scholarly journals Colorectal cancer Outcomes in people with Severe Mental Illness Cohort (COSMIC): a protocol for an Australian retrospective cohort using linked administrative data

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044737
Author(s):  
Melinda M Protani ◽  
Susan J Jordan ◽  
Bradley J Kendall ◽  
Dan Siskind ◽  
David Lawrence ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Mental Illness ◽  
General Population ◽  
Severe Mental Illness ◽  
Administrative Data ◽  
Antipsychotic Medication ◽  
Cancer Care ◽  
Retrospective Cohort ◽  
Ethics Committee ◽  
Incidence Rates

IntroductionColorectal cancer (CRC) mortality is significantly higher in those with severe mental illness (SMI) compared with the general population, despite similar incidence rates, suggesting that barriers to optimal screening and cancer care may contribute to disparities in CRC mortality in those with SMI. This study aims to compare participation in Australia’s National Bowel Cancer Screening Programme (NBCSP) in those with SMI and those in the general population. We will also investigate treatment pathways after diagnosis to determine whether treatment variations could explain differences in CRC mortality.Methods and analysisWe will undertake a retrospective cohort study of Australians using linked administrative data to assess differences in screening and cancer care between those with and without SMI, aged 50–74 years on or after 1 January 2006. People with SMI will be defined using antipsychotic medication prescription data. The comparison group will be people enrolled in Medicare (Australia’s universal healthcare system) who have not been prescribed antipsychotic medication. Data on outcomes (NBCSP participation, follow-up colonoscopy, CRC incidence and CRC-cause and all-cause mortality) and confounders will be obtained from national-based and state-based administrative health datasets. All people in New South Wales, aged 50–74 with a new diagnosis of CRC on or after 1 January 2006, will be ascertained to examine stage at diagnosis and cancer treatment in those with and without SMI. Poisson regression will be used to calculate incidence rates and rate ratios for each outcome.Ethics and disseminationEthics approval has been obtained from the University of Queensland Human Research Ethics Committee, the Australian Institute of Health and Welfare Ethics Committee and data custodians from every Australian State/Territory. Findings will be disseminated via publications in peer-reviewed journals and presented at appropriate conferences.Trial registration numberACTRN12620000781943.

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 Review of smoking cessation treatments for people with mental illness

2008 ◽  
Vol 14 (3) ◽  
pp. 208-216 ◽  
Author(s):  
Jonathan Campion ◽  
Ken Checinski ◽  
Jo Nurse
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Smoking Cessation ◽  
General Population ◽  
Antipsychotic Medication ◽  
Gold Standard ◽  
Standard Treatment ◽  
Mental Health Problems ◽  
Quit Smoking ◽  
People With Mental Illness

This article reviews the current literature regarding treatments for smoking cessation in both the general population and in those with mental health problems. The gold-standard treatment for the general population is pharmacotherapy (nicotine replacement therapy, bupropion or varenicline) coupled with individual or group psychological support. This is also effective in helping people with mental illness to reduce or quit smoking, but care must be taken to avoid adverse medication interactions and to monitor antipsychotic medication in particular as cigarette consumption reduces.

scholarly journals High risk of metabolic syndrome among black South African women with severe mental illness

2017 ◽  
Vol 23 ◽  
Author(s):  
Shamima Saloojee ◽  
Jonathan K. Burns ◽  
Ayesha A. Motala
Keyword(s):  
Metabolic Syndrome ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
South African ◽  
Antipsychotic Medication ◽  
Matched Control ◽  
Control Group ◽  
Men And Women ◽  
Matched Control Group ◽  
Black South African

Background: There is an increased prevalence of metabolic syndrome (MetS) in individuals with severe mental illness (SMI) globally. The prevalence of MetS is higher in black women compared to black men from South Africa.Aim: To compare the prevalence of MetS between black South African men and women with SMI taking antipsychotic medication. Further, this prevalence was compared to the prevalence in a matched control group of black South African men and women without SMI. Setting: A general hospital psychiatric unit.Methods: A cross-sectional study was undertaken to compare the prevalence of MetS in a group of multi-ethnic participants with SMI treated with antipsychotic medication and a matched control group without SMI, applying the 2009 Joint Interim Statement (JIS) criteria. Here, we included only the black African participants to compare MetS prevalence between men and women.Results: There were 232 participants in the group with SMI (male 155 and female 77) and without SMI (male 156 and female 76). The prevalence of MetS was more than three times higher in women with SMI compared to men with SMI (37.7% vs. 10.3%, p < 0.001). There was no significant difference in the prevalence of MetS in men or women between the groups with and without SMI. In multivariate logistic regression analysis, female gender (odds ratio [OR] 7.66), advancing age (OR 1.08) and longer duration of illness (OR = 1.15) were significant risk factors for MetS in SMI.Conclusion: In black South Africans with SMI on antipsychotic medication, there is a higher prevalence and risk for MetS in women compared to men.

scholarly journals Mammography Among Women With Severe Mental Illness: Exploring Disparities Through a Large Retrospective Cohort Study

2018 ◽  
Vol 69 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Melanie Thomas ◽  
Monique James ◽  
Eric Vittinghoff ◽  
Jennifer M. Creasman ◽  
Dean Schillinger ◽  
...  
Keyword(s):  
Mental Illness ◽  
Cohort Study ◽  
Severe Mental Illness ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort

