scholarly journals Oral health inequality in people with severe mental illness: a cross-sectional study using National Health and Nutrition Examination Survey 1999-2016

2021 ◽  
Author(s):  
Jing Kang ◽  
Jianhua Wu ◽  
Vishal Aggarwal ◽  
David Shiers ◽  
Tim Doran ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mental Illness ◽  
Oral Health ◽  
General Population ◽  
Health Outcomes ◽  
Severe Mental Illness ◽  
Tooth Loss ◽  
List Type ◽  
Cross Sectional ◽  
Oral Health Outcomes

AbstractOBJECTIVETo explore whether people with severe mental illness (SMI) experience worse oral health compared to the general population, and the risk factors for poor oral health in people with SMI.METHODThis study used cross-sectional data from the National Health and Nutrition Examination Survey (1999-2016) including on self-rated oral health, ache in mouth, tooth loss, periodontitis stage, and number of decayed, missing, and filled teeth. Candidate risk factors for poor oral health included demographic characteristics, lifestyle factors, physical health comorbidities, and dental hygiene behaviours. The authors used ordinal logistic regression and zero-inflated negative binomial models to explore predictors of oral health outcomes.RESULTS53,348 cases were included in the analysis, including 718 people with SMI. In the fully adjusted model, people with SMI were more likely to suffer from tooth loss (OR 1.40, 95% CI: 1.12-1.75). In people with SMI, the risk factors identified for poor oral health outcomes were older age, white ethnicity, lower income, smoking history, and diabetes. Engaging in physical activity and daily use of dental floss were associated with better oral health outcomes.CONCLUSIONSPeople with SMI experience higher rates of tooth loss than the general population, and certain subgroups are particularly at risk. Having a healthy lifestyle such as performing regular physical exercise and flossing may lower the risk of poor oral health. These findings suggest opportunities for targeted prevention and early intervention strategies to mitigate adverse oral health outcomes.Significant outcomes (x3)People with severe mental illness were at 40% higher risk of tooth loss when compared to the general population.Older adults, smokers and people with diabetes were at particularly high risk of poor oral health.Physical exercise and daily use of dental floss were associated with better oral health outcomes.Limitations (x3)The number of cases with data on periodontal disease was limited.The study was cross-sectional so causation could not be inferred.The analysis used prescriptions of antipsychotic and mood stabilising medication as a proxy measure of severe mental illness, as clinical diagnoses were not available in the dataset.Data availability statementThe NHANES 1999-2016 data is available at CDC website: https://www.cdc.gov/nchs/nhanes/index.htm, and is accessible and free to download for everyone.

scholarly journals The physical health of people with severe mental illness in Bangladesh and Pakistan: A cross-sectional survey

2021 ◽  
Author(s):  
Gerardo Antonio Zavala ◽  
Asiful Haidar ◽  
Krishna Prasad-Muliyala ◽  
Faiza Aslam ◽  
Rumana Huque ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mental Illness ◽  
General Population ◽  
Health Risk ◽  
Severe Mental Illness ◽  
Common Mental Disorders ◽  
Risk Behaviours ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Health Risk Behaviours

Abstract BackgroundPeople with severe mental illness (SMI) die earlier than the general population, primarily due to physical disorders. There is limited information on physical illnesses and health-risk behaviours in people with SMI in low and middle-income countries.MethodsWe conducted a cross-sectional survey in adults with SMI attending specialist mental health services in Bangladesh and Pakistan. Data were collected on non-communicable diseases (NCDs), their risk factors, health-risk behaviours, treatments and health risk modification advice (using questions from the WHO STEPwise approach to Surveillance of NCDs (STEPS)) and on common mental disorders, health-related quality of life and infectious diseases. We performed a descriptive analysis, and compared weighted prevalence for these variables in our survey with prevalence for the general population in the STEPS reports from Bangladesh and Pakistan.ResultsWe recruited 2,344 participants with bipolar disorder (36.7%), non-affective psychosis (42.2%), and depression with psychosis (21.1%). Eight percent had diabetes, 24.7% hypertension and 3.1% tuberculosis. 43.4% were overweight or obese, and half had hypercholesterolemia. Most participants with diabetes, hypertension and hypercholesterolemia were previously undiagnosed; of those diagnosed only around half were receiving treatment. Fifty-four percent of men and 17.2% of women used tobacco; 46.9% and 87.1% did not meet WHO recommendations for physical activity and fruit and vegetable intake respectively. Compared with the general population, people with SMI were more likely to have diabetes (O.R.=1.56,95%C.I.=1.30 to 1.88 Bangladesh), hypercholesterolemia (O.R.=2.35,95%C.I.=2.08 to 2.65 Bangladesh) and overweight or obesity (O.R.=1.97, 95%C.I.=1.75 to 2.22 Bangladesh; O.R.=1.61,95%C.I.=1.40 to 1.86 Pakistan). They were less likely to receive tobacco cessation (O.R.=0.33,95%C.I.=0.26 to 0.42 Bangladesh; O.R.=0.42,95%C.I.=0.31 to 0.55 Pakistan), and weight management advice (O.R.=0.51,95%C.I.=0.41 to 0.63 Bangladesh; and O.R.=0.65,95%C.I.=0.51 to 0.82 Pakistan).ConclusionDespite the high prevalence we found significant gaps in detection, prevention and treatment of NCDs and their risk factors in people with SMI.RegistrationISRCTN88485933; https://doi.org/10.1186/ISRCTN88485933

