Skip to main content

Advertisement

Log in

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

  • ORIGINAL PAPER
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  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):28–33

    Article  PubMed  Google Scholar 

  2. Bazire S (2003) Psychotropic drug directory, 120. C2.2 p 180. The Bath Press. Bath

    Google Scholar 

  3. Brown S, Birtwistle J, Roe L, et al. (1999) The unhealthy lifestyle of people with schizophrenia. Psychol Med 29(3):697–701

    Article  PubMed  CAS  Google Scholar 

  4. Department of Health (1994) Nutritional aspects of cardiovascular disease. Her Majesty’s Stationery Office. London

    Google Scholar 

  5. Dinan TG (2004) Schizophrenia and diabetes 2003: an expert consensus meeting. Introduction. Br J Psychiatry 184(suppl. 47):s53–s54

    Article  Google Scholar 

  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 83:590–593

    Article  PubMed  CAS  Google Scholar 

  7. Godin G, Shephard RJ (1985) A simple method to assess exercise behaviour in the community. Can J Appl Sports Sci 10:141–146

    CAS  Google Scholar 

  8. Holt RIG (2004) Diagnosis, epidemiology and pathogenesis of diabetes mellitus: an update for psychiatrists. Br J Psychiatry. 184(suppl. 47):s55–s63

    Article  Google Scholar 

  9. Hooper L, Summerbell CD, Higgins JPT, et al. (2001) Dietary fat intake and prevention of cardiovascular disease: systematic review. BMJ 322:757–763

    Article  PubMed  CAS  Google Scholar 

  10. Krawiecka M, Goldberg D, Vaughan M (1977) A standardised psychiatric assessment scale for rating chronic psychotic patients. Acta Psychiatiatrica Scandinavica 55:299–308

    Article  CAS  Google Scholar 

  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 182:31–36

    Article  PubMed  Google Scholar 

  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 7:15–18

    Article  Google Scholar 

  13. Marder SR, Essock SM, Miller AL, et al. (2004) Physical health monitoring of patients with schizophrenia. Am J Psychiatry 161:1334–1349

    Article  PubMed  Google Scholar 

  14. McCreadie R, Macdonald E, Blacklock C, et al. (1998) Dietary intake of schizophrenic patients in Nithsdale, Scotland: case-control study. BMJ 317:784–785

    PubMed  CAS  Google Scholar 

  15. McCreadie RG, Kelly C (2000) Patients with schizophrenia who smoke. Private disaster, public resource. Br J Psychiatry. 176:109

    Article  PubMed  CAS  Google Scholar 

  16. McCreadie R, The Scottish Schizophrenia lifestyle group (2003) Diet, smoking and cardiovascular risk in people with schizophrenia: descriptive study. Br J Psychiatry. 183:534–539

    Article  PubMed  CAS  Google Scholar 

  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 326:1122–1123

    Article  PubMed  CAS  Google Scholar 

  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 188:271–277

    Article  PubMed  Google Scholar 

  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 64:242–249

    Article  PubMed  Google Scholar 

  20. Peet M (2004) Diet diabetes and schizophrenia. Br J Psychiatry 184(suppl. 47):s102–s105

    Article  Google Scholar 

  21. Phelan M, Stradins L, Morrison S (2001) Physical health of people with severe mental illness. Br Med J 322:443–444

    Article  CAS  Google Scholar 

  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 11:375–381

    Article  PubMed  CAS  Google Scholar 

  23. Rothenbacher D, Hoffmeister A, Brenner H, et al. (2003) Physical activity, coronary heart disease, and inflammatory response. Arch Intern Med 163(10):1200–1205

    Article  PubMed  Google Scholar 

  24. Ryan MCM, Thakore JH (2002) Physical consequences of schizophrenia and its treatment: the metabolic syndrome. Life Sci 71(3):239–257

    Article  PubMed  CAS  Google Scholar 

  25. Safeer RS, Cornell MO (2000) The emerging role of HDL cholesterol. Postgraduate Medicine 108(7) 87–90 & 93–98

    Google Scholar 

  26. Stata Corp. (1999) Stata Reference manual release 6. Stata Press, College Station, Texas

    Google Scholar 

  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 319:943–948

    PubMed  CAS  Google Scholar 

  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 6:16

    Article  PubMed  Google Scholar 

Download references

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.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David P. J. Osborn PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Osborn, D.P.J., Nazareth, I. & King, M.B. Physical activity, dietary habits and Coronary Heart Disease risk factor knowledge amongst people with severe mental illness. Soc Psychiat Epidemiol 42, 787–793 (2007). https://doi.org/10.1007/s00127-007-0247-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-007-0247-3

Keywords

Navigation