of decreased tongue-lip motor function in non-elderly inpatients (96.8%) and elderly inpatients (97.0%) was significantly higher than that in elderly controls (56.1%). The frequency of decreased tongue pressure in non-elderly inpatients (66.1%) and elderly inpatients (80.7%) was significantly higher than that in elderly controls (43.9%). Finally, the frequency of decreased masticatory function was highest in elderly inpatients (76.5%), followed by non-elderly inpatients (54.8%) and elderly controls (15.3%). CONCLUSION Oral function was decreased in both non-elderly and elderly Japanese inpatients with schizophrenia compared with elderly controls.
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Affiliation(s)
- Yuichiro Watanabe
- Department of PsychiatryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Masataka Otake
- Department of PsychiatryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Shin Ono
- Department of PsychiatryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Masaya Ootake
- Department of PsychiatryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Kazuhiro Murakami
- Division of Comprehensive Prosthodontics, Faculty of Dentistry and Graduate School of Medical and Dental SciencesNiigata UniversityNiigataJapan
| | - Koichiro Kumagai
- Department of PsychiatryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Koji Matsuzawa
- Department of PsychiatryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Hiroyuki Kasahara
- Department of PsychiatryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Kazuhiro Hori
- Division of Comprehensive Prosthodontics, Faculty of Dentistry and Graduate School of Medical and Dental SciencesNiigata UniversityNiigataJapan
| | - Toshiyuki Someya
- Department of PsychiatryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
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Kang J, Palmier-Claus J, Wu J, Shiers D, Larvin H, Doran T, Aggarwal VR. Periodontal disease in people with a history of psychosis: Results from the UK biobank population-based study. Community Dent Oral Epidemiol 2023; 51:985-996. [PMID: 36258297 DOI: 10.1111/cdoe.12798] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/04/2022] [Accepted: 09/29/2022] [Indexed: 03/09/2023]
Abstract
OBJECTIVES To test the hypotheses that: (1) Prevalence of periodontal disease would be higher in people with a history of psychosis when compared to the general population and (2) Demographic, life-style related factors and co-morbid medical conditions would predict periodontal disease in people experiencing psychosis. METHODS The authors performed cross-sectional analysis of baseline data from the UK Biobank study (2007-2010), identifying cases with psychosis using clinical diagnosis, antipsychotic medication, and self-report. Demographic (age, gender, ethnicity, socioeconomic status), lifestyle-related(BMI, blood pressure, smoking and alcohol intake, physical activity) and physical co-morbidities (cancer, cardiovascular, respiratory, inflammatory disease and metabolic conditions) were included as potential risk factors for periodontal disease among people with a history of psychosis using logistic regression analyses. The analysis sample included 502,505 participants. RESULTS Risk of periodontal disease was higher in people with psychosis, regardless of how cases were identified. Patients with a clinical diagnosis had the highest proportion of periodontal disease compared to the general population (21.3% vs. 14.8%, prevalence ratio 1.40, 95% CI: 1.26-1.56). Older and female cases were more likely to experience periodontal disease. Lifestyle factors (smoking) and comorbidities (cardiovascular, cancer or respiratory disease) were associated with periodontal disease among people with a history of psychosis. CONCLUSIONS The findings suggest that periodontal disease is more common in people with a history of psychosis, compared to the general population. Prevention and early diagnosis of periodontal disease should be a priority for oral health promotion programmes, which should also address modifiable risk factors like smoking which also contribute to co-morbid systemic disease.
