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Sass MR, Christensen AMB, Christensen ML, Gruber E, Nerdrum H, Pedersen LM, Resch M, Jørgensen TH, Ekstrøm CT, Nielsen J, Vilsbøll T, Fink-Jensen A. Liraglutide 3.0 mg once daily for the treatment of overweight and obesity in patients hospitalised at a forensic psychiatric department: A 26-week open-label feasibility study. Acta Psychiatr Scand 2024; 150:35-47. [PMID: 38631670 DOI: 10.1111/acps.13690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 03/23/2024] [Accepted: 04/04/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION Overweight and obesity constitute a major concern among patients treated at forensic psychiatric departments. The present clinical feasibility study aimed at investigating the extent to which glucagon-like peptide 1 receptor agonist (GLP-1RA) treatment with once-daily liraglutide 3.0 mg could be a feasible pharmacological treatment of these conditions in patients with schizophrenia spectrum disorders hospitalised in forensic psychiatry. METHODS The 26-week, open-label feasibility study included participants aged 18-65 years diagnosed with a severe mental illness and hospitalised at a forensic psychiatric department. At the time of inclusion, all participants fulfilled the indication for using liraglutide as a treatment for overweight and obesity. Participants' baseline examinations were followed by a 26-week treatment period with liraglutide injection once daily according to a fixed uptitration schedule of liraglutide, with a target dose of 3.0 mg. Each participant attended seven visits to evaluate the efficacy and adverse events. The primary endpoint was the number of "completers", with adherence defined as >80% injections obtained in the period, weeks 12-26. Determining whether liraglutide is a feasible treatment was pre-defined to a minimum of 75% completers. RESULTS Twenty-four participants were included in the study. Sex, male = 19 (79.2%). Mean age: 42.3 [25th and 75th percentiles: 39.1; 48.4] years; body mass index (BMI): 35.7 [31.7; 37.5] kg/m2; glycated haemoglobin (HbA1c): 37 [35; 39] mmol/mol. Eleven out of 24 participants (46%) completed the study. For the completers, the median net body weight loss after 26 weeks of participation was -11.4 kg [-15.4; -5.9]. The net difference in HbA1C and BMI was -2.0 mmol/mol [-4; -1] and -3.6 kg/m2 [-4.7; -1.8], respectively. The weight change and reduction in HbA1c and BMI were all statistically significant from baseline. CONCLUSION The study did not confirm our hypothesis that liraglutide is a feasible treatment for a minimum of 75% of the patients initiating treatment with liraglutide while hospitalised in a forensic psychiatric department. The high dropout rate may be due to the non-naturalistic setting of the clinical trial. For the proportion of patients compliant with the medication, liraglutide 3.0 mg was an efficient treatment for overweight.
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Affiliation(s)
- Marie Reeberg Sass
- Psychiatric Centre Copenhagen, Mental Health Services in the Capitol Region of Denmark, University of Copenhagen, Copenhagen, Denmark
| | | | - Margit Lykke Christensen
- Psychiatric Centre Sct. Hans, Forensic Mental Health Services in the Capitol Region of Denmark, Roskilde, Denmark
| | - Ema Gruber
- Psychiatric Centre Sct. Hans, Forensic Mental Health Services in the Capitol Region of Denmark, Roskilde, Denmark
| | - Helle Nerdrum
- Psychiatric Centre Sct. Hans, Forensic Mental Health Services in the Capitol Region of Denmark, Roskilde, Denmark
| | - Lone Marianne Pedersen
- Psychiatric Centre Sct. Hans, Forensic Mental Health Services in the Capitol Region of Denmark, Roskilde, Denmark
| | - Maximilian Resch
- Psychiatric Centre Glostrup, Mental Health Services in the Capitol Region of Denmark, Roskilde, Denmark
| | | | - Claus T Ekstrøm
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jimmi Nielsen
- Psychiatric Centre Glostrup, Mental Health Services in the Capitol Region of Denmark, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tina Vilsbøll
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Clinical Research, Steno Diabetes Center Copenhagen, Herlev Hospital, Herlev, Denmark
| | - Anders Fink-Jensen
- Psychiatric Centre Copenhagen, Mental Health Services in the Capitol Region of Denmark, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Vestphal TK, Tingleff EB, Jørgensen R, Rowaert S, Gildberg FA. Tilting at Windmills - A Qualitative Study about Family Caregiver Interactions and Perceptions in Forensic Mental Health Care. Issues Ment Health Nurs 2024; 45:322-330. [PMID: 38412043 DOI: 10.1080/01612840.2024.2308544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
In forensic mental health care (FMHC), family caregivers perceive themselves as burdened in their relationships with the service user (the family member with mental illness) and by difficult collaboration with healthcare professionals (HCPs). There is a political objective to involve this group in the care and treatment of the service user in mental health care. To improve family caregiver involvement in care and treatment in FMHC, research about their perceptions is needed. This study aims to explore family caregivers' perceptions of their interactions with the service user and HCPs. The method used was qualitative. Semi-structured, in-depth interviews with 12 family caregiver participants were carried out and analyzed thematically. The analysis resulted in three interrelated main themes: Strategies to normalize everyday living; Distrust of the quality of care; and Loss and grief. Family caregiver feelings of loss and grief may be suppressed, which additionally could prevent them from supporting the service user.