scholarly journals Improving oral health in people with severe mental illness (SMI): A systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260766
Author(s):  
Alexandra Macnamara ◽  
Masuma Pervin Mishu ◽  
Mehreen Riaz Faisal ◽  
Mohammed Islam ◽  
Emily Peckham
Keyword(s):  
Systematic Review ◽  
Mental Illness ◽  
Oral Health ◽  
Health Outcomes ◽  
Motivational Interviewing ◽  
Severe Mental Illness ◽  
Dental Education ◽  
Grey Literature ◽  
Health Interventions ◽  
Oral Health Outcomes

Background Those with severe mental illness (SMI) are at greater risk of having poor oral health, which can have an impact on daily activities such as eating, socialising and working. There is currently a lack of evidence to suggest which oral health interventions are effective for improving oral health outcomes for people with SMI. Aims This systematic review aims to examine the effectiveness of oral health interventions in improving oral health outcomes for those with SMI. Methods The review protocol was registered with PROSPERO (ID CRD42020187663). Medline, EMBASE, PsycINFO, AMED, HMIC, CINAHL, Scopus and the Cochrane Library were searched for studies, along with conference proceedings and grey literature sources. Titles and abstracts were dual screened by two reviewers. Two reviewers also independently performed full text screening, data extraction and risk of bias assessments. Due to heterogeneity between studies, a narrative synthesis was undertaken. Results In total, 1462 abstracts from the database search and three abstracts from grey literature sources were identified. Following screening, 12 studies were included in the review. Five broad categories of intervention were identified: dental education, motivational interviewing, dental checklist, dietary change and incentives. Despite statistically significant changes in plaque indices and oral health behaviours as a result of interventions using dental education, motivational interviewing and incentives, it is unclear if these changes are clinically significant. Conclusion Although some positive results in this review demonstrate that dental education shows promise as an intervention for those with SMI, the quality of evidence was graded as very low to moderate quality. Further research is in this area is required to provide more conclusive evidence.

scholarly journals Comorbidity associated with Severe Mental illness (The APNA study)

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
I Aguinaga-Ontoso ◽  
A Brugos-Larumbe ◽  
S Guillén-Aguinaga
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Chronic Disease ◽  
General Population ◽  
Health Services ◽  
Severe Mental Illness ◽  
Chronic Diseases ◽  
Poor Mental Health ◽  
Cross Sectional ◽  
Age And Sex

Abstract People with severe mental illness (SMI) that includes bipolar disorder or schizophrenia die on average 10-20 years sooner than the general population. Poor mental health can negatively affect quality of life and life expectancy more so than having multiple physical illnesses. The division between health services treating mental and physical health often means that patients suffering from both physical and mental conditions are at particular risk of poor care. Although more than 50 million people in the EU suffer multiple from more than one chronic disease, it is not well know the comorbidity associated with severe mental illness. Methods The study is a cross-sectional study within the APNA Study (Navarre primary health care prospective cohort) that included 470942 people over 18 years old in Navarre (Spain). Age, sex, chronic diseases diagnosis and SMI) that includes (bipolar disorder or schizophrenia were extracted. Lineal regression models for the number of chronic disease were computed. Logistic regression adjusted by sex and age, was computed for each chronic disease. Results Adjusting by age and sex, people with SMI have 1.47 (95% CI 1.44-1.50) more chronic diseases than people without SMI. Adjusting by age and sex, persons with SMI have a higher prevalence of comorbidity: OR = 13.29 (95% CI = 12.27-14.36). Patients with SMI have a higher prevalence of asthma OR = 1.41 (95% CI 1.21-1.64), COPD OR = 2.30 (95% CI 2.51-3.35), Type 2 DM OR = 1.50 (95% CI 1.31-1.70) hyperthyroidism OR = 1.63 (95% CI 1.26-2.10), Chronic kidney disease OR = 1.,43 (95% IC 1.10-1.88), Obesity OR = 1.68 (95% CI 1.47-1,92) and Hypothyroidism OR 1.63 (95% IC 1.43-1,85). Conclusions Patients with severe mental illness have a higher prevalence of comorbidity than the general population with an OR of 13.29. Health service should screen patient with severe mental illness for chronic diseases due to their high prevalence and mortality. Key messages Patients with severe mental illness die on average 10-20 years sooner than the general population this could be to a higher prevalence of comorbidity. Health services should screen patients with severe mental illness for chronic diseases due to their higher prevalence.

