BACKGROUND: The excess of mortality in people with severe mental illness is due to unnatural causes such as accidents or suicides and natural causes such as metabolic syndrome. The presence of modifiable risk factors like tobacco consumption increases cardiovascular and metabolic risk. AIMS: The purpose of this study was to identify the prevalence of metabolic syndrome and other cardiovascular risk factors in people with severe mental illness. This study also aimed to identify the prevalence of patients receiving treatment for any metabolic syndrome risk factor. METHOD: A cross-sectional descriptive study was performed. A total of 125 participants from two community mental health centers in Spain were recruited. RESULTS: More than half of the participants (58.4%) were active smokers. The prevalence of metabolic syndrome was 60%. A total of 16.8% received previous treatment for hypertension, 17.6% for hypertriglyceridemia, and 11.2% for diabetes. No differences were found between centers (22.7% vs. 18.7%, p = .9). CONCLUSIONS: The findings underscore the importance of monitoring the physical health of patients on antipsychotic therapy. The identification and management of cardiovascular and metabolic risks factors is an essential part of nursing care for people with severe mental illness. Mental health nurses are ideally positioned to carry out this task by performing physical health screening, health education, and lifestyle interventions.
BernardoM.CañasF.BanegasJ. R.CasademontJ.RiesgoY.VarelaC., & RICAVA Study Group. (2009). Prevalence and awareness of cardiovascular risk factors in patients with schizophrenia: A cross-sectional study in a low cardiovascular disease risk geographical area. European Psychiatry, 24, 431-441. doi:10.1016/j.eurpsy.2009.07.010
2.
BernardoM.SafontG.OliveiraC. (2014). Recommendations for the monitoring and promotion of the physical health of patients with schizophrenia and other severe disorders (Project “Monitor”). Barcelona, Spain: Government of Catalonia, General Directorate of Health Planning and Research, Health Department. (Original work published in Spanish)
3.
BobesJ.SáizJ.MontesJ. M.MostazaJ.Rico-VillademorosF.VietaE., & Expert Group on the Physical Health of Bipolar Disorder Patient (2008). Spanish consensus on physical health of patients with bipolar disorder. Revista de Psiquiatría y Salud Mental, 1, 26-37. (Original work published in Spanish)
4.
BressingtonD. T.MuiJ.CheungE. F. C.PetchJ.ClarkA. B.GrayR. (2013). The prevalence of metabolic syndrome amongst patients with severe mental illness in the community in Hong Kong—A cross sectional study. BMC Psychiatry, 13, 87. doi:10.1186/1471-244X-13-87
5.
BruneroS.LamontS. (2009). Systematic screening for metabolic syndrome in consumers with severe mental illness. International Journal of Mental Health Nursing, 18, 144-150. doi:10.1111/j.1447-0349.2009.00595.x
6.
CabassaL.EzellJ. M.Lewis-FernándezR. (2010). Lifestyle interventions for adults with serious mental illness: A systematic literature review. Psychiatric Services, 61, 774-782.
7.
CatSalut. (2003). Specific attention program for serious mental illness. Barcelona, Spain: Department of Health and Social Security, Government of Catalonia. (Original work published in Catalan)
8.
Community of Madrid. (2010). Strategic plan for mental health 2010-2014. Madrid, Spain: Ministry of Health of the Community of Madrid. (Original work published in Spanish)
9.
CortésB. (2011). Metabolic syndrome and second antipsychotics generation. Revista de la Asociación Española de Neuropsiquiatría, 31, 303-320. (Original work published in Spanish)
10.
Council of Andalusia, Health Department. (2011). Health promotion in people with severe mental disorder. Situation analysis and recommendations on balanced diet and physical activity. Seville, Spain: Ministry of Health. (Original work published in Spanish)
11.
DaumitG. L.DickersonF. B.WangN.-Y.DalcinA.JeromeG. J.AndersonC. A. M.. . . AppelL. J. (2013). A behavioural weight-loss intervention in persons with serious mental illness. New England Journal of Medicine, 368, 1594-1602.
