Metabolic Syndrome and Mental Illness

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 17110

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Guest Editor
Department of Nursing, I-Shou University, Kaohsiung, Taiwan
Interests: cognitive and behavioral research; interventions in mental health and psychiatry; metabolic syndrome; management of cognitive and behavioral problems; clinical trial
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Special Issue Information

Dear Colleagues, 

People with mental illnesses are at a greater risk of developing subsequent medical conditions, such as obesity, dyslipidemia, glycemic dysregulation, elevated blood pressure, etc. Many of these conditions are referred to as metabolic syndrome. The risk of developing metabolic syndrome varies depending on the presence and composition of its risk factors. Evidence has shown a high prevalence of metabolic syndrome in patients with mental illness. Patients with high risk of metabolic syndrome are also associated with an increased risk of all-cause mortality and cardiovascular morbidity. Thus, comorbidity caused by metabolic syndrome has a major impact on a patient’s quality of life and places a high caregiving burden on the family. The relationship between mental illness and metabolic syndrome is becoming an important concern to the healthcare field and healthcare professionals. This also underlines the importance of early detection and management of metabolic syndrome. Furthermore, patients with mental illness tend to have difficulty in self-management of metabolic syndrome and its progression. Therefore, a better understanding of the connection between metabolic syndrome and mental illness may help to provide more patient-centered and effective strategies and tailored interventions. 

For this Special Issue of Healthcare, authors are welcome to submit papers on innovative findings regarding the prevalence of metabolic syndrome, its comorbidities, risk factors, associations with mortality and survival rate, the burden of metabolic syndrome on healthcare, the management and intervention of metabolic syndrome, patient education, and other related fields of study, among people with mental illnesses. Authors are also welcome to submit papers describing the education of healthcare professionals, e.g., how nurses should prepare for the implementation of health promotion programs that help patients with both mental illness and metabolic syndrome. Different levels of professional education and patient education as well as other areas of healthcare systems may also be considered. 

Dr. Mei-Chi Hsu
Guest Editor

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Keywords

  • metabolic syndrome
  • mental illness
  • prevention
  • management of metabolic syndrome
  • interventions in mental health and psychiatry
  • psychiatric care

Published Papers (8 papers)