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Affiliation(s)
- Tina Kirstine Vestphal
- Forensic Mental Health Research Unit Middelfart (RFM), Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Ellen Boldrup Tingleff
- Forensic Mental Health Research Unit Middelfart (RFM), Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Rikke Jørgensen
- Unit for Psychiatric Research, Psychiatry, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Sara Rowaert
- Department of Special Needs Education, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Frederik Alkier Gildberg
- Forensic Mental Health Research Unit Middelfart (RFM), Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
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Guo M, Wang X, Li Y, Luo A, Zhao Y, Luo X, Li S. Intermittent Fasting on Neurologic Diseases: Potential Role of Gut Microbiota. Nutrients 2023; 15:4915. [PMID: 38068773 PMCID: PMC10707790 DOI: 10.3390/nu15234915] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 11/13/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
As the global population ages, the prevalence of neurodegenerative diseases is surging. These disorders have a multifaceted pathogenesis, entwined with genetic and environmental factors. Emerging research underscores the profound influence of diet on the development and progression of health conditions. Intermittent fasting (IF), a dietary pattern that is increasingly embraced and recommended, has demonstrated potential in improving neurophysiological functions and mitigating pathological injuries with few adverse effects. Although the precise mechanisms of IF's beneficial impact are not yet completely understood, gut microbiota and their metabolites are believed to be pivotal in mediating these effects. This review endeavors to thoroughly examine current studies on the shifts in gut microbiota and metabolite profiles prompted by IF, and their possible consequences for neural health. It also highlights the significance of dietary strategies as a clinical consideration for those with neurological conditions.
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Affiliation(s)
- Mingke Guo
- Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Department of Anesthesiology, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (M.G.); (X.W.); (Y.L.); (A.L.); (Y.Z.)
| | - Xuan Wang
- Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Department of Anesthesiology, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (M.G.); (X.W.); (Y.L.); (A.L.); (Y.Z.)
| | - Yujuan Li
- Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Department of Anesthesiology, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (M.G.); (X.W.); (Y.L.); (A.L.); (Y.Z.)
| | - Ailin Luo
- Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Department of Anesthesiology, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (M.G.); (X.W.); (Y.L.); (A.L.); (Y.Z.)
| | - Yilin Zhao
- Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Department of Anesthesiology, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (M.G.); (X.W.); (Y.L.); (A.L.); (Y.Z.)
| | - Xiaoxiao Luo
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Shiyong Li
- Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Department of Anesthesiology, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (M.G.); (X.W.); (Y.L.); (A.L.); (Y.Z.)
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McCartan C, Davidson G, Bradley L, Greer K, Knifton L, Mulholland A, Webb P, White C. 'Lifts your spirits, lifts your mind': A co-produced mixed-methods exploration of the benefits of green and blue spaces for mental wellbeing. Health Expect 2023. [PMID: 37128668 DOI: 10.1111/hex.13773] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 05/03/2023] Open
Abstract
INTRODUCTION Mental health problems are a considerable public health issue and spending time in nature has been promoted as a way to access a range of psychological benefits leading to the development of nature-based interventions for people with severe and enduring mental health problems. Less, however, is understood about the potential benefits and efficacy of day-to-day routine access to outdoor green and blue spaces for mental health service users. METHODS Using a mixed-methods design between April and October 2021, we explored the benefits and barriers to spending time outdoors with a purposive sample of mental health service users (N = 11) using qualitative interviews and an online general population survey (N = 1791). Qualitative evidence highlighted the restorative benefits of nature and identified a number of barriers associated with fears around personal safety, social anxiety, fatigue and lack of motivation. COVID-19 had also restricted access to green and blue spaces. Having social contact and support encouraged people to spend time outdoors. In the quantitative survey, self-report and standardised measures (the Patient Health Questionnaire and the Warwick-Edinburgh Wellbeing Scale) were used to assess past and current mental wellbeing. FINDINGS Statistically significant differences were found between wellbeing and the use of green and blue spaces. Those with mental health problems spent time outdoors because they: felt guilty; wanted to reduce their anxiety; or rely on someone for encouragement. Those without mental health problems endorsed more positively framed reasons including relaxation, improving physical health or getting exercise. Barriers for people with mental health problems involved safety concerns, feeling anxious and having a poor self-image. These findings give insight into motivations for an outdoor activity to help inform the design of public mental health interventions. CONCLUSION Further work is required to improve access and safety to promote the benefits of green and blue spaces for everyone. PATIENT OR PUBLIC CONTRIBUTION The research team included expert experienced researchers with a mental health service provider (Praxis Care) and they were involved in the development of the research idea, funding application, design, data collection, analysis, writing up and dissemination activities.
