scholarly journals Serious physical assault and subsequent risk for rehospitalization in individuals with severe mental illness: a nationwide, register-based retrospective cohort study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Karolina Mlada ◽  
Tomas Formanek ◽  
Jan Vevera ◽  
Klara Latalova ◽  
Petr Winkler ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Psychiatric Hospitalization ◽  
Psychiatric Evaluation ◽  
Physical Assault ◽  
Mixed Effect ◽  
Drug Use Disorders ◽  
Increased Risk ◽  
Clinical Consequences ◽  
Serious Injuries

Abstract Background Victimization is associated with worse social and clinical outcomes of individuals with severe mental illness (SMI). A relapse of SMI may be one of the clinical consequences of assaultive trauma. As far as we know, there is no published study that analyzes nationwide health registers to assess the risk of SMI rehospitalization following assault. Aim We aimed to assess whether exposure to assault is associated with an increased risk of psychiatric hospitalization in those with SMI. Methods We utilized data from the Czech nationwide registers of all-cause hospitalizations and all-cause deaths. We defined exposed individuals as those discharged from a hospitalization for SMI between 2002 and 2007, and hospitalized for serious injuries sustained in an assault in the subsequent 7 years. For each assaulted individual, we randomly selected five counterparts, matched on SMI diagnosis, age and sex, who were not assaulted in the examined time period. We used mixed effect logistic regression to assess the effect of assault on the risk of SMI rehospitalization within the following 6 months. We fitted unadjusted models and models adjusted for the number of previous SMI hospitalizations and drug use disorders. Results The sample consisted of 248 exposed and 1 240 unexposed individuals. In the unadjusted model, assaulted individuals were almost four times more likely to be rehospitalized than their non-assaulted counterparts (odds ratio (OR) = 3.96; 95% CI 2.75; 5.71). After adjusting for all covariates, the OR remained threefold higher (OR = 3.07; 95% CI 2.10; 4.49). Conclusion People with a history of SMI hospitalization were approximately three times more likely to be rehospitalized for SMI within 6 months after an assault than their non-assaulted SMI counterparts. Soon after a person with SMI is physically assaulted, there should be a psychiatric evaluation and a close follow-up.

Physical activity as an intervention in severe mental illness

2021 ◽  
pp. 1-10
Author(s):  
Aaron A. Kandola ◽  
David P. J. Osborn
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Mental Illness ◽  
Physical Health ◽  
Severe Mental Illness ◽  
Routine Practice ◽  
Physical And Mental Health ◽  
Increased Risk ◽  
Physical Health Problems ◽  
Health Complications

SUMMARY Physical activity is a modifiable risk factor for several physical and mental health conditions. It is well established that people with severe mental illness have increased risk of physical health complications, particularly cardiovascular disease. They are also more likely to be physically inactive, contributing to the elevated cardiovascular and metabolic risks, which are further compounded by antipsychotic medication use. Interventions involving physical activity are a relatively low risk and accessible way of reducing physical health problems and weight in people with severe mental illness. They also have wider benefits for mental health symptoms and quality of life. However, many barriers still exist to the widespread implementation of physical activity interventions in the treatment of severe mental illness. A more concerted effort is needed to facilitate their translation into routine practice and to increase adherence to activity interventions.

Severe Mental Illness and Cancer – A Program for Psychiatric Patients in a Cancer Center

2017 ◽  
Vol 41 (S1) ◽  
pp. S670-S670
Author(s):  
J. Graça ◽  
F. Silva Carvalho ◽  
R. Ramos Coutinho ◽  
A. Ribeiro ◽  
L. Monteiro
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Psychiatric Patients ◽  
Cancer Center ◽  
Health Staff ◽  
Mental Health Staff ◽  
Oncological Treatment ◽  
Increased Risk ◽  
Co Morbidity