scholarly journals Victimisation in adults with severe mental illness: Prevalence and risk factors

2015 ◽  
Vol 207 (6) ◽  
pp. 515-522 ◽  
Author(s):  
Liselotte D. de Mooij ◽  
Martijn Kikkert ◽  
Nick M. Lommerse ◽  
Jaap Peen ◽  
Sabine C. Meijwaard ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mental Illness ◽  
General Population ◽  
Severe Mental Illness ◽  
Sheltered Housing ◽  
Property Crimes ◽  
High Prevalence ◽  
Violent Victimisation ◽  
The Relationship ◽  
Housing Facility

BackgroundPatients with a severe mental illness (SMI) are more likely to experience victimisation than the general population.AimsTo examine the prevalence of victimisation in people with SMI, and the relationship between symptoms, treatment facility and indices of substance use/misuse and perpetration, in comparison with the general population.MethodVictimisation was assessed among both randomly selected patients with SMI (n = 216) and the general population (n=10 865).ResultsCompared with the general population, a high prevalence of violent victimisation was found among the SMI group (22.7% v. 8.5%). Compared with out-patients and patients in a sheltered housing facility, in-patients were most often victimised (violent crimes: 35.3%; property crimes: 47.1%). Risk factors among the SMI group for violent victimisation included young age and disorganisation, and risk factors for property crimes included being an in-patient, disorganisation and cannabis use. The SMI group were most often assaulted by someone they knew.ConclusionsCaregivers should be aware that patients with SMI are at risk of violent victimisation. Interventions need to be developed to reduce this vulnerability.

scholarly journals Cardiovascular risk factors among people with severe mental illness in Italy: A cross-sectional comparative study

2014 ◽  
Vol 36 (6) ◽  
pp. 698-702 ◽  
Author(s):  
Massimo Clerici ◽  
Francesco Bartoli ◽  
Daniele Carretta ◽  
Cristina Crocamo ◽  
Paul Bebbington ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mental Illness ◽  
Cardiovascular Risk ◽  
Comparative Study ◽  
Severe Mental Illness ◽  
Cardiovascular Risk Factors ◽  
Cross Sectional

scholarly journals Cardiovascular risk in patients with severe mental illness in Italy

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
Virginio Salvi ◽  
Andrea Aguglia ◽  
Francesco Barone-Adesi ◽  
Davide Bianchi ◽  
Chiara Donfrancesco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Mental Illness ◽  
General Population ◽  
Severe Mental Illness ◽  
Smoking Habit ◽  
Density Lipoprotein ◽  
Bipolar Disorders ◽  
Risk Algorithm ◽  
Younger Age

Abstract Background Patients with severe mental illness (SMI), such as schizophrenia or bipolar disorders, are more frequently affected by metabolic syndrome and cardiovascular (CV) diseases than the general population, with a significant reduction in life expectancy. Beyond metabolic syndrome, quantifying the risk of CV morbidity in the long-term may help clinicians to put in place preventive strategies. In this study, we assessed 10-year CV risk in patients with SMI and healthy individuals using an algorithm validated on the Italian general population. Methods Patients aged 35–69 years diagnosed with SMI were consecutively recruited from psychiatric acute care units. Single CV risk factors were assessed, and 10-year CV risk calculated by means of the CUORE Project 10-year CV risk algorithm, based on the combination of the following risk factors: age, systolic blood pressure, total and high-density lipoprotein cholesterol, diabetes, smoking habit, and hypertensive treatment. Patients’ data were compared with those from the general population. The 10-year CV risk was log-transformed, and multivariable linear regression was used to estimate mean ratios, adjusting for age, and education. Results Three hundred patients and 3,052 controls were included in the analysis. Among men, the 10-year CV risk score was very similar between patients with SMI and the general population (mean ratio [MR]: 1.02; 95%CI 0.77–1.37), whereas a 39% increase in 10-year CV risk was observed in women with SMI compared to the general population (MR: 1.39; 95%CI 1.16–1.66). Conclusions In our study, women with SMI were consistently more at risk than the general population counterpart, even at younger age.

