The Somatic Care Situation of Patients with Severe Mental Disorders

Abstract

Background: Patients with severe mental illness (SMI) have worse physical health and reduced life expectancy compared to the general population. Individuals with mental disorders also more often suffer from influenceable risk factors such as obesity, smoking, diabetes, arterial hypertension and dyslipidaemia. Moreover, they have more difficulties to access health services and fewer opportunity for cardiovascular risk screening and prevention than would be expected in a non-psychiatric population. Therefore, we aimed to investigate the somatic care situation of psychiatric patients. Methods: This study used a 14-item-questionnaire to survey the physical status of hospital patients with SMI. Main subjects were psychiatric and somatic diagnoses, metabolic risk factors, regular somatic care (by general practitioners and specialists), and routine check-ups. Data collection underwent pseudonymisation and descriptive analysis. Outcome: 350 patients (49.1% male, mean age 46,31 ±16,02 years) were included. More than three quarters had access to a general practitioner (78.2%), whom most of the patients reported to see quite regularly. Patients with affective and anxiety disorders reported significantly more contact with medical specialists for somatic diseases, compared to other diagnostic subgroups. Nearly all of the patients received psychiatric medication, but some had never before a blood sample taken or received an ecq. Interpretation: Although the access to a general practitioner is quite high, it can be concluded, that the interaction of patient, provider, and system factors has created a situation in which access to and quality of health care is problematic for individuals with especially a SMI. Funding: None. Declaration of Interest: The authors declare that they have no conflict of interest. Ethical Approval: The analysis has been performed in accordance with the Declaration of Helsinki. The Ruhr-University Bochum ethics committee approved the analysis, and written informed consent was obtained from the patient.