IntroductionThe prevalence of severe mental illness (SMI) is estimated to be 4%. There are increased risk factors for cancer in SMI patients. People with SMI have deficient access and referral to routine cancer screening and psychiatric illness is often associated to late oncological diagnosis.ObjectivesCharacterize the population of SMI patients that undergoes oncological treatment; establish a comparison with the general population in terms of stage at the time of diagnosis and the type of follow-up that ensued; characterize the psychiatric care available to these patients; propose the necessary changes to ensure adequate healthcare for SMI patients.AimsTo assess and improve the quality of oncological care for SMI patients in our hospital.MethodsWe analyzed the data from SMI patients suffering from SMI observed by our group during a 12 month period.ResultsLow percentage of SMI patients being treated in our center regarding general rates; surprisingly high referral time to psychiatry unity; good compliance with treatments and appointments; have mostly been submitted to the standard oncological protocols of treatment.ConclusionIn spite of serious psychiatric co-morbidity and psychosocial deficits, our SMI patients are able for standard cancer treatment and present sufficient compliance. We value the help of family members and social workers. We have to insist in educational sessions and psychiatric screening procedures for oncological teams. It is also fundamental to implement educational programs for mental health centers in Lisbon in order to sensitize for cancer risks among SMI and alert for the pivotal role of mental health staff, namely the psychiatrists.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Heavy daily smoking among under 18-year-old psychiatric inpatients is associated with increased risk for suicide attempts

2007 ◽  
Vol 22 (4) ◽  
pp. 219-222 ◽  
Author(s):  
Kaisa Riala ◽  
Kaisa Viilo ◽  
Helinä Hakko ◽  
Pirkko Räsänen
Keyword(s):  
Suicide Attempts ◽  
Psychiatric Hospitalization ◽  
Psychiatric Inpatients ◽  
Smoking Behaviour ◽  
Daily Smoking ◽  
Psychiatric Evaluation ◽  
Psychiatric Illnesses ◽  
Increased Risk ◽  
Waking Up ◽  
The Relationship

AbstractPurposeTo investigate the relationship between heavy daily smoking and suicidality among adolescent psychiatric inpatients in Finland.MethodsData were collected from 411 patients (age 12–17 years) admitted to inpatient psychiatric hospitalization between April 2001 and July 2005. The number of daily cigarettes (>15) and the time of first cigarette after waking up (within 30 min) were used as indicators of heavy daily smoking.ResultsAfter adjusting for psychiatric diagnoses an over twofold risk for suicide attempts was found among adolescents who smoked over 15 cigarettes a day. Additionally, if an adolescent also smoked the first cigarette immediately after waking up the risk was over threefold. Suicidal ideation was not associated with smoking behaviour.Discussion and conclusionsAmong adolescents with severe psychiatric illnesses, heavy daily smoking may increase the risk of suicidal behaviour independently of current psychiatric diagnosis. The degree of nicotine dependence of an adolescent should therefore be carefully assessed as part of psychiatric evaluation.

scholarly journals An evaluation of symptom domains in the 2 years before pregnancy as predictors of relapse in the perinatal period in women with severe mental illness

2021 ◽  
Vol 64 (1) ◽  
Author(s):  
Sharvari Khapre ◽  
Robert Stewart ◽  
Clare Taylor
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Language Processing ◽  
Mental Healthcare ◽  
Positive Association ◽  
Perinatal Period ◽  
Health Records ◽  
Increased Risk ◽  
Pregnancy And Postpartum ◽  
Symptom Domains

Abstract Background Symptoms may be more useful prognostic markers for mental illness than diagnoses. We sought to investigate symptom domains in women with pre-existing severe mental illness (SMI; psychotic and bipolar disorder) as predictors of relapse risk during the perinatal period. Methods Data were obtained from electronic health records of 399 pregnant women with SMI diagnoses from a large south London mental healthcare provider. Symptoms within six domains characteristically associated with SMI (positive, negative, disorganization, mania, depression, and catatonia) recorded in clinical notes 2 years before pregnancy were identified with natural language processing algorithms to extract data from text, and associations investigated with hospitalization during pregnancy and 3 months postpartum. Results Seventy-six women (19%) relapsed during pregnancy and 107 (27%) relapsed postpartum. After adjusting for covariates, disorganization symptoms showed a positive association at borderline significance with relapse during pregnancy (adjusted odds ratio [aOR] = 1.36; 95% confidence interval [CI] = 0.99–1.87 per unit increase in number of symptoms) and depressive symptoms negatively with relapse postpartum (0.78; 0.62–0.98). Restricting the sample to women with at least one recorded symptom in any given domain, higher disorganization (1.84; 1.22–2.76), positive (1.50; 1.07–2.11), and manic (1.48; 1.03–2.11) symptoms were associated with relapse during pregnancy, and disorganization (1.54; 1.08–2.20) symptom domains were associated with relapse postpartum. Conclusions Positive, disorganization, and manic symptoms recorded in the 2 years before pregnancy were associated with increased risk of relapse during pregnancy and postpartum. The characterization of routine health records from text fields is relatively transferrable and could help inform predictive risk modelling.

