Korean J Schizophr Res.  2019 Apr;22(1):14-20. 10.16946/kjsr.2019.22.1.14.

Factors Related to Physical Health Monitoring in Community-Dwelling Patients with Schizophrenia Spectrum Disorder

• Kim M
• Jhon M
• Lee JY
• Kim SY
• Kim JM
• Yoon JS
• Kim SJ
• Kim SW

• KMID: 2444217
• DOI: http://doi.org/10.16946/kjsr.2019.22.1.14

Abstract

OBJECTIVES
To identify factors related to physical health monitoring of patients with schizophrenia spectrum disorder.
METHODS
A total of 172 patients with schizophrenia spectrum disorder registered in mental health welfare centers and rehabilitation facilities in Gwangju were recruited. Physical health monitoring was defined by two health behaviors; fasting blood tests within recent 2 years in all participants and routine medical check-ups covered by national insurance within recent 5 years in participants aged 40 years or older. Demographic and clinical characteristics including overweight, metabolic syndrome and knowledge about physical illness were compared according to physical health monitoring.
RESULTS
Prevalence of overweight and metabolic syndrome were 62.8% and 40.1%, respectively. The rates of fasting blood tests and routine medical check-ups were 34.9% and 67.9%, respectively. The rates of fasting blood tests were significantly higher in general hospital and university hospital compared to mental hospital or private clinic. Rates of routine medical check-ups were significantly lower in individuals using daily rehabilitation service and smokers. Knowledge about cancer and chronic illness were significantly better in individuals receiving routine medical check-ups compared with those not receiving it.
CONCLUSION
Education about physical health should be integrated to mental health service in community mental health center.

Keyword

Schizophrenia; Physical health; Smoking; Medical check-ups; Community

MeSH Terms

Chronic Disease
Education
Fasting
Gwangju
Health Behavior
Hematologic Tests
Hospitals, General
Hospitals, Psychiatric
Humans
Insurance
Mental Health
Mental Health Services
Overweight
Prevalence
Rehabilitation
Schizophrenia*
Smoking

Reference

1. Oakley P, Kisely S, Baxter A, Harris M, Desoe J, Dziouba A, et al. Increased mortality among people with schizophrenia and other non-affective psychotic disorders in the community: a systematic review and meta-analysis. J Psychiatr Res. 2018; 102:245–253.

2. Hjorthøj C, Stürup AE, McGrath JJ, Nordentoft M. Years of potential life lost and life expectancy in schizophrenia: a systematic review and meta-analysis. Lancet Psychiatry. 2017; 4:295–301.

3. Brown S, Inskip H, Barraclough B. Causes of the excess mortality of schizophrenia. Br J Psychiatry. 2000; 177:212–217.

4. Thornicroft G. Physical health disparities and mental illness: the scandal of premature mortality. Br J Psychiatry. 2011; 199:441–442.

5. Marder SR, Essock SM, Miller AL, Buchanan RW, Casey DE, Davis JM, et al. Physical health monitoring of patients with schizophrenia. Am J Psychiatry. 2004; 161:1334–1349.

6. Penninx B, Lange SMM. Metabolic syndrome in psychiatric patients: overview, mechanisms, and implications. Dialogues Clin Neurosci. 2018; 20:63–73.

7. Lee WC, Lee SY. National health screening program of Korea. J Korean Med Assoc. 2010; 53:363–370.

8. Broyles RW, Narine L, Brandt EN Jr, Biard-Holmes D. Health risks, ability to pay, and the use of primary care: is the distribution of service effective and equitable? Prev Med. 2000; 30:453–462.

9. Roberts L, Roalfe A, Wilson S, Lester H. Physical health care of patients with schizophrenia in primary care: a comparative study. Fam Pract. 2006; 24:34–40.

10. Holmberg SK, Kane C. Health and self-care practices of persons with schizophrenia. Psychiatr Serv. 1999; 50:827–829.

11. Han SH, Jo EH, Son JA, So ES. Factors association national health screening program participation according to sex in Korean: using the fifth Korea national health and nutrition examination survey (KNHANES VI, 2013). Korean J Health Educ Promot. 2016; 33:37–48.

12. Park JH. Factors affecting the participation rate of the mass screenings of the disabled of national [dissertation]. Cho BH (MO): Seoul National Univ.;2006.