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Affiliation(s)
- Jing Kang
- School of Dentistry, University of Leeds, Leeds, UK
| | - Jasper Palmier-Claus
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, UK
- Lancashire & South Cumbria NHS Foundation Trust, Preston, UK
| | - Jianhua Wu
- School of Dentistry, University of Leeds, Leeds, UK
| | - David Shiers
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
- Psychosis Research Unit, Greater Manchester Mental Health NHS Trust, Manchester, UK
- School of Medicine, Keele University, Keele, UK
| | | | - Tim Doran
- Health Services & Policy, University of York, York, UK
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Hilton C, Morris A, Burnside G, Harris R, Aggarwal VR, Procter S, Griffiths R, French P, Laverty L, Lobban F, Berry K, Shiers D, Golby R, Fazekas F, Valemis K, Perry A, Newens C, Kerry E, Mupinga P, Gkioni E, Lodge C, Dawber A, Elliott E, Lunat F, Palmier-Claus J. A two-arm, randomised feasibility trial using link workers to improve dental visiting in people with severe mental illness: a protocol paper. Pilot Feasibility Stud 2023; 9:157. [PMID: 37684682 PMCID: PMC10485965 DOI: 10.1186/s40814-023-01383-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND People with severe mental illness (e.g. psychosis, bipolar disorder) experience poor oral health compared to the general population as shown by more decayed, missing and filled teeth and a higher prevalence of periodontal disease. Attending dental services allows treatment of oral health problems and support for prevention. However, people with severe mental illness face multiple barriers to attending routine dental appointments and often struggle to access care. Link work interventions use non-clinical support staff to afford vulnerable populations the capacity, opportunity, and motivation to navigate use of services. The authors have co-developed with service users a link work intervention for supporting people with severe mental illness to access routine dental appointments. The Mouth Matters in Mental Health Study aims to explore the feasibility and acceptability of this intervention within the context of a feasibility randomised controlled trial (RCT) measuring outcomes related to the recruitment of participants, completion of assessments, and adherence to the intervention. The trial will closely monitor the safety of the intervention and trial procedures. METHODS A feasibility RCT with 1:1 allocation to two arms: treatment as usual (control) or treatment as usual plus a link work intervention (treatment). The intervention consists of six sessions with a link worker over 9 months. Participants will be adults with severe mental illness receiving clinical input from secondary care mental health service and who have not attended a planned dental appointment in the past 3 years. Assessments will take place at baseline and after 9 months. The target recruitment total is 84 participants from across three NHS Trusts. A subset of participants and key stakeholders will complete qualitative interviews to explore the acceptability of the intervention and trial procedures. DISCUSSION The link work intervention aims to improve dental access and reduce oral health inequalities in people with severe mental illness. There is a dearth of research relating to interventions that attempt to improve oral health outcomes in people with mental illness and the collected feasibility data will offer insights into this important area. TRIAL REGISTRATION The trial was preregistered on ISRCTN (ISRCTN13650779) and ClinicalTrials.gov (NCT05545228).
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Affiliation(s)
- Claire Hilton
- The Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
| | - Abigail Morris
- The Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
| | - Girvan Burnside
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Rebecca Harris
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | | | - Sarah Procter
- Lancashire & South Cumbria NHS Foundation Trust, Lancashire, UK
| | - Robert Griffiths
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Paul French
- Manchester Metropolitan University, Manchester, UK
- Pennine Care NHS Foundation Trust, Ashton-Under-Lyne, UK
| | - Louise Laverty
- Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, UK
| | - Fiona Lobban
- The Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
| | - Katherine Berry
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
| | - David Shiers
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Rebecca Golby
- Lancashire & South Cumbria NHS Foundation Trust, Lancashire, UK
| | - Fanni Fazekas
- Pennine Care NHS Foundation Trust, Ashton-Under-Lyne, UK
| | - Kyriakos Valemis
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Antonia Perry
- Lancashire & South Cumbria NHS Foundation Trust, Lancashire, UK
| | - Connie Newens
- Lancashire & South Cumbria NHS Foundation Trust, Lancashire, UK
| | - Eirian Kerry
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | | | - Efstathia Gkioni
- Institute of Population Health, University of Liverpool, Liverpool, UK
- Liverpool Clinical Trials Centre, Clinical Directorate, University of Liverpool, Liverpool, UK
| | - Christopher Lodge
- The Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
| | - Alison Dawber
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Emma Elliott
- School of Dentistry, University of Leeds, Leeds, UK
| | - Farah Lunat
- Lancashire & South Cumbria NHS Foundation Trust, Lancashire, UK
| | - Jasper Palmier-Claus
- The Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK.
- Lancashire & South Cumbria NHS Foundation Trust, Lancashire, UK.
