Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-08T11:32:24.008Z Has data issue: false hasContentIssue false

Physical health and attendance at primary care in people with schizophrenia

Published online by Cambridge University Press:  13 June 2014

Caragh Behan*
Affiliation:
Cluain Mhuire Family Services, Blackrock, Co. Dublin, Ireland
Nicola McGlade
Affiliation:
Cluain Mhuire Family Services, Blackrock, Co. Dublin, Ireland
Farhan Haq
Affiliation:
Cluain Mhuire Family Services, Blackrock, Co. Dublin, Ireland
Anthony Kinsella
Affiliation:
Department of Mathematics, Dublin Institute of Technology, Kevin Street, Dublin 3, Ireland
Michael Gill
Affiliation:
Department of Psychiatry, Trinity Centre for Health Sciences, St James's Hospital, Dublin 8, Ireland
Aiden Corvin
Affiliation:
Department of Psychiatry, Trinity Centre for Health Sciences, St James's Hospital, Dublin 8, Ireland
Eadbhard O'Callaghan
Affiliation:
Department of Psychiatry, University College Dublin, Dublin 4, and DELTA/DETECT Early Intervention in Psychosis Services, Co. Dublin, Ireland
*
*Correspondence Email: [email protected]

Abstract

Objectives: People with schizophrenia are at increased risk of cardiovascular and endocrine disease. National guidelines recommend the physical health of people with schizophrenia be monitored by primary care, but little is known about whether such people attend primary care. We sought to examine the prevalence of cardiovascular and endocrine disease in a stable population with schizophrenia, and factors associated with attending primary care.

Method: A cross sectional survey of people with a diagnosis of schizophrenia/schizoaffective disorder was taken from a larger cohort participating in the Resource for Psychoses and Genomics in Ireland (RPGI) study. Participants were interviewed using standardised clinical assessments, and underwent anthropometric measurements, and further information was collected by medical record review and contacting the general practitioner (GP).

Results: Thirteen percent (n = 14) had established cardiovascular disease and 4.3% (n = 4) had type 2 diabetes. Risk factors for cardiovascular disease and type 2 diabetes were higher than the general population. Sixty-eight point five percent (n = 63) had attended their GP at least once in the previous year. Only 35% self reported a physical illness. Females (p = 0.03), those with both self-reported presence of physical illness (p = 0.007), and diagnosed physical illness (p = 0.001) were more likely to attend their GP. Other psychosocial, psychological and illness related variables did not predict attendance at primary care.

Conclusion: While established patients attend their GP, they had significant unidentified risk factors for cardiovascular disease and type 2 diabetes. It is likely that non-attendees at secondary care would fare worse yet.

Type
Brief Report
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Harris, EC, Barraclogh, B. Excess mortality of mental disorder. Br J Psychiatry 1998; 173:1153.CrossRefGoogle ScholarPubMed
2.Hennekens, CH, Hennekens, AR, Hollar, D, Casey, DE. Schizophrenia and increased risks of cardiovascular disease. Am heart J 2005; 150:1115–21.CrossRefGoogle ScholarPubMed
3.Clinical Guideline 1. Schizophrenia: Core Interventions in the Treatment and Management of Schizophrenia in Primary and Secondary Care. National Institute for Clinical Excellence. London: NICE 2002.Google Scholar
4.A vision for Change. Report of the Expert Group on Mental Health Policy. Department of Health and Children (Ireland). Dublin: The Stationary Office 2006.Google Scholar
5.Nazareth, I, King, M, Davies, S. Care of schizophrenia in general practice: the general practitioner and the patient. Br J Gen Pract 1995; 45, 343347.Google ScholarPubMed
6.Roberts, L, Roalfe, A, Wilson, S, Lester, H. Physical health care of patients with schizophrenia in primary care: a comparative study. Fam Pract 2007; 24: 3440.CrossRefGoogle ScholarPubMed
7.First, MB, Spitzer, RL, Gibbons, M, Williams, JBW. Structured Clinical Interview for DSM-IV Axis 1 Disorders – Patient Edition (SCID I/P, version 2.0). New York: New York State Psychiatric Institute, Biometrics Research Department; 1995.Google Scholar
8.Andreasen, NC.The Scale for Assessment of Negative Symptoms (SANS). The University of Iowa, Iowa City. 1983.Google Scholar
9.Andreasen, NC. The Scale for Assessment of Positive Symptoms (SAPS). The University of Iowa, Iowa City. 1984.Google Scholar
10Birchwood, M, Smith, J, Drury, V, Healy, J, MacMillan, F, Slade, M, A self-report insight scale for psychosis: reliability, validity and sensitivity to change. Acta Psychiatr Scand 1994; 89: 6267.CrossRefGoogle ScholarPubMed
11.David, AS. Insight and psychosis. Br J Psychiatry 1990; 156: 798808.CrossRefGoogle ScholarPubMed
12.Loeb, PA. ILS: Independent Living Scales Manual. San Antonio, Tex, Psychological Corp, Harcourt Brace Jovanovich, 1996.Google Scholar
13.Chisholm, D, Knapp, M, Hudson, H, Amaddeo, L, Gaite, B, van Wijngaarden, and the EPSILON study group. Client Socio-Demographic Service and Receipt Inventory – European Version: Development of an instrument for international research. Br J Psychiatry 2000; 177(suppl 39): S28S33CrossRefGoogle Scholar
14.De Backer, G, Ambrosioni, E, Borch-Johnsen, K, Brotons, C, Cifkova, R, Dallongeville, Jet al.European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention Clinical Practice. Eur Heart J 2003; 24:1601–10CrossRefGoogle Scholar
15.Alberti, KG, Zimmet, P, Shaw, J. IDF Epidemiology Task Force Consensus Group. The metabolic syndrome – a new worldwide definition. Lancet 2005; 366:1059–62.CrossRefGoogle Scholar
16.Creagh, Det al.Established cardiovascular disease and CVD risk factors in a primary care population of middle aged Irish men and women. Ir J Med 2002; 95: 298301Google Scholar
17.Report on the National Task Force for Obesity. Department of Health and Children, Ireland. Dublin: The Stationary Office, 2005.Google Scholar
18.Making diabetes count. A systematic approach to estimating population prevalence in the island of Ireland in 2005. The Institute of Public Health 2006. First report of The Ireland and Northern Ireland's Population health Observatory, 2006.Google Scholar
19.Nolan, B (Ed). The provision and use of health services, health inequalities and health and social gain. Economic and Social Research Institute (ESRI). Dublin, 2007.Google Scholar
20.Kupur, N, Hunt, I, Lunt, M, McBeth, J, Creed, F, Macfarlane, G. Primary care consultation predictors in men and women: a cohort study. Br J Gen Pract 2005; 55:108113.Google Scholar
21.Druss, Get alQuality of Preventive Medical Care for patients with mental disorders Med Care 2002;40:129136.CrossRefGoogle ScholarPubMed
22.De Hert, M, Van Eyck, D, De Nayer, A. Metabolic abnormalities associated with second generation antipsychotics: fact or fiction? Development of guidelines for screening and monitoring. Int Clin Psychopharmacol 2006; 21 (suppl 2): S11S15.Google ScholarPubMed