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Social Psychiatry and Psychiatric Epidemiology

, Volume 42, Issue 10, pp 787–793 | Cite as

Physical activity, dietary habits and Coronary Heart Disease risk factor knowledge amongst people with severe mental illness

A cross sectional comparative study in primary care
  • David P. J. Osborn
  • Irwin Nazareth
  • Michael B. King
ORIGINAL PAPER

Abstract

Background

Evidence regarding Coronary Heart Disease (CHD) related lifestyle in people with severe mental illnesses (SMI) such as schizophrenia is sparse. We aimed to quantify adverse CHD knowledge, diet and exercise in a representative primary care sample, and to determine whether socio-economic deprivation explained any findings.

Method

We compared CHD lifestyle and CHD knowledge in 74 people with SMI and 148 without from seven general practices. We measured CHD knowledge, dietary fibre, fats and exercise using validated instruments and adjusted for socio-economic status.

Results

Fewer people with SMI had higher CHD knowledge: OR 0.49 (95% CI: 0.27–0.88), higher total exercise scores 0.49 (0.27–0.86), higher fibre 0.46 (0.26–0.82) or lower saturated fat diets 0.53 (0.30–0.94). These results were stable irrespective of antipsychotic medication, socio-economic status or type of statistical analysis.

Conclusion

High fat, low fibre diets, lack of exercise and smoking are the likely causes of the majority of CHD in this high-risk group, irrespective of medication and socio-economic deprivation. This lifestyle and particularly the lower CHD knowledge provides a theoretical focus for more comprehensive preventative CHD interventions in SMI.

Keywords

mental disorders schizophrenia diet exercise cardiovascular disease 

Notes

Acknowledgements

We are grateful to all the participants, their general practitioners and practice staff. We also acknowledge the support of the Camden and Islington Mental Health and Social Care Trust. DO was funded by a United Kingdom MRC research fellowship in Health Services Research. The study received additional funding from the North Central Thames Primary Care Research Network Research. Role of the funding source: The United Kingdom Medical Research Council funded this study, and reviewed the initial study design. The investigators were independent of the funding source. The funders had no role in the data collection, analysis, interpretation or writing of this report.

