title: Poor monitoring of physical health in patients referred to a mood disorders service.
abstract: BACKGROUND
  Severe mental illness is associated with significantly increased morbidity and mortality, most commonly from cardiovascular disease. Much of the risk is explicable by potentially modifiable factors such as diabetes and dyslipidaemia, and regular screening of patients with severe mental illness is recommended. Screening and intervention for physical illness among people with schizophrenia is often suboptimal, but little is known about monitoring physical health in patients with affective (mood and anxiety) disorders.
  
  
  METHODS
  Electronic and paper records were examined for evidence of monitoring of cardiovascular disease risk factors in the 12 months prior to assessment in patients attending a tertiary referral specialist service for affective disorders over a period of 39 months. The number of contacts with healthcare services was calculated for each patient to provide an estimate of the opportunities for monitoring.
  
  
  RESULTS
  Notes for 113 patients were examined. The mean number of contacts with outpatient services in the 12 months before assessment was 6.9 (standard deviation 7.7). Documented evidence of physical-health monitoring was seen in only 29 patients: monitoring was more commonly undertaken in patients with recurrent unipolar depression and in those who had undergone recent inpatient treatment. Contacts that could have allowed monitoring of physical health were common.
  
  
  CONCLUSIONS
  Although most patients had multiple contacts with health services in the 12-month period before their assessment in the service, there was little evidence of use of primary-prevention measures to reduce the risks of diabetes and cardiovascular disease in this vulnerable population.
authors: Alexandra Hospital, Worcestershire Acute NHS Trust, Redditch, UK.
authors: David
authors: D
authors: Lack
authors: Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, UK.
authors: Richard I G
authors: RI
authors: Holt
authors: Professor of Psychiatry, Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton, University Department of Psychiatry, 4-12 Terminus Terrace, Southampton, SO14 3DT, UK.
authors: David S
authors: DS
authors: Baldwin
keywords: affective disorder; monitoring; physical health
references: Psychosom Med. 1999 Jan-Feb;61(1):6-17
references: 10024062
references: World Psychiatry. 2011 Jun;10(2):138-51
references: 21633691
references: J Psychopharmacol. 2010 Jun;24(6):867-73
references: 19304868
references: BMC Health Serv Res. 2013 Oct 21;13:426
references: 24144438
references: Schizophr Bull. 2007 Nov;33(6):1397-403
references: 17483101
references: J Affect Disord. 2010 Nov;126(3):366-87
references: 20541810
references: Ment Health Fam Med. 2010 Jun;7(2):115-22
references: 22477930
references: J Affect Disord. 2002 Jun;70(1):19-26
references: 12113916
references: Ann Clin Psychiatry. 2011 Feb;23(1):40-7
references: 21318195
references: J Clin Psychiatry. 2008 Aug;69(8):1319-27
references: 18681750
references: J Clin Psychiatry. 2012 Jan;73(1):31-6
references: 21903027
references: Eur Psychiatry. 2009 Sep;24(6):412-24
references: 19682863
references: Br J Psychiatry. 1997 Dec;171:502-8
references: 9519087
references: Acta Psychiatr Scand. 2008 Jul;118(1):26-33
references: 18582345
references: Br J Psychiatry. 2000 Sep;177:212-7
references: 11040880
references: Early Interv Psychiatry. 2009 Nov;3(4):312-6
references: 22642736
references: Acta Psychiatr Scand Suppl. 2013;(442):3-10
references: 23581787