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Research

12 pages, 2347 KiB  
Article
A Non-Randomized Combined Program of Walking and Low-Load Resistance Exercise Improves Cognitive Function and Cardiometabolic Risk Factors in Community-Dwelling Elderly Women
by Jeonghyeon Kim, Seamon Kang, Haeryun Hong, Mingyu Joo and Hyunsik Kang
Healthcare 2022, 10(10), 2106; https://doi.org/10.3390/healthcare10102106 - 21 Oct 2022
Cited by 1 | Viewed by 1516
Abstract
Background: This study examines whether changes in cardiometabolic risk factors, functional fitness, and depressive symptoms following a six-month exercise intervention were associated with cognitive function in Korean women aged 65 years and older. Methods: A non-randomized study design was used to compare post-intervention [...] Read more.
Background: This study examines whether changes in cardiometabolic risk factors, functional fitness, and depressive symptoms following a six-month exercise intervention were associated with cognitive function in Korean women aged 65 years and older. Methods: A non-randomized study design was used to compare post-intervention changes in measured variables between control (n = 30) and exercise (n = 30) groups. The exercise intervention consisted of three days of low-load resistance exercise and two days of walking. Cognitive function and depressive symptoms were assessed with the Korean version of the Mini–Mental State Examination and the Korean version of the Geriatric Depression Scale, respectively. Functional fitness was measured using a senior fitness test battery. Results: The exercise group showed a significant improvement in cognitive function (p < 0.001) in conjunction with significant decreases in blood glucose (p = 0.052), triglycerides (p = 0.011), insulin (p = 0.002), tumor necrosis factor-α (p = 0.043), and depressive symptoms (p = 0.006) and an increase in interleukin-10 (p = 0.037), compared with the control group. Multivariate stepwise regression showed that changes in depressive symptoms (p < 0.001), insulin resistance (p < 0.001), and upper body muscle strength (p = 0.003) were positively associated with cognitive function. Conclusion: A six-month exercise intervention consisting of walking and low-load/high-repetition elastic band resistance exercise has the potential to improve cognitive function, as well as physical function and cardiometabolic risk factors, and to decrease depressive symptoms in older women. Full article
(This article belongs to the Special Issue Metabolic Syndrome and Mental Illness)
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13 pages, 1539 KiB  
Article
Analysis of Antidepressants Utilization for Patients Visiting Psychiatric Out-Patient Clinic in a Tertiary Care Hospital
by Seema Mehdi, Kishor Manohar, Atiqulla Shariff, Shahid Ud Din Wani, Mansour Almuqbil, Sultan Alshehri, Faiyaz Shakeel, Mohammad T. Imam and Kamsagara L. Krishna
Healthcare 2022, 10(10), 2081; https://doi.org/10.3390/healthcare10102081 - 19 Oct 2022
Cited by 6 | Viewed by 2008
Abstract
Depression is a prevalent mental health condition treated with antidepressants and other psychotropic medications. This study aimed to assess the utilization pattern of antidepressants among patients visiting the outpatient clinic of the psychiatry department of a tertiary care hospital. The study included the [...] Read more.
Depression is a prevalent mental health condition treated with antidepressants and other psychotropic medications. This study aimed to assess the utilization pattern of antidepressants among patients visiting the outpatient clinic of the psychiatry department of a tertiary care hospital. The study included the patients who visited the study site and fulfilled the mental and behavioral diagnostic criteria for depression. The demographic and clinical details, including drugs prescribed, were documented in a study-specific data collection form. The ratio of Prescribed Daily Dose to Defined Daily Dose (PDD: DDD) was calculated to assess the adequacy of antidepressant utilization. Data total of 154 patients were collected. A total of 22 psychotropic drugs were used among the study patients as mono (n = 70), dual (n = 69), triple (n = 10), or quadruple therapy (n = 1). Escitalopram was the most often prescribed antidepressant out of the nine antidepressants alone and in combination and was used in slightly high doses (PDD: DDD ratio 1.6). Sertraline, paroxetine, and desvenlafaxine, were used in adequate doses (PDD: DDD between 1 and 1.1), and fluoxetine, duloxetine, amitriptyline, imipramine, and mirtazapine, were used in inadequate doses (PDD: DDD <0.5). Our study findings reveal the need for continuous assessment of antidepressants medications usage in a hospital set up. Full article
(This article belongs to the Special Issue Metabolic Syndrome and Mental Illness)
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12 pages, 316 KiB  
Article
Interaction between Work and Metabolic Syndrome: A Population-Based Cross-Sectional Study
by Amália Ivine Costa Santana, Magno Conceição das Merces, Marcio Costa de Souza, Bruno Gil de Carvalho Lima, Maria José Quina Galdino, Nuno Damácio de Carvalho Félix, Lucelia Batista Neves Cunha Magalhães, Julita Maria Freitas Coelho, Paulo José Bastos Barbosa, Érica Velasco Dias Gomes, Rodrigo Fernandes Weyll Pimentel, Anderson Reis de Sousa, Márcia Aparecida Ferreira de Oliveira, Aline Macêdo de Queiroz, Raíssa Millena Silva Florencio, Jorge Lopes Cavalcante Neto, Antonio Marcos Tosoli Gomes, Thadeu Borges Souza Santos, Silvana Lima Vieira, Danilo Guimarães de Sousa, Priscila Cristina da Silva Thiengo de Andrade, Isolda Prado de Negreiros Nogueira Maduro, Sandra Lúcia Fernandes, Kairo Silvestre Meneses Damasceno, Dandara Almeida Reis da Silva and Argemiro D’Oliveira Júnioradd Show full author list remove Hide full author list
