Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-17T17:15:22.816Z Has data issue: false hasContentIssue false

Diet, smoking and cardiovascular risk in schizophrenia in high and low care supported housing

Published online by Cambridge University Press:  11 April 2011

Avirup Gupta*
Affiliation:
South London and Maudsley NHS Foundation Trust, Croydon North Community Mental Health Team, Croydon (United Kingdom)
Tom K. J. Craig
Affiliation:
Health Service and Population Research, Institute of Psychiatry, KCL, London (United Kingdom)
*
Address for correspondence: Professor T.K.J. Craig, Box 33, Health Service and Population Research, Institute of Psychiatry, KCL, De Crespigny Park, Denmark Hill, London SE5 8AF (United Kingdom). E-mail: [email protected]

Summary

Background – People suffering from schizophrenia have markedly increased physical morbidity and mortality. A poor diet and sedentary lifestyle make a significant contribution to this ill health. Healthcare professionals need to include assessments of diet and to promote a ‘healthy living’ lifestyle. Aims – To describe the dietary habits and cardiovascular risk factors of people with chronic schizophrenia living in supported accommodation and to audit the provision of cardiovascular health screening in this population. Method – The dietary habits of 69 people with chronic schizophrenia living in community settings were assessed. Tobacco smoking, body mass indices and waist circumference were also measured. The dietary behaviour of patients living in high care settings with care staff present every day was compared with those in low care settings. Results – Residents in both levels of care made poor dietary choices. Patients in high care were consuming more fast food than those in low care. The dietary habits of men and women in both levels of care were worse than reported by surveys of the general population in England. All patients had seen their GP in the previous year though only 3 had received diabetes screening and fewer than half had lipid profiles. Conclusions – People with schizophrenia do not improve their diet just by the provision of healthy food as was the case in high care settings. Secondary care services must address physical health monitoring as well as mental health if the increased mortality of patients with schizophrenia is to be addressed effectively. More effective interventions are necessary to improve and sustain a healthy diet.

Declaration of Interest: Nothing to declare.

