High prevalence of risk factors for physical illness in a long-stay psychiatric unit

The aim of this study was to determine the prevalence of risk factors for physical illness in a long stay psychiatric unit, where all care (both psychiatric and physical) is provided by the psychiatric team.

All patients in the long-stay ward had a full physical examination including calculation of BMI. All patients had blood sampling including FBC, U&E, LFTs, TFTs, lipid profile (total cholesterol, triglycerides, HDL and LDL), glucose, HbA1c, and prolactin. ATP111 criteria were used to determine the presence of the metabolic syndrome.

We found the mean number of comorbid medical diagnosis was 2.7. The prevalence of metabolic syndrome was 40.7% (44.4% of females and 24.1% of males). The prevalence of obesity was 51%, and 51% also had a total cholesterols in excess of 5.0mmol/l. Prolactin was elevated in two-thirds of female patients.

We conclude that the annual physical examination is of limited value in long-stay psychiatric unit. The high prevalence of physical illness and physical risk factors warrants primary care involvement in screening and treatment of long-stay psychiatric patients.