Obesity, Disease Linked With Chronic Mental Disorders in Urban Patients

July 2006, Vol. XXIII, No. 8

Researchers found a high incidence of health problems such as obesity, hypertension, and diabetes in predominantly Hispanic outpatients with chronic mental disorders. David J. Hellerstein,MD, and colleagues from the New York State Psychiatric Institute in New York City, reviewed 69 community day treatment program patients with chronic psychotic disorders (mostly schizophrenia- spectrum disorders). Data were recorded for blood pressure, weight, girth, body mass index (BMI), glucose and lipid levels, nutritional habits, and medical care.

Eighty-nine percent of women and 59% of men were overweight (BMI greater than 25), and 60% of women and 40% of men were obese (BMI greater than 30). Not surprisingly, the investigators found that treatment with atypical antipsychotics was significantly associated with obesity. Female patients had a striking degree of abdominal obesity, which is associated with increased rate of heart disease, diabetes, and premature death. The women's mean BMI was 31.7, compared with 30.3 for women with schizophrenia in the general US population; the BMI for the men in the study averaged 27.8, which was comparable to the 27.2 average among men with schizophrenia in the general population.

The study also found that 77% of the participants had elevated blood pressure, 32% were hypertensive, and 53% had elevated random blood glucose levels. These medical conditions had often not been noted by treating clinicians. The researchers noted that these findings suggest a high risk of cardiac illness in chronically mentally ill Hispanic outpatients and emphasized the need for developing culturally sensitive interventions for this group. The investigators are currently replicating these findings in other clinic patients and are beginning an intervention that will include enhanced health monitoring, nutritional education, and exercise programming.