Police Violence among Adults Diagnosed with Mental Disorders

2020 ◽  
Vol 45 (2) ◽  
pp. 81-89
Author(s):  
Hyun-Jin Jun ◽  
Jordan E DeVylder ◽  
Lisa Fedina
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
General Population ◽  
Mental Disorders ◽  
Severe Mental Illness ◽  
Violence Exposure ◽  
Health Conditions ◽  
Psychotic Symptoms ◽  
Police Violence ◽  
Mental Health Conditions

Abstract Police violence is reportedly common among those diagnosed with mental disorders characterized by the presence of psychotic symptoms or pronounced emotional lability. Despite the perception that people with mental illness are disproportionately mistreated by the police, there is relatively little empirical research on this topic. A cross-sectional general population survey was administered online in 2017 to 1,000 adults in two eastern U.S. cities to examine the relationship between police violence exposure, mental disorders, and crime involvement. Results from hierarchical logistic regression and mediation analyses revealed that a range of mental health conditions are broadly associated with elevated risk for police violence exposure. Individuals with severe mental illness are more likely than the general population to be physically victimized by police, regardless of their involvement in criminal activities. Most of the excess risk of police violence exposure related to common psychiatric diagnoses was explained by confounding factors including crime involvement. However, crime involvement may necessitate more police contact, but does not necessarily justify victimization or excessive force (particularly sexual and psychological violence). Findings support the need for adequate training for police officers on how to safely interact with people with mental health conditions, particularly severe mental illness.

scholarly journals Effectiveness and cost-effectiveness of a cardiovascular risk prediction algorithm for people with severe mental illness (PRIMROSE)

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e018181 ◽  
Author(s):  
Ella Zomer ◽  
David Osborn ◽  
Irwin Nazareth ◽  
Ruth Blackburn ◽  
Alexandra Burton ◽  
...  
Keyword(s):  
Mental Illness ◽  
Cardiovascular Risk ◽  
Cost Effectiveness ◽  
General Population ◽  
Cost Saving ◽  
Severe Mental Illness ◽  
Secondary Outcome ◽  
Health Improvement ◽  
Parameter Estimates ◽  
Life Years

ObjectivesTo determine the cost-effectiveness of two bespoke severe mental illness (SMI)-specific risk algorithms compared with standard risk algorithms for primary cardiovascular disease (CVD) prevention in those with SMI.SettingPrimary care setting in the UK. The analysis was from the National Health Service perspective.Participants1000 individuals with SMI from The Health Improvement Network Database, aged 30–74 years and without existing CVD, populated the model.InterventionsFour cardiovascular risk algorithms were assessed: (1) general population lipid, (2) general population body mass index (BMI), (3) SMI-specific lipid and (4) SMI-specific BMI, compared against no algorithm. At baseline, each cardiovascular risk algorithm was applied and those considered high risk (>10%) were assumed to be prescribed statin therapy while others received usual care.Primary and secondary outcome measuresQuality-adjusted life years (QALYs) and costs were accrued for each algorithm including no algorithm, and cost-effectiveness was calculated using the net monetary benefit (NMB) approach. Deterministic and probabilistic sensitivity analyses were performed to test assumptions made and uncertainty around parameter estimates.ResultsThe SMI-specific BMI algorithm had the highest NMB resulting in 15 additional QALYs and a cost saving of approximately £53 000 per 1000 patients with SMI over 10 years, followed by the general population lipid algorithm (13 additional QALYs and a cost saving of £46 000).ConclusionsThe general population lipid and SMI-specific BMI algorithms performed equally well. The ease and acceptability of use of an SMI-specific BMI algorithm (blood tests not required) makes it an attractive algorithm to implement in clinical settings.

scholarly journals Social exclusion of people with severe mental illness in Switzerland: results from the Swiss Health Survey

2017 ◽  
Vol 28 (04) ◽  
pp. 427-435 ◽  
Author(s):  
D. Richter ◽  
H. Hoffmann
Keyword(s):  
Mental Illness ◽  
General Population ◽  
Severe Mental Illness ◽  
Social Exclusion ◽  
Health Survey ◽  
Social Situation ◽  
Physical Illness ◽  
Swiss Health Survey ◽  
Swiss Health ◽  
The Social

Aims.People with severe mental illness (SMI) have a high risk of living socially excluded from the mainstream society. Policy initiatives and health systems aim to improve the social situation of people who suffer from mental health disabilities. The aim of this study was to explore the extent of social exclusion (employment and income, social network and social activities, health problems) of people with SMI in Switzerland.Methods.Data from the Swiss Health Survey 2012 were used to compare the social exclusion magnitude of people with SMI with those suffering from severe physical illness, common mental illness and the general population.Results.With the exception of Instrumental Activities of Daily Living, we found a gradient of social exclusion that showed people with SMI to be more excluded than the comparison groups. Loneliness and poverty were widespread among people with SMI. Logistic regression analyses on each individual exclusion indicator revealed that people with SMI and people with severe physical illness were similarly excluded on many indicators, whereas people with common mental illness and the general population were much more socially included.Conclusions.In contrast to political and health system goals, many people with SMI suffer from social exclusion. Social policy and clinical support should increase the efforts to counter exclusionary trends, especially in terms of loneliness and poverty.

Sign in / Sign up

Export Citation Format

Share Document