scholarly journals Beverages Consumption and Oral Health in the Aging Population: A Systematic Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Roberta Zupo ◽  
Fabio Castellana ◽  
Sara De Nucci ◽  
Vittorio Dibello ◽  
Madia Lozupone ◽  
...  
Keyword(s):  
Systematic Review ◽  
Oral Health ◽  
Periodontal Disease ◽  
Health Outcomes ◽  
Tooth Loss ◽  
Alcohol Intake ◽  
Aging Population ◽  
Alcoholic Beverages ◽  
Sugary Drinks ◽  
Oral Health Outcomes

Little study has yet been made of the effect of different beverages on oral health outcomes in the aging population. The purpose of this systematic review is to evaluate the association between different beverages, including alcohol intake, coffee, milk, tea, and sugary drinks, and a cluster of oral health outcomes, including periodontal disease, oral dysbiosis, and tooth loss in older adults. The literature was screened from the inception up to May 2021 using six different electronic databases. Two independent researchers assessed the eligibility of 1308 retrieved articles regarding inclusion criteria; only 12 fitted the eligibility requirements, representing 16 beverage entries. A minimum age of 60 was the inclusion criterion. No exclusion criteria were applied to outcomes assessment tools, recruiting facilities (hospital or community), general health status, country, and study type (longitudinal or cross-sectional). The consumption of alcoholic beverages was expressed as alcohol intake in all eligible studies, thereby replacing alcoholic beverages in the analysis. The quality of evidence was judged as moderate for alcohol and low or very low for beverages. In regard to oral health in the elderly, the review identified information on alcohol (56.25%), followed by coffee (18.75%), milk (12.50%), tea (6.25%), and sugary drinks (6.25%). Alcohol, sugary drinks, and coffee were found to be related to tooth loss. Periodontal disease was inversely related to coffee and milk, but fostered by alcohol consumption. In one article, tea but not coffee seemed to improve oral microbiota. In summary, alcohol seems to be a driver for tooth loss and periodontal disease in the aging population. However, more research is needed to gain a more solid knowledge in this research area.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, PROSPERO, Identifier: CRD42021256386.

scholarly journals Adverse Childhood Experiences and Oral Health Outcomes in U.S. Children and Adolescents: A Cross-Sectional Study of the 2016 National Survey of Children’s Health

2021 ◽  
Vol 18 (23) ◽  
pp. 12313
Author(s):  
Alyssa Simon ◽  
Jamie Cage ◽  
Aderonke Akinkugbe
Keyword(s):  
Oral Health ◽  
Health Outcomes ◽  
Children And Adolescents ◽  
National Survey ◽  
Adverse Childhood Experiences ◽  
Cross Sectional ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Fair Poor ◽  
Oral Health Outcomes

This study investigated the cross-sectional associations between exposure to nine Adverse Childhood Experiences (ACEs) and U.S. children’s and adolescent’s oral health outcomes. Data from 41,294 participants of the 2016 National Survey of Children’s Health (NSCH) were analyzed. Past year exposure to ACE, oral health outcomes (decayed teeth, bleeding gums, and condition of the teeth), and child and caregiver sociodemographic factors were self-reported. Using SAS v. 9.4, propensity score weighted, multilevel survey-logistic regression estimated adjusted odds ratios (AORs) and 95% Confidence Intervals (CIs) of the proposed associations. The overall mean (SE) age was 8.9 (0.1) years with 51% being male. Fifty-four percent (54%) identified as non-Hispanic white, and 12% as non-Hispanic black. The prevalence of the nine ACE measures ranged from 3% for caregiver death to 25% for financial hardship and parental divorce. Children who experienced caregiver mental illness, when compared to those who did not, were more likely to report decayed teeth (AOR: 1.73 (95% CI: 1.24, 2.42)) and the condition of their teeth as fair/poor (AOR: 1.60, 95% CI: 0.61, 4.19). Children in households with financial hardship were about twice as likely to report dental caries (AOR: 1.85, 95% CI: 1.50, 2.29) and have fair/poor teeth (AOR: 1.87, 95% CI: 1.40, 2.51) and bleeding gums (AOR: 2.39, 95% CI: 1.48, 3.86). ACEs appear to be associated with worse oral health outcomes among children and adolescents. Nevertheless, the cross-sectional nature of this study precludes a causal interpretation of these findings and necessitates more research to elucidate the oral health impacts of exposure to ACEs in longitudinal follow-up studies.

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