Overweight, obesity prevalent in psychiatric inpatients

By Mark Cowen

Most inpatients with psychiatric disorders are overweight or obese, say Australian researchers who urge closer monitoring of the physical health of patients with mental illnesses.

"Early identification [of physical health problems] enables preventive interventions and assists clinicians and mental health staff to more effectively address the disparity in physical health outcomes between people with a mental illness and the general public," comment Susanne Stanley and colleagues from Fremantle Hospital in Western Australia.

In a study of 508 psychiatric inpatients from a public mental health service center in Western Australia, the team found that 32.7% were overweight (body mass index [BMI] 25.0-29.9 kg/m2) and 30.3% were obese (BMI =30.0 kg/m2).

Dividing the patients into six major diagnostic categories, the researchers found that patients with personality disorders had the highest mean BMI (30.07 kg/m2), followed by those with bipolar disorder (28.88 kg/m2), schizophrenia (27.76 kg/m2), "other" disorders (26.79 kg/m2), anxiety disorders (26.59 kg/m2), and depression (26.45 kg/m2).

A significantly higher proportion of men than women were overweight, at 37.6% versus 27.7%. Conversely, a significantly greater proportion of women than men were obese, at 34.0% versus 26.7%.

Among patients who were assessed more than once over a 9-month period, almost all showed a gradual increase in weight, the researchers note.

Writing in Social Psychiatry and Psychiatric Epidemiology, Stanley et al conclude: "The proportion of obese people within the mental health system far exceeds that of the general population, with these people at a much greater risk of becoming obese."

They add: "The findings of this study deal specifically with a sample of inpatients, where chronic illnesses present. Further research is needed to assess overweight and obesity, particularly with regard to personality disorders, with all patients in contact with mental health services.

"In addition, the identification of specific characteristics observed in patients who are gaining weight over time may work to prevent obesity and the resulting cardiovascular disease and Type 2 diabetes mellitus."

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