Inpatients with severe mental illness at increased risk for diabetes, hypertension

Patients hospitalized with serious mental illness had a cardiometabolic profile that conferred increased risk for diabetes and hypertension-related mortality, according to results of an observational study published in Psychiatry Research.

“Some patients with severe mental illness are poorly engaged with outpatient treatment and their contact with services occurs mostly in moments of crisis that lead to hospitalization,” Luca Lavagnino, MD, PhD, assistant professor of psychiatry and behavioral sciences at the University of Texas Health Science Center at Houston, and colleagues wrote. “These patients might present a different profile of cardiometabolic risk factors. No studies have compared cardiometabolic risk factors in hospitalized patients with severe mental illness to a representative sample of the general population.”

To address this research gap, the investigators used a form of propensity score matching called entropy balancing to compare cardiometabolic health of a sample of the general population from the National Health and Nutrition Examination Survey (NHANES) datasets with that of inpatients hospitalized in an urban psychiatric hospital in Texas. Lavagnino and colleagues analyzed data via independent linear regression models, with outcome variables including blood pressure, blood glucose, triglyceride to high-density lipoprotein (TG:HDL) ratio, total cholesterol and BMI.

Results showed elevations in systolic blood pressure, diastolic blood pressure, blood glucose and the TG:HDL ratio among the psychiatric inpatient sample compared with the NHANES samples. However, the psychiatric inpatient sample had lower cholesterol and BMI compared with the NHANES sample.

“Our study suggests a specific risk profile for cardiometabolic disorders in hospitalized patients with severe mental illness,” Lavagnino and colleagues wrote. “Further work is necessary to determine the underlying pathophysiology in psychiatric inpatients and to plan appropriate interventions to reduce morbidity and mortality in this at-risk population.”