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Happell B, Furness T, Jacob A, Stimson A, Curtis J, Watkins A, Platania-Phung C, Scholz B, Stanton R. Nurse-Led Physical Health Interventions for People with Mental Illness: A Scoping Review of International Literature. Issues Ment Health Nurs 2023:1-16. [PMID: 37294933 DOI: 10.1080/01612840.2023.2212772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
People with mental illness have a higher prevalence of co-occurring physical health conditions and poor health behaviors, leading a mortality gap of up to 16 years, compared with the general population. Nurses working in mental health settings play an important role in addressing factors influencing sub-optimal physical health. Therefore, this scoping review aimed to identify nurse-led physical health interventions and align interventions to eight recognized physical healthcare priority areas (i.e. Equally Well in Victoria Framework). A systematic search strategy was used to identify relevant literature. Data extraction included alignment to the Equally Well priority areas, research design, and indication of co-design (meaningful and collaborative involvement of consumers and significant others) and recovery-oriented practice (focusing on needs and goals of a consumer's recovery journey). All included papers (n = 74) were aligned to at least one of eight Equally Well priority areas. Papers were predominately quantitative (n = 64, 86%), with the remainder mixed methods (n = 9, 9%) or qualitative (n = 4, 5%). Most papers were aligned to improving metabolic health and support to quit smoking. One study focused on nurse-led intervention designed to reduce falls. Recovery-oriented practice was evident in six papers. No paper described evidence of co-design. A research gap was identified for nurse-led intervention to reduce falls and improve dental/oral care. Relative to mental healthcare policy, there is a need for future nurse-led physical health research to be co-designed and include recovery-oriented practice. Evaluation and description of future nurse-led physical interventions should seek to report perspectives of key stakeholders as these remain relatively unknown.
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Affiliation(s)
- Brenda Happell
- Mental Health and Psychosocial Well-being Theme, Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | | | - Alycia Jacob
- School of Nursing and Midwifery, Australian Catholic University, Fitzroy, Australia
| | - Alisa Stimson
- School of Nursing, Midwifery and Social Sciences, CQUniversity, Rockhampton, Queensland, Australia
| | - Jackie Curtis
- Mindgardens Neuroscience Network, South East Sydney Local Health District, University of New South Wales - Cliffbrook Campus, Coogee, Australia
| | - Andrew Watkins
- Mindgardens Neuroscience Network, South East Sydney Local Health District, University of New South Wales - Cliffbrook Campus, Coogee, Australia
| | | | - Brett Scholz
- Medical School, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Robert Stanton
- Cluster for Resilience and Wellbeing, Appleton Institute, Rockhampton, South Australia, Australia
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Queensland, Australia
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Joury E, Kisely S, Watt RG, Ahmed N, Morris AJ, Fortune F, Bhui K. Mental Disorders and Oral Diseases: Future Research Directions. J Dent Res 2023; 102:5-12. [PMID: 36081351 DOI: 10.1177/00220345221120510] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The poor physical health (including oral health) of people with mental disorders is a global problem. The burden of oral diseases among this group is substantial given their high prevalence and ability to increase the personal, social, and economic impacts of mental disorders. This article summarizes causes of mental disorders and oral diseases, critically reviews current evidence on interventions to reduce the burden of oral diseases in people with mental disorders, and suggests future research directions. The relationship between mental disorders and oral diseases is complex due to the shared social determinants and bidirectional interaction mechanisms that involve interconnected social, psychological, behavioral, and biological processes. Research has, to date, failed to produce effective and scalable interventions to tackle the burden of oral diseases among people with mental disorders. Transformative research and actions informed by a dynamic involvement of biological, behavioral, and social sciences are needed to understand and tackle the complex relationship between mental disorders and oral diseases, as well as inform the design of complex interventions. Examples of future research on complex public health, health service, and social care interventions are provided. The design and testing of these interventions should be carried out in real-world settings, underpinned by the principles of coproduction and systems thinking, and conducted by a transdisciplinary team. We propose this starts with setting research priorities and developing complex intervention theory, which we report to support future research to improve oral health and hence physical and mental health in this disadvantaged group.