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Affiliation(s)
- Claire McCartan
- Regional Trauma Network, IMPACT Research Centre, Northern Health and Social Care Trust, Antrim, UK
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, UK
| | - Gavin Davidson
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, UK
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Repo V, Kymäläinen P. Negotiating body and power in forensic mental health care. SOCIAL THEORY & HEALTH 2023. [DOI: 10.1057/s41285-023-00193-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
AbstractSince the beginning of the 2000s, the reduction of coercive methods has been a tendency in psychiatric care in Finland. Combined with the transforming ideas of healing, the reduction has changed practices in the institutions of forensic mental health care, by encouraging efforts to increase self-determination and individual responsibility. This article addresses the coexistence of the previous and current bodily regimes, and the resulting complex and contested spatial and bodily arrangements. We combine the discussions on biopower and bodily regimes in our analysis of the practices and negotiations related to the alternative methods to coercion (special observation and restricting garments), mundane practices (eating and exercising), and negotiations related to touch and sexuality. As our study shows, bodily regimes and care practices are constantly under negotiation, during which there may be inconsistences in what is or is not allowed. Moreover, what seems to be a positive tendency towards increased self-determination has led to new forms of pressure, resulting from the increased possibility to protest by using one’s own body (e.g. by ignoring hygiene), or from the diminishing self-determination of the nurses (e.g. during special observation).
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Czarnecki D, Ziółkowski M, Chodkiewicz J, Długosz A, Budzyński J, Waszkiewicz N, Kułak-Bejda A. Confusion of Alcohol Craving With Food Hunger in Alcohol-Dependent Individuals Entering In-Patient Drug Treatment. Alcohol Alcohol 2023; 58:151-158. [PMID: 36625065 DOI: 10.1093/alcalc/agac072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/18/2022] [Accepted: 12/27/2022] [Indexed: 01/11/2023] Open
Abstract
AIM To identify the distinguishing characteristics of alcohol dependent patients who confuse alcohol cravings with pre-meal hunger. METHODS Data were collected at interview on sociodemographic status, clinical status and anthropometry in 179 patients (163 men and 16 women) undergoing in-patient treatment for alcohol dependence. RESULTS A comparison of the patient subgroups studied showed that patients who did not confuse, and those who did confuse, alcohol craving with pre-meal hunger differed significantly in terms of alcohol craving scale scores (9 vs. 4 points). Patients confusing alcohol cravings with pre-meal hunger were more likely to recognize that experiencing severe pre-meal hunger can cause relapse (67.9 vs. 22.8%) and that not being able to distinguish between the sensations under study also increases the risk of breaking abstinence (75.0% vs. 50.4%). This was independent of severity of dependence and intensity of recent alcohol consumption. CONCLUSIONS Alcohol-dependent persons who confuse alcohol craving with pre-meal hunger differ from those who do not confuse these hunger pangs in terms of feeling stronger alcohol craving and more frequent occurrence of symptoms accompanying the feeling of alcohol craving during pre-meal hunger. At the start of treatment for alcohol withdrawal, alcohol-dependent individuals who report confusing alcohol cravings with pre-meal hunger are less confident of maintaining abstinence. This is relevant to treatment. The role of possible confounders (depressive symptoms, cognitive and educational deficiency) could not be elucidated definitively.
