Obesity and Associated Complications in Patients With Severe Mental Illnesses: A Cross-Sectional Survey
J Clin Psychiatry 2005;66(2):167-173
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: This naturalistic cross-sectional
survey of patients with severe mental illnesses explores the
association between important variables and obesity, extreme
obesity, diabetes mellitus type 2, hypertension, and
hyperlipidemia in the clinical environment.
Method: Weight and height were obtained
from 560 patients with severe mental illnesses (including DSM-IV
schizophrenia, schizoaffective disorder, bipolar disorder, and
major depressive disorder) at central Kentucky inpatient and
outpatient facilities to estimate their body mass index (BMI).
Chart diagnoses of diabetes mellitus, hypertension, and
hyperlipidemia were obtained.
Results: When comparing the patients with severe
mental illnesses with Kentucky adults from the general
population, the odds ratio (OR) of obesity (BMI >= 30 kg/m2)
was 2.6 (95% confidence interval [CI] = 2.2 to 3.0), and the OR
of diabetes mellitus was 2.9 (95% CI = 2.3 to 3.6). Female
gender, African American race, early start of psychiatric
medication, and long psychiatric medication duration were
significantly associated with obesity. Current alcohol and
nicotine use exhibited significant ORs of obesity lower than 1,
particularly in males. Obesity was closely associated with
hypertension, type 2 diabetes mellitus, and hyperlipidemia. These
complications were closely associated with each other and may
indicate a further progression of obesity after aging.
Conclusions: These results suggest a
complex pattern of variables that may influence the development
of obesity and its complications in patients with severe mental
illnesses, but they need replication. The major factors
associated with obesity appear to be a long-term illness or
treatment duration and substance use. The former may be more
important in females, while the latter may be more important in
males. Clinical diagnoses (schizophrenic or mood disorders) or
current treatment did not appear to be fundamental factors.