Physical health status of older adults with severe mental illness: The PHiSMI-E cohort study

N. Houben, E.P.C.J. Janssen, M.R.C. Hendriks, D. van der Kellen, B.P.J. van Alphen, B. Meijel

Research output: Contribution to journalArticleScientificpeer-review

Abstract

The objective was to use various somatic parameters as basis for investigating the physical health of older adults with severe mental illnesses (SMI). A cross‐sectional study design is performed by using baseline data from the Physical Health in SMI‐elderly (PHiSMI‐E) study. Data were collected using the Nursing Monitoring of Somatic Status and Lifestyle – Mental Health instrument in adults aged over 60 with SMI in a large Dutch mental health institute. Ninety‐nine elderly SMI patients were included. Somatic comorbidity (84.8%), use of somatic medication (77.7%) and polypharmacy (67.7%) were prevalent. Extrapyramidal symptoms were experienced by 51% of patients, mainly in the subgroup with psychotic disorders (75.6%). Unhealthy diet was reported in 16.2%, obesity in 27.3%, and physical inactivity in 57.6%. Fatigue (67.7%) and dry mouth (66.6%) were the commonest reported physical symptoms. Mean VAS score (scale 0–10) indicating participants’ self‐perceived physical health was 6.7 (SD ± 1.6). After division of the total patient group into tertiles based on the VAS scores, the lowest tertile was characterized by less physical activity, unhealthier diet, more use of medication, more fatigue, somnolence, and inner agitation. In conclusion, impaired physical health status was common in these older patients with SMI. Although they had more psychiatric and somatic comorbidity than adult SMI patients described in the literature, they had a healthier lifestyle. To reduce morbidity and premature mortality in these frail patients, it is essential that healthcare providers are aware of the high prevalence of somatic comorbidity and symptoms, and of their interactions with the psychiatric disorders. This study improves our understanding of differences in vulnerability factors of older patients with SMI. The (early) detection of somatic comorbidities may improve long‐term health outcomes of these patients.
Original languageEnglish
Pages (from-to)457-467
Number of pages11
JournalInternational Journal of Mental Health Nursing
Volume28
Issue number2
Early online date2019
DOIs
Publication statusPublished - Apr 2019

Fingerprint

Comorbidity
Mentally Ill Persons
Mental Health
Health Personnel
Exercise

Keywords

  • ANTIPSYCHOTICS
  • ASSOCIATION
  • CARE
  • DISORDERS
  • MANAGEMENT
  • MEDICAL COMORBIDITY
  • MORTALITY
  • PEOPLE
  • PREVALENCE
  • SCHIZOPHRENIA
  • elderly
  • health status
  • mental health nursing
  • mental illnesses
  • severe mental illness

Cite this

Houben, N. ; Janssen, E.P.C.J. ; Hendriks, M.R.C. ; van der Kellen, D. ; van Alphen, B.P.J. ; Meijel, B. / Physical health status of older adults with severe mental illness : The PHiSMI-E cohort study. In: International Journal of Mental Health Nursing. 2019 ; Vol. 28, No. 2. pp. 457-467.
@article{14c59efaf8ff4936957599bdb9093886,
title = "Physical health status of older adults with severe mental illness: The PHiSMI-E cohort study",
abstract = "The objective was to use various somatic parameters as basis for investigating the physical health of older adults with severe mental illnesses (SMI). A cross‐sectional study design is performed by using baseline data from the Physical Health in SMI‐elderly (PHiSMI‐E) study. Data were collected using the Nursing Monitoring of Somatic Status and Lifestyle – Mental Health instrument in adults aged over 60 with SMI in a large Dutch mental health institute. Ninety‐nine elderly SMI patients were included. Somatic comorbidity (84.8{\%}), use of somatic medication (77.7{\%}) and polypharmacy (67.7{\%}) were prevalent. Extrapyramidal symptoms were experienced by 51{\%} of patients, mainly in the subgroup with psychotic disorders (75.6{\%}). Unhealthy diet was reported in 16.2{\%}, obesity in 27.3{\%}, and physical inactivity in 57.6{\%}. Fatigue (67.7{\%}) and dry mouth (66.6{\%}) were the commonest reported physical symptoms. Mean VAS score (scale 0–10) indicating participants’ self‐perceived physical health was 6.7 (SD ± 1.6). After division of the total patient group into tertiles based on the VAS scores, the lowest tertile was characterized by less physical activity, unhealthier diet, more use of medication, more fatigue, somnolence, and inner agitation. In conclusion, impaired physical health status was common in these older patients with SMI. Although they had more psychiatric and somatic comorbidity than adult SMI patients described in the literature, they had a healthier lifestyle. To reduce morbidity and premature mortality in these frail patients, it is essential that healthcare providers are aware of the high prevalence of somatic comorbidity and symptoms, and of their interactions with the psychiatric disorders. This study improves our understanding of differences in vulnerability factors of older patients with SMI. The (early) detection of somatic comorbidities may improve long‐term health outcomes of these patients.",
keywords = "ANTIPSYCHOTICS, ASSOCIATION, CARE, DISORDERS, MANAGEMENT, MEDICAL COMORBIDITY, MORTALITY, PEOPLE, PREVALENCE, SCHIZOPHRENIA, elderly, health status, mental health nursing, mental illnesses, severe mental illness",
author = "N. Houben and E.P.C.J. Janssen and M.R.C. Hendriks and {van der Kellen}, D. and {van Alphen}, B.P.J. and B. Meijel",
year = "2019",
month = "4",
doi = "10.1111/inm.12547",
language = "English",
volume = "28",
pages = "457--467",
journal = "International Journal of Mental Health Nursing",
issn = "1445-8330",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "2",

}

Physical health status of older adults with severe mental illness : The PHiSMI-E cohort study. / Houben, N.; Janssen, E.P.C.J.; Hendriks, M.R.C.; van der Kellen, D.; van Alphen, B.P.J.; Meijel, B.

