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Skjærpe JN, Hegelstad WTV, Joa I, Storm M. Exploring key determinants of health among individuals with serious mental Illness: qualitative insights from a first episode psychosis cohort, 20 years postdiagnosis. BMC Psychiatry 2023; 23:784. [PMID: 37884979 PMCID: PMC10605780 DOI: 10.1186/s12888-023-05270-1] [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] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Individuals with serious mental illness (SMI) are more likely to experience functional decline, low well-being, comorbidities, shorter lifespan, and diminished quality of life than the general population. This qualitative study explores determinants of health that individuals with SMI perceive as important to their health, well-being, and ability to live a meaningful life. METHOD We conducted interviews with 13 individuals with early detected first episode psychosis as part of a 20-year follow-up study of a larger cohort. Interview data were analyzed using qualitative content analysis. RESULTS Analysis identified two themes comprising eight categories representing determinants of health. The first theme reflected management of mental and physical health. Categories in this theme were: access to mental healthcare adapted to individual needs, strategies during deterioration, use of psychotropic medication, maintenance of physical health and lifestyle. The second theme reflected social health determinants in coping with mental illness and comprised three categories: family and friends, engaging in meaningful hobbies and activities, and the influence of employment on mental health. CONCLUSIONS Individuals with SMI outlined mental, physical, and social determinants of health that were important for their health, well-being, and ability to live a meaningful life. In future clinical practice, coordinated care addressing the complexity of health determinants will be important.
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Affiliation(s)
- Jorunn Nærland Skjærpe
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
| | - Wenche Ten Velden Hegelstad
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
- Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
| | - Inge Joa
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
| | - Marianne Storm
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
- Research Department, Research Group of Nursing and Health Sciences, Stavanger University Hospital, Stavanger, Norway
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Lamadé EK, Özer N, Schaupp B, Krumm B, Deuschle M, Häfner S. Association of hypertension, type 2 diabetes mellitus and dyslipidemia with the duration of inpatient treatments and recurrence of schizophrenia. J Psychosom Res 2023; 172:111436. [PMID: 37454415 DOI: 10.1016/j.jpsychores.2023.111436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 06/26/2023] [Accepted: 07/01/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE People with schizophrenia have an increased cardiovascular risk with higher mortality than the general population. Only a few studies have investigated the impact of cardiovascular risk on the later course of schizophrenia. This study aims to explore the association of cardiovascular risk factors, as detected during an index inpatient treatment for schizophrenia, with the duration of psychiatric inpatient treatments and number of inpatient admissions in the subsequent 10 years, in patients with schizophrenia. METHODS Cardiovascular risk factors of 736 patients with schizophrenia, identified through retrospective chart review, were assessed by hypertension, type 2 diabetes mellitus and dyslipidemia during an index inpatient stay. The duration of inpatient treatments, assessed by the total duration of psychiatric inpatient treatments in days, and the number of inpatient admissions, over the next 10 years were assessed and analyzed for an association with cardiovascular risk factors. RESULTS Hypertension associated with longer duration of inpatient treatments and higher number of inpatient admissions. Type 2 diabetes mellitus and dyslipidemia associated with a higher number of psychiatric inpatient treatments. Hypertension remained significantly associated with the duration of inpatient treatments (β = 0.174; p < 0.001) and the number of inpatient treatments (β = 0.144; p < 0.001), when adjusting for age, sex and BMI. CONCLUSION Out of the investigated cardiovascular risk factors documented during an index inpatient stay for schizophrenia, only hypertension associated with an increased duration of in-hospital stay and an increased number of re-hospitalizations during the subsequent ten years when adjusting for confounders. Screening for hypertension should be considered in all patients with schizophrenia.
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Affiliation(s)
- Eva Kathrin Lamadé
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
| | - Nicole Özer
- Department of Psychiatry and Psychotherapy, University of Göttingen, Germany
| | - Bernhard Schaupp
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Bertram Krumm
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Michael Deuschle
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Sibylle Häfner
- Department of Psychiatry and Psychotherapy, University of Göttingen, Germany; Department of Psychiatry and Psychotherapy, University of Heidelberg, Germany
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Chua YC, Abdin E, Tang C. A retrospective database study on 2-year weight trajectories in first-episode psychosis. Front Psychiatry 2023; 14:1185874. [PMID: 37476538 PMCID: PMC10354663 DOI: 10.3389/fpsyt.2023.1185874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/07/2023] [Indexed: 07/22/2023] Open
Abstract
Introduction It is critical to focus on individual weight profiles in line with efforts to tailor treatment, given the heterogeneous nature of the clinical population. This study aims to identify and describe possible two-year weight trajectories among patients accepted to the Early Psychosis Intervention Programme (EPIP) in Singapore. Methods De-identified data was extracted from EPIP's standing database for patients accepted from 2014 to 2018 with a schizophrenia spectrum disorder. Data collected at fixed time-points (baseline, 1-year, and 2-year) included anthropometric measures (height and weight), and sociodemographic (age, sex, highest education level, and vocational status) and clinical (duration of untreated psychosis, number of inpatient admissions, and scores on the Positive and Negative Syndrome Scale and Global Assessment of Functioning) information. Results A total of 391 complete data sets were included for main analyses. Those with missing weight data were more likely to be males, older at baseline, have a highest education level of tertiary and above at baseline, and have a longer duration of untreated psychosis. The weight change across two years resulted in the following membership breakdown: 151 (38.6%) in super high risk; 133 (34.0%) in high risk mitigated; 17 (4.3%) in at risk; 34 (8.8%) in delayed risk; and 56 (14.4%) in low risk. Discussion The lack of pharmacological, dietary, and physical activity data is a significant limitation in this study; however, the results reinforce the justification for future studies to prospectively capture and examine the influence of these data, with the aim of early detection and weight intervention for high risk groups.
