[Lipid balance and cardiovascular risk in patients in a psychiatric long-term facility]

Increase in weight and changes in lipid and glucose metabolism often occur in severe mental illness. It is established that this may hinge on the mental illness as such, and on lifestyle, resident living in institutions and on medication. We performed an explorative study of these factors in a general psychiatric long-term facility.

30 resident patients gave fasting blood samples that were analysed for lipid and glucose variables. Body mass index, blood pressure and smoking habits were noted, as was medication history of neuroleptics. Patients were asked about family risk of coronary heart disease and diabetes.

Body mass index was > 25 in 80% and > 30 in 40% of patients. Four patients had diabetes. Total cholesterol was > 6 mmol/l in 10 patients. The ratio of total cholesterol to HDL cholesterol was > 5 in 60%. An atherogenic index containing apolipoprotein measurements was above cut-off in 11 patients. The patients had experience with the use of a mean of 4.1 (SD = 2.1) different neuroleptics. 9 out of 12 patients who had used clozapin and/or olanzapin had a body mass index > 30. 25 patients smoked a mean of 17 cigarettes a day.

Most of our patients carry a high risk of coronary heart disease and diabetes. Even if this risk may partly be due to the mental illness itself, risk is also attributable to a combination of an unhealthy life style, medication and smoking. It is of utmost importance that health professionals, leisure time therapists and catering personnel do their best in order to reduce organisationally induced risk, as these patients cannot be expected to respond adequately to advice.