Prevalence of physical health conditions and health risk behaviours in people with severe mental illness in South Asia: protocol for a cross-sectional study (IMPACT SMI survey)

Abstract

IntroductionPeople with severe mental illness (SMI) die on average 10–20 years earlier than the general population. Most of these deaths are due to physical health conditions. The aim of this cross-sectional study is to determine the prevalence of physical health conditions and their associations with health-risk behaviours, health-related quality of life and various demographic, behavioural, cognitive, psychological and social variables in people with SMI attending specialist mental health facilities in South Asia.Methods and analysisWe will conduct a survey of patients with SMI attending specialist mental health facilities in Bangladesh, India and Pakistan (n=4500). Diagnosis of SMI will be confirmed using the Mini-international neuropsychiatric interview V.6.0. We will collect information about physical health and related health-risk behaviours (WHO STEPwise approach to Surveillance (STEPS)); severity of common mental disorders (Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder scale (GAD-7)) and health-related quality of life (EQ-5D-5L). We will measure blood pressure, height, weight and waist circumference according to WHO guidelines. We will also measure glycated haemoglobin, lipid profile, thyroid function, liver function, creatinine and haemoglobin. Prevalence rates of physical health conditions and health-risk behaviours will be presented and compared with the WHO STEPS survey findings in the general population. Regression analyses will explore the association between health-risk behaviours, mental and physical health conditions.Ethics and disseminationThe study has been approved by the ethics committees of the Department of Health Sciences University of York (UK), Centre for Injury Prevention and Rehabilitation (Bangladesh), Health Ministry Screening Committee and Indian Council of Medical Research (India) and National Bioethics Committee (Pakistan). Findings will be disseminated in peer-reviewed articles, in local and international conferences and as reports for policymakers and stakeholders in the countries involved.Trial registration numberISRCTN88485933; 3 June 2019.

Knowledge and Response to the COVID-19 Pandemic in People With Severe Mental Illness in Bangladesh and Pakistan: A Cross-Sectional Survey

“…We conducted a cross-sectional survey of health, health risk behaviors, and healthcare use in people with SMI in three South Asian countries before the pandemic started: the IMPACT study [ISRCTN registry: 88485933; ( 8 , 25 )].…”

“…Adults aged 18 years and above with SMI [schizophrenia, bipolar disorder, schizoaffective disorder, and depression with psychotic symptoms; clinician-diagnosed and confirmed using the international neuropsychiatric interview; MINI version 6.0 ( 26 )], attending three national institutes of mental health (in Bangladesh, India, and Pakistan) between July 2019 and March 2020 were recruited to the IMPACT survey ( 25 ). Stratified sampling was used to recruit a sample comprising 80% outpatients and 20% inpatients, reflecting the service usual case mix proportion of inpatients and outpatients ( 25 ). The protocol provides further details including the justification of the sample size ( 25 ).…”

“…Stratified sampling was used to recruit a sample comprising 80% outpatients and 20% inpatients, reflecting the service usual case mix proportion of inpatients and outpatients ( 25 ). The protocol provides further details including the justification of the sample size ( 25 ).…”

“…Data were collected via a telephone interview and recorded in a tablet device using Qualtrics ( 25 ). Each participant took around 40–60 min to answer the questions via phone.…”

“…Demographic data (gender, age, education, employment status, monthly income, and marital status) were taken from the IMPACT survey ( 25 ).…”