David P J Osborn1, Irwin Nazareth, Michael B King. 1. Department of Mental Health Sciences, (Hampstead Campus), Royal Free and University College Medical School, London, UK. d.osborn@medsch.ucl.ac.uk
Abstract
BACKGROUND: Evidence regarding Coronary Heart Disease (CHD) related lifestyle in people with severe mental illnesses (SMI) such as schizophrenia is sparse. We aimed to quantify adverse CHD knowledge, diet and exercise in a representative primary care sample, and to determine whether socio-economic deprivation explained any findings. METHOD: We compared CHD lifestyle and CHD knowledge in 74 people with SMI and 148 without from seven general practices. We measured CHD knowledge, dietary fibre, fats and exercise using validated instruments and adjusted for socio-economic status. RESULTS: Fewer people with SMI had higher CHD knowledge: OR 0.49 (95% CI: 0.27-0.88), higher total exercise scores 0.49 (0.27-0.86), higher fibre 0.46 (0.26-0.82) or lower saturated fat diets 0.53 (0.30-0.94). These results were stable irrespective of antipsychotic medication, socio-economic status or type of statistical analysis. CONCLUSION: High fat, low fibre diets, lack of exercise and smoking are the likely causes of the majority of CHD in this high-risk group, irrespective of medication and socio-economic deprivation. This lifestyle and particularly the lower CHD knowledge provides a theoretical focus for more comprehensive preventative CHD interventions in SMI.
BACKGROUND: Evidence regarding Coronary Heart Disease (CHD) related lifestyle in people with severe mental illnesses (SMI) such as schizophrenia is sparse. We aimed to quantify adverse CHD knowledge, diet and exercise in a representative primary care sample, and to determine whether socio-economic deprivation explained any findings. METHOD: We compared CHD lifestyle and CHD knowledge in 74 people with SMI and 148 without from seven general practices. We measured CHD knowledge, dietary fibre, fats and exercise using validated instruments and adjusted for socio-economic status. RESULTS: Fewer people with SMI had higher CHD knowledge: OR 0.49 (95% CI: 0.27-0.88), higher total exercise scores 0.49 (0.27-0.86), higher fibre 0.46 (0.26-0.82) or lower saturated fat diets 0.53 (0.30-0.94). These results were stable irrespective of antipsychotic medication, socio-economic status or type of statistical analysis. CONCLUSION: High fat, low fibre diets, lack of exercise and smoking are the likely causes of the majority of CHD in this high-risk group, irrespective of medication and socio-economic deprivation. This lifestyle and particularly the lower CHD knowledge provides a theoretical focus for more comprehensive preventative CHD interventions in SMI.
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