Type
Special Articles
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Alberti, K. G. & Zimmet, P.Z. (1998). Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: Diagnosis and classification of diabetes mellitus, provisional report of a WHO Commission. Diabetic Medicine 15, 539553.3.0.CO;2-S>CrossRefGoogle Scholar
Aston University (2006). Nutritional Supplement Study. Retrieved May 5, 2009, from http:/;/www.aston.ac.uk/downloads/lhs/food_freq_quest.pdfGoogle Scholar
Black, D.W. & Fisher, R. (1992). Mortality in DSM-III-R Schizophrenia. Schizophrenia Research 7, 109116.CrossRefGoogle Scholar
Brown, S., Inskip, H. & Barraclough, B. (2000). Causes of excess mortality of schizophrenia. British Journal of Psychiatry 177, 212217.CrossRefGoogle ScholarPubMed
Calle, E.E., Thun, M.J. & Petrelli, J.M. (1999). Bodymass Index and mortality in a prospective cohort of US Adults. New England Journal of Medicine 341, 10971105.CrossRefGoogle Scholar
Craig, R. & Mindell, J. (Eds) (2008). Health Survey for England 2006: Cardiovascular Disease and Risk Factors in Adults. The Information Centre: Leeds. Retrieved May 5, 2009, from http://www.ic.nhs.uk/webfiles/publications/HSE06/HSE%2006%20report%20VOL%201 %20v2.pdfGoogle Scholar
Department of Health (2007). 5 A Day FAQ. Retrieved May 5, 2009, from http://www.dh.gov.uk/en/Publichealth/Healthimprovement/FiveADay/FAQ/DH_064832Google Scholar
Family Food in 2002–2003 (2004). Retrieved May 5, 2009, from https://statistics.defra.gov.uk/esg/publications/efs/2003/chapter8.pdf, page 78.Google Scholar
Food Standard Agency, UK (2007). Eat Well, Be Well: Helping You Make Healthier Choices. Retrieved May 5, 2009, from http://www.eatwell.gov.ukh/ealthydietn/utritionessentials/eggsandpulses/pulses/Google Scholar
Haupt, D.W. & Newcomer, J.W. (2001). Hyperglycemia and antipsychotic medications. Journal of Clinical Psychiatry 62, Suppl 27, 1526.Google ScholarPubMed
Heiskanen, T., Niskanen, L. & Lyytikainen, R. (2003). Metabolic syndrome in patients with schizophrenia. Journal of Clinical Psychiatry 64, 575579.CrossRefGoogle ScholarPubMed
Henderson, L., Gregory, J. & Swan, G. (2002). National Diet and Nutrition Survey: Adults Aged 19 to 64 Years: Volume 1: Types and Quantities of Food Consumed. TSO: London.Google Scholar
Henderson, L., Gregory, J., Irving, K. & Swan, G. (2003). National Diet and Nutrition Survey: Adults Aged 19 to 64 Years. Volume 2: Engergy, Protein, Carbohydrate, Fat and Alcohol Intake. TSO: London.Google Scholar
Hingorami, A.D. & Vallance, P. (1999). A simple computer programme for guiding management of cardiovascular risk factors and prescribing. British Medical Journal 318, 101105.CrossRefGoogle Scholar
Kay, S.R., Fiszbein, A. & Opler, L.A. (1987). The Positive and Negative Syndrome Scale (PANSS) for and Negative Schizophrenia. Schizophrenia Bulletin 13, 261276.CrossRefGoogle Scholar
Llerena, A., de la Rubia, A. & Penas-Liedo, E.M. (2003). Schizophrenia and tobacco smoking in a Spanish psychiatric hospital. Schizophrenia Research 60, 313317.CrossRefGoogle Scholar
Manson, J.E., Colditz, G.A. & Stampfer, M.J. (1990). A prospective study of obesity and risk of coronary heart disease in women. New England Journal of Medicine 323, 882889.CrossRefGoogle Scholar
McCreadie, R.G. (2002). Use of drugs, alcohol and tobacco by people with schizophrenia: case-control study. British Journal of Psychiatry 181, 321325.CrossRefGoogle ScholarPubMed
McCreadie, R.G. (2003). Diet, smoking and cardiovascular risk in people with schizophrenia. British Journal of Psychiatry 183: 534539.Google ScholarPubMed
McCreadie, R.G., Macdonald, E., Blacklock, C., Tilak-Singh, D., Wiles, D., Halliday, J. & Paterson, J. (1998). Dietary intake of schizophrenic patients in Nithsdale, Scotland: case-control study. British Medical Journal 317, 784 -785.CrossRefGoogle ScholarPubMed
McCreadie, R., Kelly, C., Connelly, M., Williams, S., Baxter, G., Lean, M. & Paterson, J. R. (2005). Dietary improvement in people with schizophrenia. British Journal of Psychiatry 187, 34.CrossRefGoogle ScholarPubMed
Mukherjee, S., Schnur, D.B. & Reddy, R. (1989). Family history of type 2 diabetes in schizophrenic patients [letter]. Lancet 1, 495.CrossRefGoogle ScholarPubMed
NHS Executive (1999). Health Service Circular 1999/107. NHSE: London.Google Scholar
Ohlsen, R.I., Peacock, G. & Smith, S. (2005). Developing a service to monitor and improve physical health in people with serious mental illness. Journal of Psychiatric and Mental Health Nursing 12, 614619.CrossRefGoogle ScholarPubMed
Osborn, D.P., Nazareth, I. & King, M.B. (2006). Risk for coronary heart disease in people with severe mental illness; cross-sectional comparative study in primary care. British Journal of Psychiatry 188, 271277.CrossRefGoogle ScholarPubMed
Pendlebury, J., Bushe, C., Wildgust, H. & Holt, R. (2007). Long term maintenance of weight loss in patients with severe mental illness through a behavioural programme in the UK. Acta Psychiatrica Scandinavica 115, 286294CrossRefGoogle ScholarPubMed
Phelan, M., Stradins, L. & Morrison, S. (2001). Physical health of people with severe mental illness. British Medical Journal 322, 443444.CrossRefGoogle ScholarPubMed
Ryan, M.C.M, Collins, P. & Thakore, J.H. (2003). Impaired fasting glucose tolerance in first episode drug-naïve patients with schizophrenia. American Journal of Psychiatry 160, 284289.CrossRefGoogle ScholarPubMed
Scottish Executive (1998). The Scottish Health Survey, vols I and II. Scottish Executive Health Department: Edinburgh.Google Scholar
Scottish Executive (2003). The Scottish Health Survey, vol 2. Retrieved May 5, 2009, from http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/scottish-health-survey/PublicationsGoogle Scholar
Smith, S., Yeomans, D., Bushe, C., Eriksson, C., Harrison, T., Holmes, R., Mynors-Wallis, L., Oatway, H. & Sullivan, G. (2007). A well-being programme in severe mental illness. Reducing risk for physical ill health: a post programme service evaluation at 2 years. European Psychiatry 22, 413418.CrossRefGoogle Scholar
World Health Organization (2000). Obesity: Preventing and Managing the Global Epidemic. Technical Report Series No: 894. WHO: Geneva.Google Scholar