13. Guy W. ECDEU Assessment Manual for Psychopharmacology, Revised. Rockville, MD: National Institute of Mental Health;1976.

14. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001; 285:2486–2497.

15. Lee S, Park HS, Kim SM, Kwon HS, Kim DY, Kim DJ, et al. Cut-off points of waist circumference for defining abdominal obesity in the Korean population. J Obes Metab Syndr. 2006; 15:1–9.

16. Committee IR. Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ)-short and long forms. 2005. http://www.ipaqkise/scoring.pdf.

17. Park E, Choi SJ, Lee HY. The prevalence of metabolic syndrome and related risk factors based on the KNHANES V 2010. J Agric Med Community Health. 2013; 38:1–13.

18. Kwon HS, Park YM, Lee JH, Lee JH, Choi YH, Ko SH, et al. The prevalence and clinical characteristics of the metabolic syndrome in middle-aged Korean adults. Korean J Med. 2005; 68:359–368.

19. Nam YY, Kim CS, Ahn CW, Park KM, Ryu B, Kim CH. Clinical correlates of metabolic syndrome in patients with chronic schizophrenia. Korean J Psychopharmacol. 2006; 17:335–341.

20. Kang KD, Sea YH, Yoon BH. Prevalence of metabolic syndrome in chronic schizophrenic inpatients. J Korean Soc Biol Ther Psychiatry. 2012; 18:281–289.

21. Lee SH, Cho SH. Factors influencing metabolic syndrome among mental health facility patients with schizophrenia. J Korean Acad Psychiatr Ment Health Nurs. 2016; 25:1–10.

22. Liu NH, Daumit GL, Dua T, Aquila R, Charlson F, Cuijpers P, et al. Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas. World Psychiatry. 2017; 16:30–40.

23. Correll CU, Detraux J, De Lepeleire J, De Hert M. Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder. World Psychiatry. 2015; 14:119–136.

24. Korean Society for Schizophrenia Research. Cardiovascular-Metabolic Disorders Korean Related Guidelines Related to Antipsychotic Drugs. Korea: Seoul: 2008.

25. Excellence NIfC. Psychosis and schizophrenia in adults: prevention and management. NICE guidelines [CG178]. 2014.

26. Korean Statistical Information Service. Korea health statistics: Health screening [Internet]. Daejeon: Statistics Korea;2016. cited 2018 Dec 28. Available from URL:http://kosis.kr/statisticsList/statisticsListIndex.do?menuId=M_01_01&vwcd=MT_ZTITLE&parmTabId=M_01_01.

27. Lee W. Behavioral pattern for participating national health screening program and national cancer screening program. Seoul: National Health Insurance Corporation;2003.

28. Osborn DP, King MB, Nazareth I. Participation in screening for cardiovascular risk by people with schizophrenia or similar mental illnesses: cross sectional study in general practice. BMJ. 2003; 326:1122–1123.

29. Lambert TJ, Velakoulis D, Pantelis C. Medical comorbidity in schizophrenia. Med J Aust. 2003; 178:S67–S70.

30. Buhagiar K, Parsonage L, Osborn DP. Physical health behaviours and health locus of control in people with schizophrenia-spectrum disorder and bipolar disorder: a cross-sectional comparative study with people with non-psychotic mental illness. BMC Psychiatry. 2011; 11:104.

31. Ryan P. Integrated theory of health behavior change: background and intervention development. Clin Nurse Spec. 2009; 23:161–172.

32. Liu MH, Wang CH, Huang YY, Cherng WJ, Wang KW. A correlational study of illness knowledge, self-care behaviors, and quality of life in elderly patients with heart failure. J Nurs Res. 2014; 22:136–145.

33. Brewer NT, Chapman GB, Gibbons FX, Gerrard M, McCaul KD, Weinstein ND. Meta-analysis of the relationship between risk perception and health behavior: the example of vaccination. Health Psychol. 2007; 26:136–145.

34. Peterson NB, Dwyer KA, Mulvaney SA, Dietrich MS, Rothman RL. The influence of health literacy on colorectal cancer screening knowledge, beliefs and behavior. J Natl Med Assoc. 2007; 99:1105–1112.