12.
De HertM.CorrellC. U.BobesJ.Cetkovich-BakmasM.CohenD.AsaiI.. . . LeuchtS. (2011). Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry, 10(1), 52-77. doi:10.1002/j.2051-5545.2011.tb00014.x
13.
De HertM.DekkerJ. M.WoodD.KahlK. G.HoltR. I. G.MöllerH. J. (2009). Cardiovascular disease and diabetes in people with severe mental illness: Position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC). European Psychiatry, 24, 412-424. doi:10.1016/j.eurpsy.2009.01.005
14.
De HertM.Van WinkelR.Van EyckD.HanssensL.WampersM.ScheenA.PeuskensJ. (2006). Prevalence of the metabolic syndrome in patients with schizophrenia treated with antipsychotic medication. Schizophrenia Research, 83(1), 87-93.
15.
De HertM.YuW.DetrauxJ.SweersK.Van WinkelR.CorrellC. U. (2012). Body weight and metabolic adverse effects of asenapine, iloperidone, lurasidone and paliperidone in the treatment of schizophrenia and bipolar disorder: A systematic review and exploratory meta-analysis. CNS Drugs, 26, 733-759. doi:10.2165/11634500-000000000-00000
16.
EdwardK.-L.RasmussenB.MunroI. (2010). Nursing care of clients treated with atypical antipsychotics who have a risk of developing metabolic instability and/or type 2 diabetes. Archives of Psychiatric Nursing, 24, 46-53. doi:10.1016/j.apnu.2009.04.009
17.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. (2001). Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA, 285, 2486-2497.
18.
Fernández-BergésD.Cabrera de LeónA.SanzH.ElosuaR.GuembeM. J.AlzamoraM.. . . MarrugatJ. (2012). Metabolic syndrome in Spain: Prevalence and coronary risk associated with harmonized definition and WHO proposal (DARIOS Study). Revista Española de Cardiología, 65, 241-248. doi:10.1016/j.rec.2011.10.017
19.
FernándezS.MiguelC.EgeaE. N.GallegoM.RubioM.C. (2017). Physical health promotion program for patients with serious mental illness. Rev Presencia, 13. Retrieved from http://www.index-f.com/p2e/v13/e11521.php (Original work published in Spanish)
20.
FoguetQ.RouraP.BullónA.MauriC.GordoN.CostaR. C., & RISCA-TMS. (2013). Factors of cardiovascular risk, cardiovascular risk and quality of life in patients with severe mental disorder. Atención Primaria, 45(3), 141-148. doi:10.1016/j.aprim.2012.10.010. (Original work published in Spanish)
21.
HappellB.DaviesC.ScottD. (2012). Health behaviour interventions to improve physical health in individuals diagnosed with a mental illness: A systematic review. International Journal of Mental Health Nursing, 21, 236-247. doi:10.1111/j.1447-0349.2012.00816.x
22.
HappellB.ScottD.NankivellJ.Platania-PhungC. (2013). Screening physical health? Yes! But . . . nurses’ views on physical health screening in mental health care. Journal of Clinical Nursing, 22, 2286-2297. doi:10.1111/j.1365-2702.2012.04325.x
23.
HappellB.StantonR.HoeyW.ScottD. (2014). Cardiometabolic health nursing to improve health and primary care access in community mental health patients: Protocol for a randomised controlled trial. International Journal of Nursing Studies, 51, 236-242. doi:10.1016/j.ijnurstu.2013.06.004
24.
HeathertonT. F.KozlowskiL. T.FreckerR. C.FagerströmK. O. (1991). The Fagerström Test for Nicotine Dependence: A revision of the Fagerström Tolerance Questionnaire. British Journal of Addiction, 86, 1119-1127.
25.
