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Heart
Disease a ‘Silent Killer’ in Patients with
severe Mental Illness
Newswise — A large new study confirms that people with
severe mental disorders — such as
schizophrenia or other psychotic disorders —
are 25 percent to 40 percent more prone to
die from heart disease than people without
mental illness are.
Moreover, smoking and physical inactivity — behaviors that
individuals potentially can change —
significantly contribute to this increased
risk of death, found researchers led by Amy
Kilbourne, Ph.D.
They looked at results from the 1999 Large Health Survey of
Veteran Enrollees in conjunction with the
VA’s National Psychosis Registry and the
National Death Index of the Centers for
Disease Control and Prevention (CDC).
Including responses from more than 147,000
veterans, the study is the largest of its
kind to ever take place. Most of the
respondents were men and about two-thirds
were 50 or older.
Kilbourne, associate director of the VA Ann Arbor National
Serious Mental Illness Treatment Research
and Evaluation Center in Michigan, and
colleagues from Dartmouth Medical School
conducted the study, which appears in the
November-December issue of the journal
General Hospital Psychiatry.
Patients with mental disorders who also had a diagnosis of
diabetes — a known risk factor for heart
disease and a side effect of some
antipsychotic medications — were at high
risk for heart disease-related mortality, as
were patients with a diagnosis of dementia.
Smoking and lack of exercise, both common behaviors in
people with mental disorders, contributed to
the heart disease-related deaths
considerably.
“These are devastating illnesses that lead to a lot of
functional impairment, so many of these
individuals have difficulty staying
motivated to exercise to begin with, or
finding places where they feel comfortable
exercising,” Kilbourne said.
However, even when considering factors such as diabetes and
lifestyle, researchers found that patients
with schizophrenia or other psychotic
disorders were still more likely to die from
heart disease.
“This suggests that we are
either missing some factor, or there is
something inherent about having these
disorders that puts patients at greater risk
for heart disease-related mortality,” Kilbourne said.
Eric Goplerud, Ph.D., director of the Center for Integrated
Behavioral Health Policy in Washington, said
that results of this study and others
suggest that people with serious mental
illnesses are far less likely to receive
medical screening and general preventive
care.
He said that lack of coordinated care
has serious consequences: “Serving their
mental needs in one stovepipe and their
medical needs in another is probably
associated with premature mortality.”
“The issue of cardiovascular disease in this population is
huge,” Goplerud said. “As we look at
national health reform, it is absolutely
critical that people with mental illness and
addictions be included — they are dying of
preventable medical conditions.”
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