title: Podiatric problems are associated with worse health status in persons with severe mental illness.
abstract: The objective of this study was to determine the prevalence of self-reported podiatric impairments and their effect on health status in persons with severe mental illness. A sample of psychiatric outpatients (N=309) underwent interviews assessing medical conditions and health status with the Medical Outcomes Study Short Form-36 (SF-36). Podiatric health was assessed using nine items from the National Health Interview Survey (NHIS). Eighty percent of patients reported at least one podiatric problem. The most common problems were foot pain (48%), nail disorders (35%) and corns/calluses (28%). Prevalence rates were 4-11 times higher than those reported by the general population in the 1990 NHIS. The total number of podiatric problems was inversely related to eight self-reported health status domains and both summary SF-36 scores (all P<==.0001). After controlling for sociodemographic factors, psychiatric illness and medical conditions, the total number of podiatric limitations remained significantly associated with lower patient ratings in four of the eight SF-36 domains and both summary scores. We concluded that persons with severe and persistent mental illness have markedly elevated rates of podiatric problems when compared to the general population group. These problems are associated with worsened self-perceived health status. Addressing podiatric health may be a successful way to improve the overall health of this population.
authors.affiliation: Division of General Internal Medicine, University of Colorado Health Sciences Center, Denver, CO, USA. ccrews@dhha.org
authors.forename: Cynthia K
authors.initials: CK
authors.lastname: Crews
authors.forename: Kieu O
authors.initials: KO
authors.lastname: Vu
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Davidson
authors.forename: Lori A
authors.initials: LA
authors.lastname: Crane
authors.forename: Philip S
authors.initials: PS
authors.lastname: Mehler
authors.forename: John F
authors.initials: JF
authors.lastname: Steiner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003120:Colorado / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005530:Foot Deformities / Q000453:epidemiology*; D005534:Foot Diseases / Q000453:epidemiology*; D006305:Health Status Indicators; D006801:Humans; D007407:Interviews as Topic; D016014:Linear Models; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000150:complications / Q000453:epidemiology*; D008605:Mental Health Services; D008875:Middle Aged; D009309:National Center for Health Statistics, U.S.; D011032:Podiatry; D015995:Prevalence; D012648:Self Care; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology