Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

Brief Reports   |    
Screening for Metabolic Risk Among Patients With Severe Mental Illness and Diabetes: A National Comparison
Alex J. Mitchell, M.D.; Sheila Ann Hardy, Ph.D., R.N.
Psychiatric Services 2013; doi: 10.1176/appi.ps.201200514
View Author and Article Information

Dr. Mitchell is affiliated with the Department of Psychooncology, Leicestershire Partnership Trust and the University of Leicester, United Kingdom. Dr. Hardy is with the University of Northampton and with Park Avenue Medical Centre, 168 Park Ave. North, Northampton NN3 2HZ, United Kingdom (e-mail: sa.hardy@btinternet.com).

Copyright © 2013 by the American Psychiatric Association


Objective  People with severe mental illness have a higher risk of developing cardiovascular disease and die sooner than the general population. This study of a national sample of primary care patients in the United Kingdom compared screening for cardiometabolic risk factors among patients with severe mental illness and diabetes.

Methods  Screening for cardiovascular disease among 2,488,948 patients with diabetes (2010–2011) and 422,966 patients with severe mental illness (2011–2012) at 8,123 primary care practices was compared.

Results  The percentage of patients who received screening across four parameters (body mass index, blood pressure, blood glucose, and cholesterol) in the previous 15 months was higher among patients with diabetes than among those with severe mental illness (97.3% versus 74.7%, p<.001).

Conclusions  The proportion of patients in primary care who were given screening for cardiometabolic risk was much lower among those with severe mental illness than among those with diabetes.

Abstract Teaser
Figures in this Article

Your Session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Anchor for Jump
Table 1Metabolic testing of patients with diabetes and severe mental illness before and after exclusion of patients who were nonadherent, by measurea
Table Footer Note

a The data were reanalyzed after excluding patients with severe mental illness who were too unwell or were unwilling to attend treatment.



De Hert  M;  Dekker  JM;  Wood  D, et al:  Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC).  European Psychiatry 24:412–424, 2009
[CrossRef] | [PubMed]
Mitchell  AJ;  Vancampfort  D;  Sweers  K  et al: Prevalence of metabolic syndrome and metabolic  abnormalities in schizophrenia and related disorders: a systematic review and meta-analysis. Schizophrenia Bulletin 39:306–318, 2011
Vancampfort  D;  Vansteelandt  K;  Correll  CU  et al: Prevalence of metabolic syndrome and metabolic abnormalities in bipolar disorders: a systematic review and meta-Analysis.  American Journal of Psychiatry 170:265–274, 2013
[CrossRef] | [PubMed]
Manu  P;  Correll  CU;  van Winkel  R  et al:  Prediabetes in patients treated with antipsychotic drugs.  Journal of Clinical Psychiatry 73:460–466, 2012
[CrossRef] | [PubMed]
Chiu  CC;  Chen  CH;  Chen  BY  et al:  The time-dependent change of insulin secretion in schizophrenic patients treated with olanzapine.  Progress in Neuro-Psychopharmacology and Biological Psychiatry 34:866–870, 2010
[CrossRef] | [PubMed]
De Hert  M;  Vancampfort  D;  Correll  CU  et al:  Guidelines for screening and monitoring of cardiometabolic risk in schizophrenia: systematic evaluation.  British Journal of Psychiatry 199:99–105, 2011
[CrossRef] | [PubMed]
American Diabetes Association; American Psychiatric Association; American Association of Clinical Endocrinologists, et al: Consensus Development Conference on Antipsychotic Drugs and Obesity and Diabetes.  Diabetes Care 27:596–601, 2004
[CrossRef] | [PubMed]
Quality and Outcomes Framework Guidance for GMS Contract 2012–2013. London, British Medical Association. Available at bma.org.uk/practical-support-at-work/contracts/independent-contractors/qof-guidance.
Hardy  S;  Hinks  P;  Gray  R:  Screening for cardiovascular risk in patients with severe mental illness in primary care: a comparison with patients with diabetes.  Journal of Mental Health 22:42–50, 2013
[CrossRef] | [PubMed]
Shrivastava  A;  Johnston  M;  Bureau  Y:  Stigma of mental illness: 2. noncompliance and intervention.  Mena Sana Monographs 1 :85–97, 2012
Mitchell  AJ;  Delaffon  V;  Vancampfort  D  et al:  Guideline concordant monitoring of metabolic risk in people treated with antipsychotic medication: systematic review and meta-analysis of screening practices.  Psychological Medicine 42:125–147, 2012
[CrossRef] | [PubMed]
Osborn  DP;  Baio  G;  Walters  K  et al:  Inequalities in the provision of cardiovascular screening to people with severe mental illnesses in primary care: cohort study in the United Kingdom THIN Primary Care Database 2000–2007.  Schizophrenia Research 129:104–110, 2011
[CrossRef] | [PubMed]
Druss  BG;  von Esenwein  SA;  Compton  MT  et al:  A randomized trial of medical care management for community mental health settings: the Primary Care Access, Referral, and Evaluation (PCARE) study.  American Journal of Psychiatry 167:151–159, 2010
[CrossRef] | [PubMed]
Himelhoch  S;  Daumit  G:  To whom do psychiatrists offer smoking-cessation counseling? American Journal of Psychiatry 160:2228–2230, 2003
[CrossRef] | [PubMed]
Bernardo  M;  Cañas  F;  Banegas  JR  et al:  Prevalence and awareness of cardiovascular risk factors in patients with schizophrenia: a cross-sectional study in a low cardiovascular disease risk geographical area.  European Psychiatry 24:431–441, 2009
[CrossRef] | [PubMed]
References Container

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe

Related Content
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 42.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 42.  >
DSM-5™ Clinical Cases > Chapter 13.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 20.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 42.  >
Topic Collections
Psychiatric News
Read more at Psychiatric News >>
PubMed Articles