scholarly journals Dietary intake of people with severe mental illness: systematic review and meta-analysis

2019 ◽  
Vol 214 (5) ◽  
pp. 251-259 ◽  
Author(s):  
Scott B. Teasdale ◽  
Philip B. Ward ◽  
Katherine Samaras ◽  
Joseph Firth ◽  
Brendon Stubbs ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Dietary Intake ◽  
Physical Health ◽  
Severe Mental Illness ◽  
Diet Quality ◽  
Psychotic Disorders ◽  
Meta Analysis ◽  
Mean Difference ◽  
Dietary Intakes

BackgroundSevere mental illness (SMI) is thought to be associated with lower diet quality and adverse eating behaviours contributing towards physical health disparities. A rigorous review of the studies looking at dietary intake in psychotic disorders and bipolar disorder is lacking.AimsTo conduct a systematic, comprehensive evaluation of the published research on dietary intake in psychotic disorders and bipolar disorder.MethodSix electronic databases were searched for studies reporting on dietary intakes in psychotic disorders and bipolar disorder. Dietary-assessment methods, and dietary intakes, were systematically reviewed. Where possible, data was pooled for meta-analysis and compared with healthy controls.ResultsIn total, 58 eligible studies were identified. People with SMI were found to have significantly higher dietary energy (mean difference 1332 kJ, 95% CI 487–2178 kJ/day, P = 0.002, g = 0.463) and sodium (mean difference 322 mg, 95% CI 174–490 mg, P < 0.001, g = 0.414) intake compared with controls. Qualitative synthesis suggested that higher energy and sodium intakes were associated with poorer diet quality and eating patterns.ConclusionsThese dietary components should be key targets for preventative interventions to improve weight and other physical health outcomes in people with SMI.Declaration of interestS.B.T. and E.T. have clinical dietitian appointments within the South Eastern Sydney Local Health District and do not receive any further funding.

scholarly journals Gut dysbiosis in severe mental illness and chronic fatigue: a novel trans-diagnostic construct? A systematic review and meta-analysis

2021 ◽  
Author(s):  
Jenelle Marcelle Safadi ◽  
Alice M. G. Quinton ◽  
Belinda R. Lennox ◽  
Philip W. J. Burnet ◽  
Amedeo Minichino
Keyword(s):  
Systematic Review ◽  
Bipolar Disorder ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Meta Analysis ◽  
Sickness Behavior ◽  
Chronic Fatigue ◽  
Clinical Feature ◽  
Gut Dysbiosis ◽  
Reporting Data

AbstractReduced gut-microbial diversity (“gut dysbiosis”) has been associated with an anhedonic/amotivational syndrome (“sickness behavior”) that manifests across severe mental disorders and represent the key clinical feature of chronic fatigue. In this systematic review and meta-analysis, we investigated differences in proxy biomarkers of gut dysbiosis in patients with severe mental illness and chronic fatigue vs. controls and the association of these biomarkers with sickness behavior across diagnostic categories. Following PRISMA guidelines, we searched from inception to April 2020 for all the studies investigating proxy biomarkers of gut dysbiosis in patients with severe mental illness and chronic fatigue. Data were independently extracted by multiple observers, and a random-mixed model was used for the analysis. Heterogeneity was assessed with the I2 index. Thirty-three studies were included in the systematic review; nineteen in the meta-analysis (N = 2758 patients and N = 1847 healthy controls). When compared to controls, patients showed increased levels of zonulin (four studies reporting data on bipolar disorder and depression, SMD = 0.97; 95% Cl = 0.10–1.85; P = 0.03, I2 = 86.61%), lipopolysaccharide (two studies reporting data on chronic fatigue and depression, SMD = 0.77; 95% Cl = 0.42–1.12; P < 0.01; I2 = 0%), antibodies against endotoxin (seven studies reporting data on bipolar disorder, depression, schizophrenia, and chronic fatigue, SMD = 0.99; 95% CI = 0.27–1.70; P < 0.01, I2 = 97.14%), sCD14 (six studies reporting data on bipolar disorder, depression, schizophrenia, and chronic fatigue, SMD = 0.54; 95% Cl 0.16–0.81; P < 0.01, I2 = 90.68%), LBP (LBP, two studies reporting data on chronic fatigue and depression, SMD = 0.87; 95% Cl = 0.25–1.48; P < 0.01; I2 = 56.80%), alpha-1-antitripsin (six studies reporting data on bipolar disorder, depression, and schizophrenia, SMD = 1.23; 95% Cl = 0.57–1.88; P < 0.01, I2: 89.25%). Elevated levels of gut dysbiosis markers positively correlated with severity of sickness behavior in patients with severe mental illness and chronic fatigue. Our findings suggest that gut dysbiosis may underlie symptoms of sickness behavior across traditional diagnostic boundaries. Future investigations should validate these findings comparing the performances of the trans-diagnostic vs. categorical approach. This will facilitate treatment breakthrough in an area of unmet clinical need.

