Improving physical health in people with severe mental illness

2020 ◽  
Vol 31 (11) ◽  
pp. 456-460
Author(s):  
Sheila Hardy

People with severe mental illness have a higher mortality than the general population. Sheila Hardy explains how nurses can address the health disparities that people with severe mental illness face People with severe mental illness have a higher mortality than the general population, with the main cause of early death being from a physical condition. Practice nurses are well placed to address the health disparities that people with severe mental illness face. This article describes the reasonable adjustments that can be made to increase engagement with patients.

2008 ◽  
Vol 14 (6) ◽  
pp. 423-431 ◽  
Author(s):  
Zerrin Atakan

Cannabis use is more common among people with severe mental illness than in the general population. It has detrimental effects on the course of the illness, physical health and social life of users, as well as being a financial burden on health services. It is important to understand why some people with severe mental illness continue to use cannabis, despite experiencing its effects on their condition. This article reviews research on the scale of cannabis use by such patients, the effects on the course of their illness, possible reasons to explain why they use it, and how they can be assessed in clinical settings, as well as providing some assessment tools to measure various characteristics related to cannabis use.


2006 ◽  
Vol 3 (2) ◽  
pp. 27-28 ◽  
Author(s):  
Hamid Ghodse

The association between mental illness and poor physical health has been known for decades (Philips, 1934). This is not a trivial relationship between mental ill health and minor physical problems but an association with such poor physical health that it results in premature death. For example, a study in the USA showed that the life expectancy of those with schizophrenia or other serious mental illness was 9 years shorter than for the general population (Dembling et al, 1999). Similarly, those with learning disabilities have an increased risk of early death, and this increase is greater in those with severe disability.


2021 ◽  
pp. 000486742110314
Author(s):  
Rachael C Cvejic ◽  
Preeyaporn Srasuebkul ◽  
Adrian R Walker ◽  
Simone Reppermund ◽  
Julia M Lappin ◽  
...  

Objective: To describe and compare the health profiles and health service use of people hospitalised with severe mental illness, with and without psychotic symptoms. Methods: We conducted a historical cohort study using linked administrative datasets, including data on public hospital admissions, emergency department presentations and ambulatory mental health service contacts in New South Wales, Australia. The study cohort comprised 169,306 individuals aged 12 years and over who were hospitalised at least once with a mental health diagnosis between 1 July 2002 and 31 December 2014. Of these, 63,110 had a recorded psychotic illness and 106,196 did not. Outcome measures were rates of hospital, emergency department and mental health ambulatory service utilisation, analysed using Poisson regression. Results: People with psychotic illnesses had higher rates of hospital admission (adjusted incidence rate ratio (IRR) 1.26; 95% confidence interval [1.23, 1.30]), emergency department presentation (adjusted IRR 1.17; 95% confidence interval [1.13, 1.20]) and ambulatory mental health treatment days (adjusted IRR 2.90; 95% confidence interval [2.82, 2.98]) than people without psychotic illnesses. The higher rate of hospitalisation among people with psychotic illnesses was driven by mental health admissions; while people with psychosis had over twice the rate of mental health admissions, people with other severe mental illnesses without psychosis (e.g. mood/affective, anxiety and personality disorders) had higher rates of physical health admissions, including for circulatory, musculoskeletal, genitourinary and respiratory disorders. Factors that predicted greater health service utilisation included psychosis, intellectual disability, greater medical comorbidity and previous hospitalisation. Conclusion: Findings from this study support the need for (a) the development of processes to support the physical health of people with severe mental illness, including those without psychosis; (b) a focus in mental health policy and service provision on people with complex support needs, and (c) improved implementation and testing of integrated models of care to improve health outcomes for all people experiencing severe mental illness.


BMJ ◽  
2001 ◽  
Vol 322 (7284) ◽  
pp. 443-444 ◽  
Author(s):  
M. Phelan

2021 ◽  
Author(s):  
Jing Kang ◽  
Jianhua Wu ◽  
Vishal Aggarwal ◽  
David Shiers ◽  
Tim Doran ◽  
...  

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.


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