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Affiliation(s)
- Damian Czarnecki
- Department of Preventive Nursing, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz; ul. Ignacego Łukasiewicza 1, Bydgoszcz 85-821, Poland
| | - Marcin Ziółkowski
- Department of Preventive Nursing, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz; ul. Ignacego Łukasiewicza 1, Bydgoszcz 85-821, Poland
| | - Jan Chodkiewicz
- Institute of Psychology, Department of Clinical Psychology, University of Lodz, ul. Smugowa 10/12, Lodz 91-433, Poland
| | - Anna Długosz
- Faculty of Chemical Technology and Engineering, University of Science and Technology, ul. Seminaryjna 3, Bydgoszcz 85-326, Poland
| | - Jacek Budzyński
- Department of Vascular and Internal Diseases, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, ul Ujejskiego 75, Bydgoszcz 85-168, Poland
| | - Napoleon Waszkiewicz
- Department of Psychiatry, Medical University of Białystok, ul. Wołodyjowskiego 2, Białystok 15-272, Poland
| | - Agnieszka Kułak-Bejda
- Department of Psychiatry, Medical University of Białystok, ul. Wołodyjowskiego 2, Białystok 15-272, Poland
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Vestphal TK, Gildberg FA, Jørgensen R, Rowaert S, Tingleff EB. Experiences of family caregivers in forensic mental health care-A qualitative evidence synthesis. J Psychiatr Ment Health Nurs 2023. [PMID: 36739887 DOI: 10.1111/jpm.12910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/07/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT Internationally, research and policy agendas recommend that family caregivers of service users in mental health care be involved in care and treatment, to support the service user's recovery process. Family caregivers of service users in mental health care are often highly burdened. There is a lack of research-based knowledge about the experiences of family caregivers of service users in forensic mental health care (FMHC) and their involvement in care and treatment. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE This study indicates a persistent caregiver presence and/or caregiver advocacy in regard to care and treatment of the service user in FMHC. This study indicates that health care professionals (HCPs) might play a role in eliciting a persistent caregiver presence and/or caregiver advocacy. WHAT ARE THE IMPLICATIONS FOR PRACTICE HCPs need to develop their collaborative skills and be more willing to listen to and understand caregivers' persistent presence and/or advocacy. HCPs need to be more skilled to understand caregivers' and families' living with the complexities of mental illness and offence. HCPs are encouraged to adjust the involvement of family caregivers in care and treatment to FMHC. ABSTRACT Introduction There is a lack of research about experiences of family caregivers of service users in forensic mental health care (FMHC) and their involvement in care and treatment. Research shows that caregivers are burdened. Further knowledge is required, to provide a foundation for improving clinical practice. Aim To review research literature, to investigate existing knowledge about caregiver experiences and, secondly, caregivers' experiences of facilitators and barriers related to their involvement in care and treatment. Method Qualitative evidence synthesis undertaken in a thematic synthesis of thirteen peer-reviewed studies. Results The analysis identified three descriptive themes: violence against family; a great burden of responsibility; and difficult collaboration, together with an additional three analytical themes: bearing witness; persistent presence; and advocacy becomes necessary. Discussion Persistent caregiver presence and/or caregiver advocacy may be elicited by health care professionals' (HCPs') exclusion of caregivers from care and treatment. Caregivers' feelings of guilt in relation to the service user's offence may play an additional role in persistent presence and advocacy and, therefore, in HCPs' exclusion of them. Implications for Practice HCPs need to develop their collaboration with caregivers by their willingness to listen to caregivers to understand emotional complexities within families experiencing mental illness and offence.
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Affiliation(s)
- Tina Kirstine Vestphal
- Department of Regional Health Research, Forensic Mental Health Research Unit Middelfart (RFM), Faculty of Health Sciences, University of Southern Denmark, Middelfart, Denmark.,Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark
| | - Frederik Alkier Gildberg
- Department of Regional Health Research, Forensic Mental Health Research Unit Middelfart (RFM), Faculty of Health Sciences, University of Southern Denmark, Middelfart, Denmark.,Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark
| | - Rikke Jørgensen
- Unit for Psychiatric Research, Psychiatry, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Sara Rowaert
- Department of Special Needs Education, Faculty of Psychology and Educational Sciences, Ghent University, Gent, Belgium
| | - Ellen Boldrup Tingleff
- Department of Regional Health Research, Forensic Mental Health Research Unit Middelfart (RFM), Faculty of Health Sciences, University of Southern Denmark, Middelfart, Denmark.,Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark.,OPEN, Odense Patient data Explorative Network Odense University Hospital/Department of Clinical Research, University of Southern Denmark, Middelfart, Denmark
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Pedersen ALW, Gildberg FA, Hjorth P, Højlund M, Andersen K. Hospitalisation time is associated with weight gain in forensic mental health patients with schizophrenia or bipolar disorder. Nord J Psychiatry 2023; 77:46-54. [PMID: 35389309 DOI: 10.1080/08039488.2022.2053202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
