Cardio-metabolic abnormalities among patients with severe mental illness at a Regional Referral Hospital in southwestern Uganda
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Date
2020
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Abstract
Patients with severe mental illness (SMI) have a higher burden of premature cardio-metabolic
abnormalities, including diabetes mellitus, hypertension, hyperlipidemia, and obesity
resulting into a 3-fold increase in mortality, and up to 20% reduction in life expectancy compared
to the general population. Although over 30% of Ugandans have some form of mental
illness, there are no national or hospital-based screening guidelines for cardio-metabolic
abnormalities among these patients a general trend in most low-income countries. The
screening rates for cardio-metabolic abnormalities in most low-income countries are at only
0.6%. The objective of this study was to describe the cardio-metabolic abnormalities among
patients with SMI at Mbarara Regional Referral Hospital. Through a cross-sectional study,
we recruited 304 patients with SMI and evaluated them for cardio-metabolic abnormalities
using the National Cholesterol Education Programme Adult Treatment Panel III criteria for
dyslipidemias, World Health Organisation criteria for diabetes mellitus, obesity, and the
Joint national committee criteria for hypertension. We then determined the proportion of participants
who met the criteria for each of the individual cardio-metabolic abnormalities. Of
the 304 participants, 44.41% were male and 55.59% female with a mean age of 38.56
±13.66 years. Almost half (46.38%) of the participants were either overweight or obese,
33.22% had abdominal obesity, 40.46% were hypertensive, 34.11% had low high-density
lipoproteins, 37.42% had hypertriglyceridemia and 34.77% had hypercholesterolemia.
Based on fasting blood sugar, 11.18% and 9.87% had pre-diabetes and diabetes respectively.
There is a high level of cardio-metabolic abnormalities among patients with psychiatric
disorders and thus metabolic screening for these abnormalities should be done routinely
during psychiatric reviews. There is a need for national guidelines for screening of metabolic
abnormalities among patients with SMI so that these abnormalities can be detected early
enough at stages where they can be either reversed or delayed to progress to cardiovascular
disease.
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Keywords
Cardio-metabolic abnormalities, Patients, Mental illness, Regional Referral Hospital
Citation
Agaba DC, Migisha R, Katamba G, Ashaba S (2020) Cardio-metabolic abnormalities among patients with severe mental illness at a Regional Referral Hospital in southwestern Uganda. PLoS ONE 15(7): e0235956. https://doi. org/10.1371/journal.pone.0235956