Prevalence of metabolic syndrome and its associated risk factors in an African–Caribbean population with severe mental illness

Caluwé, Laura de; Buitenen, Nora van; Gelan, P; Crunelle, Cleo L.; Thomas, R. Lucas; Casseres, Sharon; Matthys, Frieda; Harten, Peter van; Cahn, Wiepke

doi:10.1016/j.psychres.2019.112558

Cited by 15 publications

(22 citation statements)

References 87 publications

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“…However, the rate of medical and surgical hospitalisation was not higher among Māori compared to non-Māori (as might be expected given increased health needs) which suggests under-treatment of physical health conditions in this group may be a factor in the observed higher risk of mortality from natural causes for Māori with severe mental illness. The high degree of physical morbidity (as assessed by the M3 index) is in keeping with previous research showing high levels of cardiovascular risk factors among those from non-dominant ethnic populations who experience severe mental illness (Carliner et al, 2014;De Caluwé et al, 2019). The higher M3 scores seen for Māori relative to non-Māori with bipolar disorder were consistent with differences found between ethnic groups in other populations defined by specific diseases.…”

Section: Discussionsupporting

confidence: 87%

The physical health of Māori with bipolar disorder

Cunningham

Stanley

Haitana

et al. 2020

Aust N Z J Psychiatry

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Aims: There is very little empirical evidence about the relationship between severe mental illness and the physical health of Indigenous peoples. This paper aims to compare the physical health of Māori and non-Māori with a diagnosis of bipolar disorder in contact with NZ mental health services. Methods: A cohort of Māori and non-Māori with a current bipolar disorder diagnosis at 1 January 2010 were identified from routine mental health services data and followed up for non-psychiatric hospital admissions and deaths over the subsequent 5 years. Results: Māori with bipolar disorder had a higher level of morbidity and a higher risk of death from natural causes compared to non-Māori with the same diagnosis, indicating higher levels of physical health need. The rate of medical and surgical hospitalisation was not higher among Māori compared to non-Māori (as might be expected given increased health needs) which suggests under-treatment of physical health conditions in this group may be a factor in the observed higher risk of mortality from natural causes for Māori. Conclusion: This study provides the first indication that systemic factors which cause health inequities between Māori and non-Māori are compounded for Māori living with severe mental illness. Further exploration of other diagnostic groups and subgroups is needed to understand the best approach to reducing these inequalities.

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Section: Discussionsupporting

confidence: 87%

The physical health of Māori with bipolar disorder

Cunningham

Stanley

Haitana

et al. 2020

Aust N Z J Psychiatry

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“…In addition, obesity in severe mental disorders can be attributed to an unhealthy lifestyle, poor physical activity as well as unbalanced diet. 80 , 81 Therefore, the results of our sample emphasize that adequate health care and lifestyle interventions can reduce the impact of disease and treatment on patients’ cardiometabolic health, as previously reported. 82 , 83 However, this underscores the decisive role the environment plays in TRS population outcomes, and the need to control this over the long term.…”

Section: Discussionsupporting

confidence: 79%

Clozapine Management in Schizophrenia Inpatients: A 5-Year Prospective Observational Study of Its Safety and Tolerability Profile

