High prevalence of risk factors for physical illness in a long-stay psychiatric unit

Objective: The aim of this study was to determine the prevalence of risk factors for physical illness in a long stay psychiatric unit, where all care (both psychiatric and physical) is provided by the psychiatric team. Method: All patients in the long-stay ward had a full physical examination including calculation of BMI. All patients had blood sampling including FBC, U&E, LFTs, TFTs, lipid profile (total cholesterol, triglycerides, HDL and LDL), glucose, HbA1c, and prolactin. ATP111 criteria were used to determine the presence of the metabolic syndrome. Results: We found the mean number of comorbid medical diagnosis was 2.7. The prevalence of metabolic syndrome was 40.7% (44.4% of females and 24.1% of males). The prevalence of obesity was 51%, and 51% also had a total cholesterols in excess of 5.0mmol/l. Prolactin was elevated in two-thirds of female patients. Conclusion: We conclude that the annual physical examination is of limited value in long-stay psychiatric unit. The high prevalence of physical illness and physical risk factors warrants primary care involvement in screening and treatment of long-stay psychiatric patients.