References

  1. 1.
    Agerbo E, Byrne M, Eaton WW, et al. (2004) Marital and labor market status in the long run in Schizophrenia. Arch Gen Psychiatry 61(1):28–33PubMedCrossRefGoogle Scholar
  2. 2.
    Bazire S (2003) Psychotropic drug directory, 120. C2.2 p 180. The Bath Press. BathGoogle Scholar
  3. 3.
    Brown S, Birtwistle J, Roe L, et al. (1999) The unhealthy lifestyle of people with schizophrenia. Psychol Med 29(3):697–701PubMedCrossRefGoogle Scholar
  4. 4.
    Department of Health (1994) Nutritional aspects of cardiovascular disease. Her Majesty’s Stationery Office. LondonGoogle Scholar
  5. 5.
    Dinan TG (2004) Schizophrenia and diabetes 2003: an expert consensus meeting. Introduction. Br J Psychiatry 184(suppl. 47):s53–s54CrossRefGoogle Scholar
  6. 6.
    Frank E, Winkleby M, Fortmann S, et al. (1993) Cardiovascular disease risk factors: improvements in knowledge and behaviour in the 1980s. Am J Public Health 83:590–593PubMedCrossRefGoogle Scholar
  7. 7.
    Godin G, Shephard RJ (1985) A simple method to assess exercise behaviour in the community. Can J Appl Sports Sci 10:141–146Google Scholar
  8. 8.
    Holt RIG (2004) Diagnosis, epidemiology and pathogenesis of diabetes mellitus: an update for psychiatrists. Br J Psychiatry. 184(suppl. 47):s55–s63CrossRefGoogle Scholar
  9. 9.
    Hooper L, Summerbell CD, Higgins JPT, et al. (2001) Dietary fat intake and prevention of cardiovascular disease: systematic review. BMJ 322:757–763PubMedCrossRefGoogle Scholar
  10. 10.
    Krawiecka M, Goldberg D, Vaughan M (1977) A standardised psychiatric assessment scale for rating chronic psychotic patients. Acta Psychiatiatrica Scandinavica 55:299–308CrossRefGoogle Scholar
  11. 11.
    Lawrence DM, Holman CD, Jablensky AV, et al. (2003) Death rate from ischaemic heart disease in Western Australian psychiatric patients 1980–1998. Br J Psychiatry 182:31–36PubMedCrossRefGoogle Scholar
  12. 12.
    Luty J, Kelly C, McCreadie RG (2002) Smoking habits, body mass index and risk of heart diease: Prospective 2½-year follow up of first episode schizophrenic patients. J Subst Use 7:15–18CrossRefGoogle Scholar
  13. 13.
    Marder SR, Essock SM, Miller AL, et al. (2004) Physical health monitoring of patients with schizophrenia. Am J Psychiatry 161:1334–1349PubMedCrossRefGoogle Scholar
  14. 14.
    McCreadie R, Macdonald E, Blacklock C, et al. (1998) Dietary intake of schizophrenic patients in Nithsdale, Scotland: case-control study. BMJ 317:784–785PubMedGoogle Scholar
  15. 15.
    McCreadie RG, Kelly C (2000) Patients with schizophrenia who smoke. Private disaster, public resource. Br J Psychiatry. 176:109PubMedCrossRefGoogle Scholar
  16. 16.
    McCreadie R, The Scottish Schizophrenia lifestyle group (2003) Diet, smoking and cardiovascular risk in people with schizophrenia: descriptive study. Br J Psychiatry. 183:534–539PubMedCrossRefGoogle Scholar
  17. 17.
    Osborn DPJ, King MB, Nazareth I (2003) Participation in cardiovascular risk screening by people with schizophrenia or similar mental illnesses. A cross sectional study in general practice. BMJ 326:1122–1123PubMedCrossRefGoogle Scholar
  18. 18.
    Osborn DPJ, King MB, Nazareth I (2006) Risk of cardiovascular disease in people with severe mental illness: a cross sectional comparative study in primary care. Br J Psychiatry 188:271–277PubMedCrossRefGoogle Scholar
  19. 19.
    Osborn DPJ, Levy G, Nazareth I, Petersen I, Islam A, King M (2007) Relative risk of cardiovascular and cancer mortality in people with severe mental illness from the United Kingdom’s General Practice Research Database. Arch Gen Psychiatry 64:242–249PubMedCrossRefGoogle Scholar
  20. 20.
    Peet M (2004) Diet diabetes and schizophrenia. Br J Psychiatry 184(suppl. 47):s102–s105CrossRefGoogle Scholar
  21. 21.
    Phelan M, Stradins L, Morrison S (2001) Physical health of people with severe mental illness. Br Med J 322:443–444CrossRefGoogle Scholar
  22. 22.
    Roe L, Strong C, Neil A, et al. (1994) Dietary Intervention in primary care: Validity of the Dine method for diet assessment. Fam Pract 11:375–381PubMedCrossRefGoogle Scholar
  23. 23.
    Rothenbacher D, Hoffmeister A, Brenner H, et al. (2003) Physical activity, coronary heart disease, and inflammatory response. Arch Intern Med 163(10):1200–1205PubMedCrossRefGoogle Scholar
  24. 24.
    Ryan MCM, Thakore JH (2002) Physical consequences of schizophrenia and its treatment: the metabolic syndrome. Life Sci 71(3):239–257PubMedCrossRefGoogle Scholar
  25. 25.
    Safeer RS, Cornell MO (2000) The emerging role of HDL cholesterol. Postgraduate Medicine 108(7) 87–90 & 93–98Google Scholar
  26. 26.
    Stata Corp. (1999) Stata Reference manual release 6. Stata Press, College Station, TexasGoogle Scholar
  27. 27.
    Steptoe A, Doherty S, Rink E, Kerry S, Kendrick T, Hilton S (1999) Behavioural counselling in general practice for the promotion of healthy behaviour among adults at increased risk of coronary heart disease: randomised trial. BMJ 319:943–948PubMedGoogle Scholar
  28. 28.
    Wright C, Osborn DPJ, Nazareth IN, King MB (2006) Prevention of coronary heart disease in people with severe mental illnesses: A qualitative study of patient and professionals’ preferences for care. BMC Psychiatry 6:16PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • David P. J. Osborn
    • 1
  • Irwin Nazareth
    • 2
  • Michael B. King
    • 1
  1. 1.Dept. of Mental Health Sciences, (Hampstead Campus)Royal Free and University College Medical SchoolLondonUK
  2. 2.Dept. of Primary Care and Population Sciences, (Hampstead Campus)Royal Free and University College Medical SchoolLondonUK

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