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Risk for coronary heart disease in people with severe mental illness: cross-sectional comparative study in primary

David P J Osborn1, Irwin Nazareth, Michael B King

  • 1Department of Mental Health Sciences, Hampstead Campus, Royal Free and University College Medical School, Rowland Hill Street, London NW3 2PF, UK.

The British Journal of Psychiatry : the Journal of Mental Science
|March 2, 2006
PubMed

Insights

People with severe mental illness (SMI) have higher coronary heart disease (CHD) risk factors, including smoking and diabetes, not fully explained by medication or socioeconomic status. Urgent screening and interventions are needed for this population.

Area of Science:

  • Cardiology
  • Psychiatry
  • Public Health

Background:

  • Coronary heart disease (CHD) is a significant concern in individuals with severe mental illness (SMI).
  • Limited systematic research exists on CHD risk factors within the SMI population.

Purpose of the Study:

  • Compare CHD risk factors in primary care patients with and without SMI.
  • Investigate the influence of socioeconomic variables on CHD risk.
  • Examine the association between antipsychotic medication and CHD risk.

Main Methods:

  • Cross-sectional screening approach.
  • Data collected through patient interviews.

Main Results:

  • SMI associated with elevated 10-year CHD risk scores (OR=1.8).
  • Higher prevalence of low high-density-lipoprotein (HDL)-cholesterol (OR=4.0), increased cholesterol/HDL ratios (OR=1.8), diabetes (OR=3.8), and smoking (OR=3.0) in SMI patients.
  • Associations between SMI and risk factors varied significantly with age; unemployment did not fully explain these links.

Conclusions:

  • Excess CHD risk factors in SMI are not solely due to medication or socioeconomic deprivation.
  • Urgent need for CHD screening and targeted interventions (smoking cessation, diabetes management, lifestyle advice) for patients with SMI.
Abstract

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