Filippis

Gaetano

Schoretsanitis

et al. 2021

NDT

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Background Clozapine is well known for its efficacy and clinical superiority compared to other antipsychotics in treatment-resistant schizophrenia (TRS). However, it is frequently underutilized worldwide because of its acute adverse events, as well as for its long-term cardiometabolic and hematological consequences. Objective The aim of the study was to evaluate 5-year safety in chronic TRS inpatients with continuous clozapine use. Methods Patients with TRS and clozapine treatment were evaluated for 5 years. All participants were assessed using the Brief Psychiatric Rating Scale (BPRS), Glasgow Antipsychotic Side-effect Scale for Clozapine (GASS-C), Social Performance Scale (PSP) and Short Portable Mental Status Questionnaire (SPMSQ). Clinical, cardiometabolic and hematological data were collected periodically. General linear models (GLM) repeated measures controlling for CLZ dose were utilized to determine differences in variables across the time. Results Overall, 189 inpatients were screened for study participation. The final sample included twenty-one TRS patients (16 males, 76%) with an average age of 57.6 years, all with 5-year continuous use of clozapine (mean dose 266 mg/day). There was not a significant effect of time on BPRS ( p =0.774), PSP (p=0.855) and SPMSQ (p=0.066); differences remained not significant after controlling for CLZ dose (p=0.585, p=0.467 and p=0.105, respectively). No changes were found in blood and clinical parameters except for red blood cell count, which decreased over time ( p =0.024; η 2 = 0.952). Patients reported a significant BMI decrease (−8.98 kg, p =0.008) between baseline and 5 years last observation. Conclusion The findings show how the application of a structured dietary, clinical and therapeutic monitoring program in psychiatric care facilities could allow the safe and effective long-term cardiometabolic and hematological management of clozapine. The unique role that clozapine plays in the current treatment of patients with TRS requires greater clinical awareness. Although its acute and chronic side effects are notorious, its safety management is feasible and broadens its potential practical application.

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“…There is also clear evidence of reduced life expectancy among those with severe mental illness in New Zealand (Cunningham et al, 2014). Higher levels of cardiovascular risk factors such as metabolic abnormalities have been seen among those from minority ethnic populations who experience severe mental illness (Carliner et al, 2014; De Caluwé et al, 2019). A recent study also suggests that in New Zealand, Māori with bipolar disorder had a higher level of physical morbidity and a higher risk of death from natural causes compared with non-Māori with bipolar disorder (Cunningham et al, 2020).…”

Section: Complex Presentations and Special Populationsmentioning

confidence: 99%

The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders

Malhi

Bell

Bassett³

et al. 2020

Aust N Z J Psychiatry

288

365

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Objectives: To provide advice and guidance regarding the management of mood disorders, derived from scientific evidence and supplemented by expert clinical consensus to formulate s that maximise clinical utility. Methods: Articles and information sourced from search engines including PubMed, EMBASE, MEDLINE, PsycINFO and Google Scholar were supplemented by literature known to the mood disorders committee (e.g. books, book chapters and government reports) and from published depression and bipolar disorder guidelines. Relevant information was appraised and discussed in detail by members of the mood disorders committee, with a view to formulating and developing consensus-based recommendations and clinical guidance. The guidelines were subjected to rigorous consultation and external review involving: expert and clinical advisors, key stakeholders, professional bodies and specialist groups with interest in mood disorders. Results: The Royal Australian and New Zealand College of Psychiatrists mood disorders clinical practice guidelines 2020 (MDcpg2020) provide up-to-date guidance regarding the management of mood disorders that is informed by evidence and clinical experience. The guideline is intended for clinical use by psychiatrists, psychologists, primary care physicians and others with an interest in mental health care. Conclusion: The MDcpg2020 builds on the previous 2015 guidelines and maintains its joint focus on both depressive and bipolar disorders. It provides up-to-date recommendations and guidance within an evidence-based framework, supplemented by expert clinical consensus. Mood disorders committee: Gin S Malhi (Chair), Erica Bell, Darryl Bassett, Philip Boyce, Richard Bryant, Philip Hazell, Malcolm Hopwood, Bill Lyndon, Roger Mulder, Richard Porter, Ajeet B Singh and Greg Murray.

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Prevalence of metabolic syndrome and its associated risk factors in an African–Caribbean population with severe mental illness

Cited by 15 publications

References 87 publications

The physical health of Māori with bipolar disorder

The physical health of Māori with bipolar disorder

Clozapine Management in Schizophrenia Inpatients: A 5-Year Prospective Observational Study of Its Safety and Tolerability Profile

The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders

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