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Affiliation(s)
- Yi Chian Chua
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Charmaine Tang
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
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Yusoff YS, Rahim NA, Hasmi MH. Review on Cardiovascular Disease Risk Factors Among Selected Countries in Asia. PROCEEDINGS OF THE 6TH INTERNATIONAL CONFERENCE ON FUNDAMENTAL AND APPLIED SCIENCES 2021:655-670. [DOI: 10.1007/978-981-16-4513-6_57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Bohman H, Agartz I, Mansouri S, Naessen T, Lundberg M. Preclinical atherosclerosis in adolescents with psychotic or bipolar disorders investigated with carotid high-frequency ultrasound. Brain Behav 2020; 10:e01862. [PMID: 32997440 PMCID: PMC7749529 DOI: 10.1002/brb3.1862] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 08/15/2020] [Accepted: 08/28/2020] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Early-onset psychosis (EOP) and bipolar disorder (EOBP) (at <18 years of age), are associated with an increased future risk of cardiovascular disease (CVD) and premature death. Yet it is unknown whether the arteries show visible signs of atherosclerosis in EOP and EOBP. This study investigated whether having EOP or EOBP was associated with detectable signs of preclinical atherosclerosis. METHOD By using 22 MHz high-frequency ultrasound, different layers of the arterial wall of the left common carotid artery (LCCA) were assessed in 77 individuals with EOP (n = 25), EOBP (n = 22), and in age-matched healthy controls (n = 30). Conventional CVD confounders were included in the analyses. RESULTS Adolescents with EOP and EOBP, compared to controls, had a significantly thicker LCCA intima thickness (0.132 vs. 0.095 mm, p < .001) and intima/media ratio (0.24 vs. 0.17 p < .001). There was a nonsignificant intima difference between EOP and EOBP. Conventional CVD risk factors did not explain the association between EOP/EOBP and intima thickness. In the group of EOP/EOBP, there was a significant correlation between the dose of current antipsychotic medication and intima thickness; however, the correlation was attenuated to a nonsignificant level when adjusted for global function. CONCLUSIONS Adolescents with EOP or EOBP had an increased LCCA intima thickness, interpreted as a sign of preclinical atherosclerosis. Global function of the disorders was the strongest determinant of intima thickness. The findings, if replicated, might have implications for long-term treatment of EOP and EOBP in order to reduce a future risk of CVD.
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Affiliation(s)
- Hannes Bohman
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden.,Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Agartz
- NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Shiva Mansouri
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Tord Naessen
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Mathias Lundberg
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
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Pradhan MR, Patel SK, Prusty RK. Pattern and Predictors of Tobacco Use in India: Evidence from National Family Health Survey (2015–2016). JOURNAL OF HEALTH MANAGEMENT 2019. [DOI: 10.1177/0972063419868566] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Tobacco use continues to be of research interest due to the significant amount of tobacco-attributable non-communicable diseases and deaths in India. This study examines the pattern and predictors of smoking, chewing, and any tobacco use among adults of age 15–49 years in India. This study used secondary data from the fourth round of the National Family and Health Survey (NFHS, 2015–2016) which collected information on tobacco use from men and women in the age group 15–49 ( n = 803097). Bivariate and multivariate analyses were conducted to understand the socio-economic and demographic predictors. GIS maps have been used to show inter-state variation in smoking, chewing, and any tobacco use by gender. About one out of every ten adults aged 15–49 use any tobacco, predominantly in chewing forms. Women are significantly less likely to smoke (odds ratio [OR]: 0.05, confidence interval [CI]: 0.04–0.05), chew (OR: 0.25, CI: 0.24–0.25), and use any tobacco (OR: 0.14, CI: 0.13–0.14) compared with men. Tobacco usage was found more common among the uneducated and economically weak people. There is considerable inter-state heterogeneity in the prevalence and type of tobacco use, and adults in the north-east region are among the most vulnerable population subgroups. Tobacco use continues to be a significant burden due to its magnitude and different forms of use in India. The higher use among males, illiterates, economically weak, socially backward and alcohol users suggest the need for targeted efforts to improve their knowledge and awareness about the harmful effects of tobacco use and stronger enforcement of tobacco control policies.
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Affiliation(s)
- Manas Ranjan Pradhan
- Department of Fertility Studies, International Institute for Population Sciences, Mumbai, Maharashtra, India
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