Diagnostic tests and treatment procedures performed prior to cardiovascular death in individuals with severe mental illness.

Autor: Heiberg IH; Center for Clinical Documentation and Evaluation (SKDE), Tromsø, Norway., Nesvåg R; Norwegian Medical Association, Oslo, Norway.; Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway., Balteskard L; Center for Clinical Documentation and Evaluation (SKDE), Tromsø, Norway., Bramness JG; Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.; Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Hamar, Norway., Hultman CM; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.; Icahn School of Medicine, Mt Sinai Hospital, New York, NY, USA., Naess Ø; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Institute of Health and Society, University of Oslo, Oslo, Norway., Reichborn-Kjennerud T; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway., Ystrom E; Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway.; Department of Psychology, PROMENTA Research Center, University of Oslo, Oslo, Norway.; PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy, University of Oslo, Oslo, Norway., Jacobsen BK; Center for Clinical Documentation and Evaluation (SKDE), Tromsø, Norway.; Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.; Department of Community Medicine, Centre for Sami Health Research, UiT - The Arctic University of Norway, Tromsø, Norway., Høye A; Center for Clinical Documentation and Evaluation (SKDE), Tromsø, Norway.; Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.; Division of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø, Norway.
Jazyk: angličtina
Zdroj: Acta psychiatrica Scandinavica [Acta Psychiatr Scand] 2020 May; Vol. 141 (5), pp. 439-451. Date of Electronic Publication: 2020 Feb 29.
DOI: 10.1111/acps.13157
Abstrakt: Objective: To examine whether severe mental illnesses (i.e., schizophrenia or bipolar disorder) affected diagnostic testing and treatment for cardiovascular diseases in primary and specialized health care.
Methods: We performed a nationwide study of 72 385 individuals who died from cardiovascular disease, of whom 1487 had been diagnosed with severe mental illnesses. Log-binomial regression analysis was applied to study the impact of severe mental illnesses on the uptake of diagnostic tests (e.g., 24-h blood pressure, glucose/HbA1c measurements, electrocardiography, echocardiography, coronary angiography, and ultrasound of peripheral vessels) and invasive cardiovascular treatments (i.e., revascularization, arrhythmia treatment, and vascular surgery).
Results: Patients with and without severe mental illnesses had similar prevalences of cardiovascular diagnostic tests performed in primary care, but patients with schizophrenia had lower prevalences of specialized cardiovascular examinations (prevalence ratio (PR) 0.78; 95% CI 0.73-0.85). Subjects with severe mental illnesses had lower prevalences of invasive cardiovascular treatments (schizophrenia, PR 0.58; 95% CI 0.49-0.70, bipolar disorder, PR 0.78; 95% CI 0.66-0.92). The prevalence of invasive cardiovascular treatments was similar in patients with and without severe mental illnesses when cardiovascular disease was diagnosed before death.
Conclusion: Better access to specialized cardiovascular examinations is important to ensure equal cardiovascular treatments among individuals with severe mental illnesses.
(© 2020 The Authors. Acta Psychiatrica Scandinavica published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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