Prevalence of physical health conditions and health risk behaviours in people with severe mental illness in South Asia: protocol for a cross-sectional study (IMPACT SMI survey)

Zavala, Gerardo; Prasad-Muliyala, Krishna; Aslam, Faiza; Barua, Deepa; Haidar, Asiful; Hewitt, Catherine; Huque, Rumana; Mansoor, Sana; Murthy, Pratima; Nizami, Asad Tamizuddin; Siddiqi, Najma; Sikander, Siham; Siddiqi, Kamran; Boehnke, Jan R.

doi:10.1136/bmjopen-2020-037869

Cited by 7 publications

(16 citation statements)

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“…We conducted a cross-sectional survey of health, health risk behaviors, and healthcare use in people with SMI in three South Asian countries before the pandemic started: the IMPACT study [ISRCTN registry: 88485933; ( 8 , 25 )].…”

Section: Methodsmentioning

confidence: 99%

“…Adults aged 18 years and above with SMI [schizophrenia, bipolar disorder, schizoaffective disorder, and depression with psychotic symptoms; clinician-diagnosed and confirmed using the international neuropsychiatric interview; MINI version 6.0 ( 26 )], attending three national institutes of mental health (in Bangladesh, India, and Pakistan) between July 2019 and March 2020 were recruited to the IMPACT survey ( 25 ). Stratified sampling was used to recruit a sample comprising 80% outpatients and 20% inpatients, reflecting the service usual case mix proportion of inpatients and outpatients ( 25 ). The protocol provides further details including the justification of the sample size ( 25 ).…”

Section: Methodsmentioning

confidence: 99%

“…Stratified sampling was used to recruit a sample comprising 80% outpatients and 20% inpatients, reflecting the service usual case mix proportion of inpatients and outpatients ( 25 ). The protocol provides further details including the justification of the sample size ( 25 ).…”

Section: Methodsmentioning

confidence: 99%

“…Data were collected via a telephone interview and recorded in a tablet device using Qualtrics ( 25 ). Each participant took around 40–60 min to answer the questions via phone.…”

Section: Methodsmentioning

confidence: 99%

“…Demographic data (gender, age, education, employment status, monthly income, and marital status) were taken from the IMPACT survey ( 25 ).…”

Section: Methodsmentioning

confidence: 99%

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Knowledge and Response to the COVID-19 Pandemic in People With Severe Mental Illness in Bangladesh and Pakistan: A Cross-Sectional Survey

et al. 2022

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BackgroundPeople with severe mental illnesses (SMIs) are likely to face disproportionate challenges during a pandemic. They may not receive or be able to respond to public health messages to prevent infection or to limit its spread. Additionally, they may be more severely affected, particularly in low- and middle-income countries.MethodsWe conducted a telephone survey (May–June 2020) in a sample of 1,299 people with SMI who had attended national mental health institutes in Bangladesh and Pakistan before the pandemic. We collected information on top worries, socioeconomic impact of the pandemic, knowledge of COVID-19 (symptoms, prevention), and prevention-related practices (social distancing, hygiene). We explored the predictive value of socio-demographic and health-related variables for relative levels of COVID-19 knowledge and practice using regularized logistic regression models.FindingsMass media were the major source of information about COVID-19. Finances, employment, and physical health were the most frequently mentioned concerns. Overall, participants reported good knowledge and following advice. In Bangladesh, being female and higher levels of health-related quality of life (HRQoL) predicted poor and better knowledge, respectively, while in Pakistan being female predicted better knowledge. Receiving information from television predicted better knowledge in both countries. In Bangladesh, being female, accessing information from multiple media sources, and better HRQoL predicted better practice. In Pakistan, poorer knowledge of COVID-19 prevention measures predicted poorer practice.ConclusionOur paper adds to the literature on people living with SMIs and their knowledge and practices relevant to COVID-19 prevention. Our results emphasize the importance of access to mass and social media for the dissemination of advice and that the likely gendered uptake of both knowledge and practice requires further attention.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…Data were collected via a telephone interview and recorded in a tablet device using Qualtrics ( 25 ). Each participant took around 40–60 min to answer the questions via phone.…”