Predicting Physical Activity Behavior Change Among Individuals Living With Severe Mental Illness

2021 ◽  
pp. JARC-D-19-00024
Author(s):  
Garrett Huck ◽  
Fong Chan ◽  
Dana Brickham ◽  
Shaina Shelton ◽  
Erin Scafella
Keyword(s):  
Physical Activity ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Cognitive Theory ◽  
Outcome Expectations ◽  
Physical Activity Behavior ◽  
Community Treatment ◽  
Future Research ◽  
Unhealthy Lifestyle ◽  
Increased Risk

Individuals living with a severe mental illness (SMI) have an increased risk of comorbid health conditions, many of which can be attributed to unhealthy lifestyle habits and medication side effects. The purpose of the present study is to examine health behavior theories including the social cognitive theory, self-determination theory, and theory of planned behavior in an effort to predict individuals living with SMI's stage of change (SOC) relating to physical activity (PA). Each theory focuses on important theoretical behavior changing components, such as selfefficacy, autonomy, and intention. The sample of this study includes 60 people with SMI from an assertive community treatment (ACT) program in a large Midwestern city. The results indicated that individual outcome expectations may be the proximal predictor of SOC, although significant relationships were found between SOC, self-efficacy, autonomy, and intentions as well. Future research should focus on the value of positive beliefs about the benefits of PA as that was found to be significant predictor regarding individuals with SMI and their readiness to engage in PA.

Severe mental illness and diabetes mellitus Type 2

2012 ◽  
Vol 09 (03) ◽  
pp. 159-164 ◽  
Author(s):  
J. Detraux ◽  
D. Vancampfort ◽  
W. Yu ◽  
C.U. Correll ◽  
M. De Hert
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Disease ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Antidepressant Treatment ◽  
Average Life Expectancy ◽  
Lifestyle Choices ◽  
Increased Risk ◽  
Dm Type 2

SummaryThree to four percent of the world’s population has diabetes mellitus (DM), which leads to a markedly increased risk of blindness, renal failure, amputation and cardiovascular disease, and reduces average life expectancy by 10 or more years. However, the prevalence of this severe metabolic disease among patients with severe mental illness (SMI), including schizophrenia, bipolar disorder, schizoaffective disorder and major depressive disorder, is higher than in the general population and its impact on these individuals significantly greater. We reviewed the literature on what is currently known about the relationship between SMI and DM and report prevalence rates of DM type 2 as well as important individual lifestyle choices and side effects of antipsychotic and antidepressant treatment, which each account for much of the increased risk of this metabolic disease in these patients. However, the exact cause and effect relationships between the prescription of these medications and DM type 2 still remain to be elucidated.

From conduct disorder to severe mental illness: associations with aggressive behaviour, crime and victimization

2007 ◽  
Vol 38 (7) ◽  
pp. 975-987 ◽  
Author(s):  
S. Hodgins ◽  
A. Cree ◽  
J. Alderton ◽  
T. Mak
Keyword(s):  
Mental Illness ◽  
Drug Use ◽  
Conduct Disorder ◽  
Severe Mental Illness ◽  
Violent Crime ◽  
Aggressive Behaviour ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Men And Women ◽  
Increased Risk

BackgroundConduct disorder (CD) prior to age 15 has been associated with an increased risk of aggressive behaviour and crime among men with schizophrenia. The present study aimed to replicate and extend this finding in a clinical sample of severely mentally ill men and women.MethodWe examined a cohort of in-patients with severe mental illness in one mental health trust. A total of 205 men and women participated, average age 38.5 years. CD was diagnosed using a structured diagnostic tool. Alcohol and illicit drug use, aggressive behaviour and victimization were self-reported. Information on convictions was extracted from official criminal records. Analyses controlled for age and sex.ResultsCD prior to age 15 was associated with an increased risk of assault over the lifespan [odds ratio (OR) 3.98, 95% confidence interval (CI) 1.87–8.44)], aggressive behaviour in the 6 months prior to interview (OR 2.66, 95% CI 1.24–5.68), and convictions for violent crimes (OR 3.19, 95% CI 1.46–6.97) after controlling for alcohol and illicit drug use. The number of CD symptoms present prior to age 15 significantly increased the risk of serious assaults over the lifespan, aggressive behaviour in the past 6 months, and violent crime after controlling for alcohol and illicit drug use.ConclusionsMen and women with severe mental illness who have a history of CD by mid-adolescence are at increased risk for aggressive behaviour and violent crime. These patients are easily identifiable and may benefit from learning-based treatments aimed at reducing antisocial behaviour. Longitudinal, prospective investigations are needed to understand why CD is more common among people with than without schizophrenia.