INTRODUCTION People with mental disorders have higher mortality from lifestyle diseases than the general population. Forensic mental health patients (FMHPs) are often hospitalised for longer periods of time than non-FMHPs. Thus, hospitalisation may have a greater effect on the risk of lifestyle diseases in FMHPs. OBJECTIVE Investigate associations between proportional hospitalisation time (PHT) and change in body weight or other cardiometabolic risk factors among FMHPs. METHODS Retrospective cohort study including all FMHPs with schizophrenia or bipolar disorder, prescribed antipsychotics, and treated between 01 January 2016 and 06 April 2020 in the Region of Southern Denmark either in forensic units or as outpatients. Associations between PHT and, respectively, primary and secondary outcomes were analysed using linear regression. PHT was determined between each measurement of the outcomes as the number of days hospitalised divided by the total number of days within the time-period. The primary outcome was weight change and secondary outcomes were change in waist circumference (WC), blood pressure, estimated average glucose (eAG), HDL, LDL, total cholesterol, and triglycerides. Analyses were adjusted for gender, age, smoking, and antipsychotics. RESULTS The cohort included 490 FMHPs, of which 440 were diagnosed with schizophrenia. PHT had a significant positive dose-response association with weight change, with an estimated difference of +4.0 kg/year for FMHPs who were hospitalised 100% of the time, compared to FMHPs who were exclusively treated as outpatients. The association interacted with baseline BMI. From the secondary outcomes, the association with PHT was only statistically significant for WC. CONCLUSIONS PHT was positively associated with weight gain.
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Affiliation(s)
- Anne Louise Winkler Pedersen
- CPS, Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Department of Psychiatry Middelfart, Mental Health Services Region of Southern Denmark, Middelfart, Denmark
| | - Frederik Alkier Gildberg
- CPS, Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Department of Psychiatry Middelfart, Mental Health Services Region of Southern Denmark, Middelfart, Denmark
| | - Peter Hjorth
- CPS, Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Department of Psychiatry Vejle, Mental Health Services Region of Southern Denmark, Vejle, Denmark
| | - Mikkel Højlund
- Clinical Pharmacology, Pharmacy, and Environmental Medicine, Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Department of Psychiatry Aabenraa, Mental Health Services Region of Southern Denmark, Aabenraa, Denmark
| | - Kjeld Andersen
- Department of Mental Health Odense, University Clinic, Mental Health Services, Region of Southern Denmark, Odense, Denmark
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Alharthy A, Hosler AS, Leckman-Westin E, Kammer JR. Association Between Tobacco Retailer Density and Smoking Among Adults With Diabetes and Serious Mental Illness in New York State. Prev Chronic Dis 2022; 19:E01. [PMID: 34990338 PMCID: PMC8794262 DOI: 10.5888/pcd19.210270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Smoking prevalence is high among adults with comorbid diabetes and serious mental illness. This population is at elevated risk of smoking-related health consequences and premature death. We focused on the community environment and investigated the association between tobacco retailer density and smoking in this population. METHODS We obtained individual-level data from the 2017 Patient Characteristics Survey, a medical record-based survey of patients served by the public mental health system in New York State. We computed the density of state-authorized tobacco retailers at the 3-digit zip code level. RESULTS The data included 19,492 adults (aged ≥18) with comorbid diabetes and serious mental illness. Of these, 55.6% resided in New York City, 53.1% were female, 38.1% were non-Hispanic White, 30.7% were non-Hispanic Black, 25.2% were Hispanic, and 38.1% were smokers, including electronic cigarette users. The density of tobacco retailers (range, 6.1-16.4 per 10,000 population) was positively associated with smoking (odds ratio = 1.05; 95% CI, 1.03-1.07) after adjusting for sex, race or ethnicity, education, employment, health insurance coverage, obesity, and region (New York City vs outside New York City). We observed no interaction between region and tobacco retailer density. CONCLUSION Findings of this study suggest that allocating more smoking cessation resources to zip code areas with a high density of tobacco retailers, especially in rural areas, along with supporting policy change to reduce tobacco retailor density, may mitigate the negative health consequences of smoking among people with comorbid diabetes and serious mental illness.
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Affiliation(s)
- Amani Alharthy
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, New York
- Department of Epidemiology, Princess Nourah bint Abdulrahman University College of Health and Rehabilitation Sciences, Riyadh, Saudi Arabia
- Department of Epidemiology and Health Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
| | - Akiko S Hosler
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, New York
| | - Emily Leckman-Westin
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, New York
- New York State Office of Mental Health, Albany, New York
| | - Jamie R Kammer
- New York State Office of Mental Health, Albany, New York
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