Section: Methodsmentioning

confidence: 99%

“…Demographic data (gender, age, education, employment status, monthly income, and marital status) were taken from the IMPACT survey ( 25 ).…”

Section: Methodsmentioning

confidence: 99%

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Knowledge and Response to the COVID-19 Pandemic in People With Severe Mental Illness in Bangladesh and Pakistan: A Cross-Sectional Survey

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Risk factors associated with overweight and obesity in people with severe mental illness in South Asia: cross-sectional study in Bangladesh, India, and Pakistan

Appuhamy,

Podmore,

Mitchell

et al. 2023

J Nutr Sci

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Obesity is one of the major contributors to the excess mortality seen in people with severe mental illness (SMI) and in low- and middle-income countries people with SMI may be at an even greater risk. In this study, we aimed to determine the prevalence of obesity and overweight in people with SMI and investigate the association of obesity and overweight with sociodemographic variables, other physical comorbidities, and health-risk behaviours. This was a multi-country cross-sectional survey study where data were collected from 3989 adults with SMI from three specialist mental health institutions in Bangladesh, India, and Pakistan. The prevalence of overweight and obesity was estimated using Asian BMI thresholds. Multinomial regression models were then used to explore associations between overweight and obesity with various potential determinants. There was a high prevalence of overweight (17·3 %) and obesity (46·2 %). The relative risk of having obesity (compared to normal weight) was double in women (RRR = 2·04) compared with men. Participants who met the WHO recommendations for fruit and vegetable intake had 2·53 (95 % CI: 1·65–3·88) times greater risk of having obesity compared to those not meeting them. Also, the relative risk of having obesity in people with hypertension is 69 % higher than in people without hypertension (RRR = 1·69). In conclusion, obesity is highly prevalent in SMI and associated with chronic disease. The complex relationship between diet and risk of obesity was also highlighted. People with SMI and obesity could benefit from screening for non-communicable diseases, better nutritional education, and context-appropriate lifestyle interventions.

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Prevalence of physical health conditions and health risk behaviours in people with severe mental illness in South Asia: multi-country cross-sectional survey

et al. 2023

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Background People with severe mental illness (SMI) die earlier than the general population, primarily because of physical disorders. Aims We estimated the prevalence of physical health conditions, health risk behaviours, access to healthcare and health risk modification advice in people with SMI in Bangladesh, India and Pakistan, and compared results with the general population. Method We conducted a cross-sectional survey in adults with SMI attending mental hospitals in Bangladesh, India and Pakistan. Data were collected on non-communicable diseases, their risk factors, health risk behaviours, treatments, health risk modification advice, common mental disorders, health-related quality of life and infectious diseases. We performed a descriptive analysis and compared our findings with the general population in the World Health Organization (WHO) ‘STEPwise Approach to Surveillance of NCDs’ reports. Results We recruited 3989 participants with SMI, of which 11% had diabetes, 23.3% had hypertension or high blood pressure and 46.3% had overweight or obesity. We found that 70.8% of participants with diabetes, high blood pressure and hypercholesterolemia were previously undiagnosed; of those diagnosed, only around half were receiving treatment. A total of 47% of men and 14% of women used tobacco; 45.6% and 89.1% of participants did not meet WHO recommendations for physical activity and fruit and vegetable intake, respectively. Compared with the general population, people with SMI were more likely to have diabetes, hypercholesterolemia and overweight or obesity, and less likely to receive tobacco cessation and weight management advice. Conclusions We found significant gaps in detection, prevention and treatment of non-communicable diseases and their risk factors in people with SMI.

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Prevalence of physical health conditions and health risk behaviours in people with severe mental illness in South Asia: protocol for a cross-sectional study (IMPACT SMI survey)

Cited by 7 publications

References 46 publications

Knowledge and Response to the COVID-19 Pandemic in People With Severe Mental Illness in Bangladesh and Pakistan: A Cross-Sectional Survey

Knowledge and Response to the COVID-19 Pandemic in People With Severe Mental Illness in Bangladesh and Pakistan: A Cross-Sectional Survey

Risk factors associated with overweight and obesity in people with severe mental illness in South Asia: cross-sectional study in Bangladesh, India, and Pakistan

Prevalence of physical health conditions and health risk behaviours in people with severe mental illness in South Asia: multi-country cross-sectional survey

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