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Affiliation(s)
- E Joury
- Centre for Dental Public Health and Primary Care, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, The Royal London Hospital, London, UK
| | - S Kisely
- PA-Southside Clinical Unit, School of Clinical Medicine, Faculty of Medicine, the University of Queensland, Woolloongabba, QLD, Australia
| | - R G Watt
- Research Department of Epidemiology & Public Health, University College London, London, UK
| | - N Ahmed
- Bristol Dental School, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - A J Morris
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - F Fortune
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, London, UK
| | - K Bhui
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK
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6
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Zechner MR, Singhal V, Murphy AA, York J, Karyczak S, Muhammad A. Dental pre‐doctoral student perceptions about serious mental illness: Concerns and role clarification. J Dent Educ 2022; 87:639-645. [DOI: 10.1002/jdd.13156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/26/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Michelle R. Zechner
- Department of Psychiatric Rehabilitation and Counseling Professions Rutgers School of Health Professions Piscataway New Jersey USA
| | - Vaishali Singhal
- Department of Community Health, Rutgers School of Dental Medicine and Department of Interdisciplinary StudiesRutgers School of Health Professions NewarkNew JerseyUSA
| | - Ann A. Murphy
- Department of Psychiatric Rehabilitation and Counseling Professions Rutgers School of Health Professions Piscataway New Jersey USA
| | - Jill York
- Department of Community Health Rutgers School of Dental Medicine Newark New Jersey USA
| | - Sean Karyczak
- Department of Psychiatric Rehabilitation and Counseling Professions Rutgers School of Health Professions Piscataway New Jersey USA
| | - Asiyah Muhammad
- Rutgers School of Environmental and Biological Sciences with a major in Biological Sciences and a minor in Health and Society New Brunswick New Jersey USA
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Mishu MP, Faisal MR, Macnamara A, Sabbah W, Peckham E, Newbronner L, Gilbody S, Gega L. A Qualitative Study Exploring the Barriers and Facilitators for Maintaining Oral Health and Using Dental Service in People with Severe Mental Illness: Perspectives from Service Users and Service Providers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074344. [PMID: 35410025 PMCID: PMC8998854 DOI: 10.3390/ijerph19074344] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 01/07/2023]
Abstract
People with severe mental illness suffer from a high burden of oral diseases, which can negatively impact their physical and mental well-being. Despite the high burden, they are less likely to engage in oral health care including accessing dental services. We aimed to identify both the service users' and service providers' perspective on the barriers and facilitators for maintaining oral health and dental service use in people with severe mental illness. Qualitative exploration was undertaken using dyadic or one-to-one in-depth interviews with service users in the UK with a diagnosis of schizophrenia, schizoaffective disorder or bipolar disorder. Service providers, including mental health and dental health professionals, and informal carers (people identified as family or friend who are not paid carers) were also interviewed. Thematic analysis of the data revealed three main cross-cutting themes at the personal, inter-personal and systems level: amelioration of the problem, using a tailored approach and provision of comprehensive support. The main barriers identified were impact of mental ill-health, lack of patient involvement and tailored approach, and accessibility and availability of dental services including lack of integration of services. The main facilitators identified were service providers' effective communication skills and further support through the involvement of carers. The findings suggest that the integration of dental and mental health services to provide tailored support for overall health and well-being, including the oral health of the patient, can better support people with severe mental illness regarding their oral health needs.
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Affiliation(s)
- Masuma Pervin Mishu
- Department of Health Sciences, Faculty of Sciences, University of York, Heslington, York YO10 5DD, UK; (M.R.F.); (E.P.); (L.N.); (L.G.); (S.G.)
- Correspondence:
| | - Mehreen Riaz Faisal
- Department of Health Sciences, Faculty of Sciences, University of York, Heslington, York YO10 5DD, UK; (M.R.F.); (E.P.); (L.N.); (L.G.); (S.G.)
| | - Alexandra Macnamara
- Hull York Medical School, University of York, Heslington, York YO10 5DD, UK;
| | - Wael Sabbah
- Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, Denmark Hill Campus, Caldecot Road, London SE5 9RW, UK;
| | - Emily Peckham
- Department of Health Sciences, Faculty of Sciences, University of York, Heslington, York YO10 5DD, UK; (M.R.F.); (E.P.); (L.N.); (L.G.); (S.G.)
| | - Liz Newbronner
- Department of Health Sciences, Faculty of Sciences, University of York, Heslington, York YO10 5DD, UK; (M.R.F.); (E.P.); (L.N.); (L.G.); (S.G.)
| | - Simon Gilbody
- Department of Health Sciences, Faculty of Sciences, University of York, Heslington, York YO10 5DD, UK; (M.R.F.); (E.P.); (L.N.); (L.G.); (S.G.)
- Hull York Medical School, University of York, Heslington, York YO10 5DD, UK;
| | - Lina Gega
- Department of Health Sciences, Faculty of Sciences, University of York, Heslington, York YO10 5DD, UK; (M.R.F.); (E.P.); (L.N.); (L.G.); (S.G.)
- Hull York Medical School, University of York, Heslington, York YO10 5DD, UK;
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