In: International Journal of Mental Health Nursing, Vol. 28, No. 2, 04.2019, p. 457-467.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Physical health status of older adults with severe mental illness

T2 - The PHiSMI-E cohort study

AU - Houben, N.

AU - Janssen, E.P.C.J.

AU - Hendriks, M.R.C.

AU - van der Kellen, D.

AU - van Alphen, B.P.J.

AU - Meijel, B.

PY - 2019/4

Y1 - 2019/4

N2 - The objective was to use various somatic parameters as basis for investigating the physical health of older adults with severe mental illnesses (SMI). A cross‐sectional study design is performed by using baseline data from the Physical Health in SMI‐elderly (PHiSMI‐E) study. Data were collected using the Nursing Monitoring of Somatic Status and Lifestyle – Mental Health instrument in adults aged over 60 with SMI in a large Dutch mental health institute. Ninety‐nine elderly SMI patients were included. Somatic comorbidity (84.8%), use of somatic medication (77.7%) and polypharmacy (67.7%) were prevalent. Extrapyramidal symptoms were experienced by 51% of patients, mainly in the subgroup with psychotic disorders (75.6%). Unhealthy diet was reported in 16.2%, obesity in 27.3%, and physical inactivity in 57.6%. Fatigue (67.7%) and dry mouth (66.6%) were the commonest reported physical symptoms. Mean VAS score (scale 0–10) indicating participants’ self‐perceived physical health was 6.7 (SD ± 1.6). After division of the total patient group into tertiles based on the VAS scores, the lowest tertile was characterized by less physical activity, unhealthier diet, more use of medication, more fatigue, somnolence, and inner agitation. In conclusion, impaired physical health status was common in these older patients with SMI. Although they had more psychiatric and somatic comorbidity than adult SMI patients described in the literature, they had a healthier lifestyle. To reduce morbidity and premature mortality in these frail patients, it is essential that healthcare providers are aware of the high prevalence of somatic comorbidity and symptoms, and of their interactions with the psychiatric disorders. This study improves our understanding of differences in vulnerability factors of older patients with SMI. The (early) detection of somatic comorbidities may improve long‐term health outcomes of these patients.

AB - The objective was to use various somatic parameters as basis for investigating the physical health of older adults with severe mental illnesses (SMI). A cross‐sectional study design is performed by using baseline data from the Physical Health in SMI‐elderly (PHiSMI‐E) study. Data were collected using the Nursing Monitoring of Somatic Status and Lifestyle – Mental Health instrument in adults aged over 60 with SMI in a large Dutch mental health institute. Ninety‐nine elderly SMI patients were included. Somatic comorbidity (84.8%), use of somatic medication (77.7%) and polypharmacy (67.7%) were prevalent. Extrapyramidal symptoms were experienced by 51% of patients, mainly in the subgroup with psychotic disorders (75.6%). Unhealthy diet was reported in 16.2%, obesity in 27.3%, and physical inactivity in 57.6%. Fatigue (67.7%) and dry mouth (66.6%) were the commonest reported physical symptoms. Mean VAS score (scale 0–10) indicating participants’ self‐perceived physical health was 6.7 (SD ± 1.6). After division of the total patient group into tertiles based on the VAS scores, the lowest tertile was characterized by less physical activity, unhealthier diet, more use of medication, more fatigue, somnolence, and inner agitation. In conclusion, impaired physical health status was common in these older patients with SMI. Although they had more psychiatric and somatic comorbidity than adult SMI patients described in the literature, they had a healthier lifestyle. To reduce morbidity and premature mortality in these frail patients, it is essential that healthcare providers are aware of the high prevalence of somatic comorbidity and symptoms, and of their interactions with the psychiatric disorders. This study improves our understanding of differences in vulnerability factors of older patients with SMI. The (early) detection of somatic comorbidities may improve long‐term health outcomes of these patients.

KW - ANTIPSYCHOTICS

KW - ASSOCIATION

KW - CARE

KW - DISORDERS

KW - MANAGEMENT

KW - MEDICAL COMORBIDITY

KW - MORTALITY

KW - PEOPLE

KW - PREVALENCE

KW - SCHIZOPHRENIA

KW - elderly

KW - health status

KW - mental health nursing

KW - mental illnesses

KW - severe mental illness

U2 - 10.1111/inm.12547

DO - 10.1111/inm.12547

M3 - Article

VL - 28

SP - 457

EP - 467

JO - International Journal of Mental Health Nursing

JF - International Journal of Mental Health Nursing

SN - 1445-8330

IS - 2

ER -