Cardiometabolic risk

Treating Mental Illness with an Awareness of CMR

Volume 54 - Issue 9 - September 2014

Friday, October 10, 2014 at 11:05 am

LAS VEGAS—When treating mental health patients, practitioners need to be mindful of untreated cardiometabolic co-morbidities, and prescribe treatment regimens accordingly.

Awareness of the link between mental illness and increased risk of morbidity and mortality (especially with regard to cardiometabolic syndromes) is of utmost importance, according to Saundra Jain, MA, PsyD, LPC, who discusses this overlap in her presentation, “Distress and Depression Associated with Cardiometabolic Risk.”
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Jain, an adjunct clinical affiliate at the University of Texas at Austin, analyzes data on various interventions that could reduce adverse outcomes of metabolic disorders in mentally ill patients and explains how to use certain interventions in clinical practice.

According to one study that evaluated mental health patients across 8 states, researchers discovered a 25- to 30-year decrease in the average lifespan of those suffering from a mental illness. Sixty percent of this increased mortality is due to premature cardiovascular disease (eg, myocardial infarction and stroke).1

Note: Prevalence of cardiometabolic risk factors is 24% higher in mentally ill patients versus the general population.2

Jain presents 4 strategies for physicians treating patients with mental illness and CMR:

  • Select psychotropic medications with a less adverse impact on cardiometabolics. The CATIE study shows that it is not uncommon for patients being treated for mental illness to have untreated cardiometabolic syndromes that may be exacerbated by drugs targeting mental illness.3
  • Recommend exercise. A mix of different types of exercise appears to have the most positive impact. 4
  • Recommend mindful-based meditation.  Dating back over 5000 years, meditation has proven mental health benefits. This in practice with being mindful (ie, being in the present) can have positive physical and mental improvements.
  • Focus on cognitive-behavioral therapy. An approach that focuses on the connectivity between thought, emotion, and behavior.

“Cardiometabolic risk (CMR) is something that we as clinicians must pay close attention to by proactively screening all patients with mental health disorders. In order to minimize CMR, we have several available interventions including wise selection of psychotropic medications, physical exercise, cognitive behavioral therapy, and mindfulness meditation,” said Jain.

A key focus of Dr. Jain’s presentation is to provide clear guidance on reducing CMR.

“My session will allow healthcare providers to learn more about these interventions and ways to incorporate them into their clinical practices,” she said.

-Michelle Canales

References:

  1. National Association of State Mental Health Program Directors. Morbidity and Mortality in People with Serious Mental Illness. PublishedOctober 2006. Accessed September 29, 2014.
  2. Beltrán-Sánchez H, Harhay MO, Harhay MM, et al. Prevalence and Trends of Metabolic Syndrome in the Adult U.S. Population, 1999-2010. J Am Coll Cardiol. 2013;62(8):697-703.
  3. Nasrallah HA, Meyer JM, Goff DC, et al. Low rates of treatment for hypertension, dyslipidemia and diabetes in schizophrenia: data from the CATIE schizophrenia trial sample at baseline. Schizophr Res. 2006;86(1-3):15-22.
  4. Mead GE, Morley W, Campbell P, et al. Exercise for Depression. Cochrane Database Syst Rev. 2008;(4):CD004366.