scholarly journals Advanced dental disease in people with severe mental illness: systematic review and meta-analysis

2011 ◽  
Vol 199 (3) ◽  
pp. 187-193 ◽  
Author(s):  
Steve Kisely ◽  
Lake-Hui Quek ◽  
Joanne Pais ◽  
Ratilal Lalloo ◽  
Newell W. Johnson ◽  
...  
Keyword(s):  
Mental Illness ◽  
Oral Health ◽  
General Population ◽  
Severe Mental Illness ◽  
Psychiatric Patients ◽  
Meta Analysis ◽  
Health Assessment ◽  
Mean Difference ◽  
Control Group ◽  
Dental Disease

BackgroundPsychiatric patients have increased comorbid physical illness. There is less information concerning dental disease in this population in spite of risk factors including diet and psychotropic side-effects (such as xerostomia).AimsTo compare the oral health of people with severe mental illness with that of the general population.MethodA systematic search for studies from the past 20 years was conducted using Medline, PsycINFO, Embase and article bibliographies. Papers were independently assessed. The primary outcome was total tooth loss (edentulousness), the end-stage of both untreated caries and periodontal disease. We also assessed dental decay through standardised measures: the mean number of decayed, missing and filled teeth (DMFT) or surfaces (DMFS). For studies lacking a control group we used controls of similar ages from a community survey within 10 years of the study.ResultsWe identified 21 papers of which 14 had sufficient data (n = 2784 psychiatric patients) and suitable controls (n = 31 084) for a random effects meta-analysis. People with severe mental illness had 3.4 times the odds of having lost all their teeth than the general community (95% CI 1.6–7.2). They also had significantly higher scores for DMFT (mean difference 6.2, 95% CI 0.6–11.8) and DMFS (mean difference 14.6, 95% CI 4.1–25.1). Fluoridated water reduced the gap in oral health between psychiatric patients and the general population.ConclusionsPsychiatric patients have not shared in the improving oral health of the general population. Management should include oral health assessment using standard checklists that can be completed by non-dental personnel. Interventions include oral hygiene and management of xerostomia.

The physical health of Māori with bipolar disorder

2020 ◽  
Vol 54 (11) ◽  
pp. 1107-1114
Author(s):  
Ruth Cunningham ◽  
James Stanley ◽  
Tracy Haitana ◽  
Suzanne Pitama ◽  
Marie Crowe ◽  
...  
Keyword(s):  
Mental Health ◽  
Bipolar Disorder ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Physical Health ◽  
Severe Mental Illness ◽  
Hospital Admissions ◽  
Risk Of Death ◽  
Death From Natural Causes

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.

Nutrition interventions in people with severe mental illness: Novel strategies for addressing physical health co-morbidity in a high-risk population

2016 ◽  
Vol 33 (S1) ◽  
pp. S620-S620 ◽  
Author(s):  
S. Teasdale ◽  
P. Ward ◽  
K. Samaras ◽  
S. Rosenbaum ◽  
J. Curtis ◽  
...  
Keyword(s):  
Mental Illness ◽  
Weight Gain ◽  
Severe Mental Illness ◽  
Meta Analysis ◽  
Nutrition Intervention ◽  
High Risk Population ◽  
List Type ◽  
Nutrition Interventions ◽  
Glucose Levels ◽  
Co Morbidity

