Cardio-metabolic abnormalities among patients with severe mental illness at a Regional Referral Hospital in southwestern Uganda

Patients with severe mental illness (SMI) have a higher burden of premature cardio-metabolic abnormalities, including diabetes mellitus, hypertension, hyperlipidemia, and obesity resulting into a 3-fold increase in mortality, and up to 20% reduction in life expectancy compared to the general populat...

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Bibliographic Details
Published in:PloS one 2020-07, Vol.15 (7), p.e0235956-e0235956
Main Authors: Agaba, David Collins, Migisha, Richard, Katamba, Godfrey, Ashaba, Scholastic
Format: Article
Language:English
Subjects:
Abnormalities
Adult
Alcohol
Antipsychotics
Biology and Life Sciences
Blood pressure
Body weight
Cardiovascular disease
Cardiovascular diseases
Cholesterol
Complications and side effects
Consent
Criteria
Demographic aspects
Diabetes
Diabetes mellitus
Exercise
Fasting
Female
Guidelines
Heart Diseases - complications
High density lipoprotein
Hospitals
Hospitals - statistics & numerical data
Humans
Hypercholesterolemia
Hyperlipidemia
Hypertension
Hypertriglyceridemia
Illnesses
Income
Laboratories
Life expectancy
Life span
Lipoproteins
Lipoproteins (high density)
Male
Marital status
Medicine and Health Sciences
Mental disorders
Mental Disorders - complications
Mental Disorders - metabolism
Mental health care
Metabolic syndrome
Mortality
Obesity
Overweight
Patients
People and Places
Physical fitness
Physiology
Psychotropic drugs
Referral and Consultation
Risk factors
Uganda
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Summary:Patients with severe mental illness (SMI) have a higher burden of premature cardio-metabolic abnormalities, including diabetes mellitus, hypertension, hyperlipidemia, and obesity resulting into a 3-fold increase in mortality, and up to 20% reduction in life expectancy compared to the general population. Although over 30% of Ugandans have some form of mental illness, there are no national or hospital-based screening guidelines for cardio-metabolic abnormalities among these patients a general trend in most low-income countries. The screening rates for cardio-metabolic abnormalities in most low-income countries are at only 0.6%. The objective of this study was to describe the cardio-metabolic abnormalities among patients with SMI at Mbarara Regional Referral Hospital. Through a cross-sectional study, we recruited 304 patients with SMI and evaluated them for cardio-metabolic abnormalities using the National Cholesterol Education Programme Adult Treatment Panel III criteria for dyslipidemias, World Health Organisation criteria for diabetes mellitus, obesity, and the Joint national committee criteria for hypertension. We then determined the proportion of participants who met the criteria for each of the individual cardio-metabolic abnormalities. Of the 304 participants, 44.41% were male and 55.59% female with a mean age of 38.56±13.66 years. Almost half (46.38%) of the participants were either overweight or obese, 33.22% had abdominal obesity, 40.46% were hypertensive, 34.11% had low high-density lipoproteins, 37.42% had hypertriglyceridemia and 34.77% had hypercholesterolemia. Based on fasting blood sugar, 11.18% and 9.87% had pre-diabetes and diabetes respectively. There is a high level of cardio-metabolic abnormalities among patients with psychiatric disorders and thus metabolic screening for these abnormalities should be done routinely during psychiatric reviews. There is a need for national guidelines for screening of metabolic abnormalities among patients with SMI so that these abnormalities can be detected early enough at stages where they can be either reversed or delayed to progress to cardiovascular disease.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0235956