scholarly journals Birth dimensions, severe mental illness and risk of type 2 diabetes in a cohort of Danish men born in 1953

2019 ◽  
Vol 62 ◽  
pp. 1-9 ◽  
Author(s):  
Marina Garriga ◽  
Marie K Wium-Andersen ◽  
Ida K Wium-Andersen ◽  
Merete Nordentoft ◽  
Merete Osler
Keyword(s):  
Type 2 Diabetes ◽  
Mental Illness ◽  
Birth Weight ◽  
Severe Mental Illness ◽  
Critical Role ◽  
Ponderal Index ◽  
Birth Certificates ◽  
Diabetes Diagnosis ◽  
Increased Risk

Abstract Background: Birth dimensions have been associated with increased risk of both, severe mental illness and type 2 diabetes in adulthood, however, any influence on their co-occurrence has never been examined. This cohort study examine whether birth weight/ponderal index explain or modify the later association between severe mental illness and risk of type 2 diabetes. Methods: The Metropolit cohort included 10,863 Danish men born in 1953 with information from age at conscription (between1971-84) until February 15th, 2018. Severe mental illness was defined as the exposure and information was retrieved from the national Danish health registries. Information on type 2 diabetes diagnosis or oral antidiabetic prescriptions was also obtained, as they were the outcome of interest. Information on birth weight/ponderal index was available from birth certificates. Cox proportional hazards regression models were used to estimate the associations and interactions were tested. Results: After 47.1 years of follow-up, 848 (7.8%) and 1320 (12.2%) men developed a severe mental illness or diabetes, respectively. Men with severe mental illness presented higher risk of subsequent diabetes (HR = 1.92; 95%CI, 1.61–2.30). This association was stronger in severe mental ill men with low birth weight (HR = 3.58; 95%CI, 2.11–6.07), than in those normal birth weight (HR = 1.79; 95%CI, 1.45–2.20). This effect modification was most evident for men diagnosed with schizophrenia. Conclusions: Birth information on birth weight/ponderal index could be of interest in diabetes screening on severe mental ill populations (especially in schizophrenia) since they might play a critical role in the increased risk of type 2 diabetes following severe mental illness.

scholarly journals Domestic and sexual violence against patients with severe mental illness

2014 ◽  
Vol 45 (4) ◽  
pp. 875-886 ◽  
Author(s):  
H. Khalifeh ◽  
P. Moran ◽  
R. Borschmann ◽  
K. Dean ◽  
C. Hart ◽  
...  
Keyword(s):  
Public Health ◽  
At Risk ◽  
Domestic Violence ◽  
Mental Illness ◽  
General Population ◽  
Severe Mental Illness ◽  
Sexual Violence ◽  
Control Female ◽  
Increased Risk ◽  
And Control

BackgroundDomestic and sexual violence are significant public health problems but little is known about the extent to which men and women with severe mental illness (SMI) are at risk compared with the general population. We aimed to compare the prevalence and impact of violence against SMI patients and the general population.MethodThree hundred and three randomly recruited psychiatric patients, in contact with community services for ⩾1 year, were interviewed using the British Crime Survey domestic/sexual violence questionnaire. Prevalence and correlates of violence in this sample were compared with those from 22 606 general population controls participating in the contemporaneous 2011/12 national crime survey.ResultsPast-year domestic violence was reported by 27%v.9% of SMI and control women, respectively [odds ratio (OR) adjusted for socio-demographics, aOR 2.7, 95% confidence interval (CI) 1.7–4.0], and by 13%v.5% of SMI and control men, respectively (aOR 1.6, 95% CI 1.0–2.8). Past-year sexual violence was reported by 10%v.2.0% of SMI and control women respectively (aOR 2.9, 95% CI 1.4–5.8). Family (non-partner) violence comprised a greater proportion of overall domestic violence among SMI than control victims (63%v.35%,p< 0.01). Adulthood serious sexual assault led to attempted suicide more often among SMI than control female victims (53%v.3.4%,p< 0.001).ConclusionsCompared to the general population, patients with SMI are at substantially increased risk of domestic and sexual violence, with a relative excess of family violence and adverse health impact following victimization. Psychiatric services, and public health and criminal justice policies, need to address domestic and sexual violence in this at-risk group.

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