IntroductionNutrition interventions are critical for weight management and cardiometabolic risk reduction in people experiencing severe mental illness (SMI). As mental health teams evolve to incorporate nutrition interventions, evidence needs to guide clinical practice.AimsA systematic review and meta-analysis was performed to assess whether nutrition interventions improve:– anthropometric and biochemical measures,– nutritional intake of people experiencing SMI.To evaluate the effectiveness of a dietician-led nutrition intervention, as part of a broader lifestyle intervention, in the early stages of antipsychotic prescription.MethodAn electronic database search was conducted to identify all trials with nutritional components. Included trials were pooled for meta-analysis. Meta-regression analyses were run on potential anthropometric moderators. Weekly individualised dietetic consultations plus group cooking classes were then offered to clients attending a Community Early Psychosis Programme, who had recently commenced antipsychotics for a 12-week period.ResultsFrom pooled trials, nutrition interventions resulted in significant weight loss (19 studies, g = –0.39, P < 0.001), reduced BMI (17 studies, g = –0.40, P < 0.001), decreased waist circumference (10 studies, g = –0.27, P < 0.001) and lower blood glucose levels (5 studies, g = –0.37, P = 0.02). Dietician-led interventions (g = –0.90) and trials focussing on preventing weight gain (g = –0.61) were the most effective. The 12-week nutrition intervention resulted in a 47% reduction in discretionary (junk) food intake (P < 0.001) and reductions in daily energy (–24%, P < 0.001) and sodium intakes (–26%, P < 0.001), while improving diet quality (P < 0.05).ConclusionEvidence supports the inclusion of nutrition interventions as part of standard care for preventing weight gain and metabolic deterioration among people with SMI.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The health service contact patterns of people with psychotic and non-psychotic forms of severe mental illness in New South Wales, Australia: A record-linkage study

2021 ◽  
pp. 000486742110314
Author(s):  
Rachael C Cvejic ◽  
Preeyaporn Srasuebkul ◽  
Adrian R Walker ◽  
Simone Reppermund ◽  
Julia M Lappin ◽  
...  
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Mental Illness ◽  
Health Service ◽  
Confidence Interval ◽  
Physical Health ◽  
Severe Mental Illness ◽  
New South ◽  
Service Utilisation ◽  
South Wales

Objective: To describe and compare the health profiles and health service use of people hospitalised with severe mental illness, with and without psychotic symptoms. Methods: We conducted a historical cohort study using linked administrative datasets, including data on public hospital admissions, emergency department presentations and ambulatory mental health service contacts in New South Wales, Australia. The study cohort comprised 169,306 individuals aged 12 years and over who were hospitalised at least once with a mental health diagnosis between 1 July 2002 and 31 December 2014. Of these, 63,110 had a recorded psychotic illness and 106,196 did not. Outcome measures were rates of hospital, emergency department and mental health ambulatory service utilisation, analysed using Poisson regression. Results: People with psychotic illnesses had higher rates of hospital admission (adjusted incidence rate ratio (IRR) 1.26; 95% confidence interval [1.23, 1.30]), emergency department presentation (adjusted IRR 1.17; 95% confidence interval [1.13, 1.20]) and ambulatory mental health treatment days (adjusted IRR 2.90; 95% confidence interval [2.82, 2.98]) than people without psychotic illnesses. The higher rate of hospitalisation among people with psychotic illnesses was driven by mental health admissions; while people with psychosis had over twice the rate of mental health admissions, people with other severe mental illnesses without psychosis (e.g. mood/affective, anxiety and personality disorders) had higher rates of physical health admissions, including for circulatory, musculoskeletal, genitourinary and respiratory disorders. Factors that predicted greater health service utilisation included psychosis, intellectual disability, greater medical comorbidity and previous hospitalisation. Conclusion: Findings from this study support the need for (a) the development of processes to support the physical health of people with severe mental illness, including those without psychosis; (b) a focus in mental health policy and service provision on people with complex support needs, and (c) improved implementation and testing of integrated models of care to improve health outcomes for all people experiencing severe mental illness.

scholarly journals Physical health of people with severe mental illness

BMJ ◽  
2001 ◽  
Vol 322 (7284) ◽  
pp. 443-444 ◽  
Author(s):  
M. Phelan
Keyword(s):  
Mental Illness ◽  
Physical Health ◽  
Severe Mental Illness

Physical health screening for patients with severe mental illness

2016 ◽  
Vol 20 (1) ◽  
pp. 21-25
Author(s):  
Tonsha Emerson ◽  
Kimberly Williams ◽  
Maxie Gordon
Keyword(s):  
Mental Illness ◽  
Physical Health ◽  
Severe Mental Illness ◽  
Health Screening ◽  
Physical Health Screening
Sign in / Sign up

Export Citation Format

Share Document