Systematic screening for metabolic syndrome in consumers with severe mental illness

Abstract

The high prevalence of metabolic syndrome (MetS) in people with a mental illness has been reported recently in the literature. Gaps have emerged in the widespread use of systematic screening methods that identify this collection of critical risk factors for cardiac and metabolic disorders in people with severe mental illness. A sample (n = 103) of consumers with severe mental illness was screened for MetS using the Metabolic Syndrome Screening Tool and compared to a sample (n = 72) of consumers who were not receiving a systematic approach to screening for MetS. The results demonstrated ad hoc screening of consumers for MetS in the comparison group, potentially leaving patients at risk of cardiac and metabolic disorders being untreated. Mental health nurses are well placed to show leadership in the screening, treatment, and ongoing management of MetS in people with severe mental illness. A potential new speciality role entitled the 'cardiometabolic mental health nurse' is proposed as a means leading to improved outcomes for consumers who have both the complication of physical health problems and a severe mental illness.

Nurses' views on physical activity for people with serious mental illness

“…This would involve identification, monitoring and consultation-liaison of physical health with consumers, and in particular, cardiometabolic problems (Brunero & Lamont, 2009). The centeredness of physical activity in prevention and management of cardiometabolic illnesses (USDHHS, 2008) suggests that physical activity would be appropriate for such a nursing role.…”

“…The third approach is to incorporate physical activity promotion into nursing roles under development for mental health care, such as the 'cardiovascular mental health nurse' (Brunero & Lamont, 2009). This would involve identification, monitoring and consultation-liaison of physical health with consumers, and in particular, cardiometabolic problems (Brunero & Lamont, 2009).…”

Translating theory and evidence into practice: What is the role of health professionals?

“…However, fragmentation, both in the lives of individuals living with serious mental illness, and fragmentation in healthcare and community systems, continually challenged efforts to provide holistic lifestyle support and care. These authors suggest one innovative approach to nursing practice development through the establishment of the 'cardiovascular mental health nurse' (Brunero & Lamont, 2009). Their primary role would be to tackle this fragmentation and coordinate greater interprofessional collaboration in addressing the physical health needs of patients.…”

A simple screening tool for metabolic syndrome risk in the psychiatric patient treated with antipsychotic medication

“…Obesity grade 1 was not related with the endpoint of death or cardiovascular complications, suggesting that the excess of deaths in obese patients was mainly due to increased mortality at higher BMI levels. [27] …”

“…Some recent studies may support the fact that a BMI greater than 25 but less than 35 can offer protection from cardiovascular disease as the "obesity paradox". [27] Recent findings have revealed epidemiological evidence showing that overweight and low-obesity categories may have a protective cardiovascular effect in the presence of chronic conditions (e.g., heart disease or diabetes) or older age when compared with normal weight or severe obesity.…”