Joffre-VelázquezV. M.García-MaldonadoG.Saldívar-GonzálezA. H.Lin-OchoaD.Sosa-HerreraJ. (2009). Psychiatric disease and metabolic syndrome. Emphasis on schizophrenic disorder. Medical Journal of the General Hospital, 72(1), 41-49. Retrieved from http://www.medigraphic.com/pdfs/h-gral/hg-2009/hg091h.pdf (Original work published in Spanish)
26.
LiebermanJ. A.StroupS.McEvoyJ. P.SwartzM. S.RosenheckR. A.PerkinsD. O.HsiaoJ. K. (2005). Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. New England Journal of Medicine, 353, 1209-1223. doi:10.1056/NEJMoa051688
27.
LooijmansA.JörgF.BruggemanR.SchoeversR.CorpeleijnE. (2017). Design of the Lifestyle Interventions for severe mentally ill Outpatients in the Netherlands (LION) trial: a cluster randomised controlled study of a multidimensional web tool intervention to improve cardiometabolic health in patients with severe mental illness. BMC Psychiatry, 17, 107. doi:10.1186/s12888-017-1265-7
28.
MajM. (2009). Physical health care in persons with severe mental illness: A public health and ethical priority. World Psychiatry: Official Journal of the World Psychiatric Association, 8(1), 1-2. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645006/
29.
McEvoyJ. P.MeyerJ. M.GoffD. C.NasrallahH. A.DavisS. M.SullivanL.. . . LiebermanJ. A. (2005). Prevalence of the metabolic syndrome in patients with schizophrenia: Baseline results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III. Schizophrenia Research, 80, 19-32. doi:10.1016/j.schres.2005.07.014
30.
Ministry of Labour and Social Affairs. (2007). Model of care for people with severe mental illness. Madrid, Spain: Institute for the Elderly and Social Services (IMSERSO).
31.
National Collaborating Centre for Mental Health. (Ed). (2014). Psychosis and schizophrenia in adults: Treatment and management. London, England: National Institute for Health and Care Excellence.
32.
National Institute of Mental Health. (1987). Towards a model for a comprehensive community based mental health system. Washington, DC: Author.
33.
Nursing Care Advisory Committee. (2010). Manual of procedures for community mental health nursing in the community of Madrid. Madrid, Spain: Madrid Healthcare Service, Regional Mental Health Coordination Office. (Original Work Published in Spanish)
34.
ReynoldsG. P.KirkS. L. (2010). Metabolic side effects of antipsychotic drug treatment—Pharmacological mechanisms. Pharmacology & Therapeutics, 125(1), 169-179.
35.
RichardsL.BatschaC. L.LanderV. (2016). Lifestyle and behavioural interventions to reduce the risk of metabolic syndrome in community dwelling adults with serious mental illness: Implications for nursing practice. Journal of Psychosocial Nursing, 54(1), 46-55.
36.
SáizJ.BobesJ.VallejoJ.GinerJ.García-PortillaM. P. (2008). Consensus on physical health of patients with schizophrenia from the Spanish Societies of Psychiatry and Biological Psychiatry. Actas Españolas de Psiquiatría, 36, 251-264. (Original Work Published in Spanish)
37.
Van HasseltF. M.SchorrS. G.MookhoekE. J.BrouwersJ.LoonenA.TaxisK. (2013). Gaps in health care for the somatic health of outpatients with severe mental illness. International Journal of Mental Health Nursing, 22, 249-255. doi:10.1111/j.1447-0349.2012.00859.x
38.
Van MeijelB.Van HamersveldS.Van GoolR.Van der BijlJ.Van HartenP. (2014). Effects and feasibility of the “traffic light method for somatic screening and lifestyle” in patients with severe mental illness: A pilot study. Perspectives in Psychiatric Care, 51, 106-113. doi:10.1111/ppc.12071
39.
VeraE. M.AguadoR.CastañoM. A.LópezS.MartínB.DuránF. (2014). Evolution of the prevalence of the metabolic syndrome in people with severe mental disorder and nursing intervention. Presencia, 10(20). Retrieved from http://www.index-f.com/presencia/n20/p9358.php (Original Work Published in Spanish)
