IntroductionEven in countries with universal healthcare systems, excess mortality rates due to physical chronic diseases in patients also suffering from serious mental illness like schizophrenia is such that their life expectancy could be lessened by up to 20 years. The possible explanations for this disparity include: unhealthy habits (i.e. smoking; lack of exercise); side-effects of psychotropic medication; delays in the detection or initial presentation leading to a more advanced disease at diagnosis; and inequity of access to services. The main objective of this paper is to explore the feasibility and acceptability of patient partnership for developing an interactive guide to improve access to primary care providers for chronic diseases management and health promotion among patients with severe mental illnesses.MethodsA participatory action research design was used to engage patients with mental illness as full research partners for a strategy for patient-oriented research in primary care for persons with schizophrenia who also have chronic physical illnesses. This strategy was also developed in partnership with a health and social services centre responsible for the health of the population of a territory with about 100,000 inhabitants in East-end Montreal, Canada. A new interactive guide was developed by patient research partners and used by 146 participating patients with serious mental illness who live on this territory, for them to be better prepared for their medical appointment with a General Practitioner by becoming more aware of their own physical condition.ResultsPatient research partners produced a series of 33 short videos depicting signs and symptoms of common chronic diseases and risk factors for the leading causes of mortality and study participants were able to complete the corresponding 33-item questionnaire on an electronic touch screen tablet. What proved to be most relevant in terms of interactivity was the dynamic that has developed among the study participants during the small group learning sessions, a training technique designed for healthcare professionals that was adapted for this project for, and with patient partners.ConclusionThis research has shown the feasibility and acceptability of patient partnership and patient-oriented research approaches to the R&D process of a new medical tool and intervention for patients with serious mental illness, and its acceptability for addressing inequity of this disadvantaged population in terms of access to primary care providers.

BackgroundThe “General Oral Health Assessment Index” (GOHAI) was widely used in clinical or epidemiological studies worldwide, as it was available for use in different languages. Therefore, the aim of this study was to evaluate the psychometric characteristics of the GOHAI in a representative sample of patients with schizophrenia.MethodsA total of 90 schizophrenic patients (in-patients and out-patients) were recruited from the participants of the “buccodor study” (NCT02167724) between March and September 2015. They were selected using a random stratified sampling method according to their age, sex, or residential area (urban/rural area). GOHAI validity (construct, predictive, concurrent and known group validity) and internal consistency (reliability) were tested. Test-retest reliability was evaluated in 32 subjects.ResultsThe mean age was 47.34 (SD = 12.17). Internal consistency indicated excellent agreement, with a Cronbach’s value of 0.82 and average inter-item correlation of 0.65. Intraclass correlation coefficients for test-retest reliability with 95% confidence intervals were not significantly different (p > 0.05). Construct validity was supported by three factor that accounted for 60.94% of the variance observed. Predictive validity was corroborated as statistically significant differences were observed between a high GOHAI score, which was associated with self-perceived satisfaction with oral health, lower age and high frequency of toothbrushing. Concurrent validity was corroborated as statistically significant relationships were observed between the GOHAI scores and most objective measures of dental status. For known group validity, they was no significant difference of the mean GOHAI score between out or in-patients (p > 0.05).ConclusionAcceptable psychometric characteristics of the GOHAI could help caregivers to develop ways to improve the Oral Health related Quality Of Life of schizophrenic patients.Trial registrationClinical Trials Gov NCT02167724. Date registered 17 June, 2014.

This research project was funded by the Agence Régionale de Santé de Bourgogne (ARS). Oral health in schizophrenia patients: a French multicenter cross-sectional studyObjective: The aim of this study was to assess the oral health status of a sample of patients with schizophrenia (PWS) in Côte d'Or region (France) and to determine the factors associated with dental status. Material and Methods:A multicenter cross-sectional descriptive study was performed. PWS were selected using a random stratified method. Dental status was investigated using the Decayed, Missing, or Filled Teeth (DMFT) index, based on 32 teeth. The Simplified Oral Hygiene Index (OHI-S), the Xerostomia Index (XI) and the Global Oral Health Assessment Index (GOHAI) for Oral Health related Quality of Life (OHrQoL) were recorded.Results: Among the 302 persons identified, 109 were included (acceptance rate was 49.1%). Of these, 61.5% were men. The mean age was 46.8 years ±12.0 years. The majority (78%) had completed a secondary education (SE). The mean duration of mental illness (DMI) was 17.9±9.4 years, and 55.5% were taking drugs.The mean DMFT was 16.6±8.1. There was a significant relationship between age, SE, oral health variables, medical conditions and OHrQoL.Conclusions: PWS describe a poor OHrQoL. The dental and hygiene index scores are poor. We observed a lack of brushing and of dental visit for these persons and a gap in oral health between PWS and general population.La santé bucco-dentaire des patients schizophrènes: une étude française transversale multicentrique Objectif : Le but de cette étude était d'évaluer l'état de santé bucco-dentaire d'un échantillon de patients atteints de schizophrénie (PS) en Côte d'Or (France) et de préciser les facteurs associés à la santé bucco-dentaire.Matériel et méthodes : Une étude descriptive transversale multicentrique a été réalisée. Les PS ont été sélectionnés en utilisant une méthode stratifiée aléatoire. L'état de santé bucco-