Healthcare 2022, 10(3), 544; https://doi.org/10.3390/healthcare10030544 - 15 Mar 2022
Viewed by 2048
Abstract
Metabolic syndrome (MS) is a clinical condition and a relevant risk factor in the development of cardiovascular diseases; it occurs as a result of lifestyle factors, e.g., work. The aim of this research was to estimate the interaction between work and MS among [...] Read more.
Metabolic syndrome (MS) is a clinical condition and a relevant risk factor in the development of cardiovascular diseases; it occurs as a result of lifestyle factors, e.g., work. The aim of this research was to estimate the interaction between work and MS among primary health care (PHC) nursing professionals in the state of Bahia, Brazil. A sectional multicentered study carried out in 43 municipalities in Bahia, whose study population consisted of nursing professionals. The exposure variables were occupation, professional exhaustion, and working time, and the outcome variable was MS. Interaction measures based on the additivity criteria were verified by calculating the excess risks due to the interactions and according to the proportion of cases attributed to the interactions and the synergy index. The global MS prevalence is 24.4%. There was a greater magnitude in the exposure group regarding the three investigated factors (average level occupation, professional exhaustion, and working time in PHC for more than 5 years), reaching an occurrence of 44.9% when compared to the prevalence of 13.1% in the non-exposure group (academic education, without professional burnout, and working time in PHC for up to 5 years). The study’s findings showed a synergistic interaction of work aspects for MS occurrence among PHC nursing professionals. Full article
(This article belongs to the Special Issue Metabolic Syndrome and Mental Illness)
10 pages, 248 KiB  
Article
A Comparison of Nurse Aides and Nurses Regarding the Work Competence of Nurse Aides in a Skill-Mixed Institution
by Hui-Chen Hsu, Hsiang-Wen Kung, Wen-Jen Chiang, Bih-O Lee and Ruey-Hsia Wang
Healthcare 2021, 9(12), 1725; https://doi.org/10.3390/healthcare9121725 - 13 Dec 2021
Cited by 1 | Viewed by 2219
Abstract
Objective: To compare the differences between the work competencies self-reported by nurse aides’ and those perceived by nurses. Method: A cross-sectional survey was employed. The settings were units implemented a skill mix model institution in Taiwan. The instruments consisted of the participants’ demographic [...] Read more.
Objective: To compare the differences between the work competencies self-reported by nurse aides’ and those perceived by nurses. Method: A cross-sectional survey was employed. The settings were units implemented a skill mix model institution in Taiwan. The instruments consisted of the participants’ demographic data and a nurse aide work competence scale. Results: The results indicated that the nurse aides had room for improvement in terms of “problem solving” and “activity design”. The nurse aides and nurses differed significantly in terms of the nurse aides’ competence in “activity design”, as the nurse aides reported themselves to be more competent in “activity design” than reported by the nurses. Conclusion: Nurse aides should be incorporated into cross-disciplinary teams. Activity design should be handled by other healthcare providers such as physical therapists or senior social workers. Full article
(This article belongs to the Special Issue Metabolic Syndrome and Mental Illness)
8 pages, 444 KiB  
Article
The Effectiveness of Pay-for-Performance Program of Diabetes Care for Psychiatric Patients: A Regional Psychiatric Hospital Experience
by Chin-Chou Yang, Tsuo-Hung Lan, Wei-Cheng Tsai, Ming-Chen Guo, Yee-Yung Ng and Shiao-Chi Wu
Healthcare 2021, 9(11), 1565; https://doi.org/10.3390/healthcare9111565 - 17 Nov 2021
Viewed by 1756
Abstract
Background: The Pay-for-performance (P4P) program of diabetes care has demonstrated successful outcomes in patients with type 2 diabetes. However, the effectiveness of this multidisciplinary care model for psychiatric patients has never been evaluated. The objective of this study is to examine the effectiveness [...] Read more.
Background: The Pay-for-performance (P4P) program of diabetes care has demonstrated successful outcomes in patients with type 2 diabetes. However, the effectiveness of this multidisciplinary care model for psychiatric patients has never been evaluated. The objective of this study is to examine the effectiveness of P4P program of diabetes for psychiatric patients with diabetes. Methods: This study utilized a retrospective cohort design to examine the effectiveness of P4P program of diabetes care for psychiatric patients with diabetes. The participants’ HbA1c (hemoglobin A1c) data of the fourth quarter in 2018 were used as baseline value, while P4P program was not applied yet. HbA1c data of every quarter in 2019 were collected. Generalized estimating equations (GEE) was used to analyze the change of HbA1c level. Results: The HbA1c level increased slightly in the first quarter, and then decreased gradually since the second quarter. The HbA1c level was significantly lower in the fourth quarter after P4P program intervention (p < 0.05). Conclusion: P4P program of diabetes care is also effective on psychiatric patients with diabetes, and this multidisciplinary care model could be encouraged and promoted for psychiatric patients with diabetes. Full article
(This article belongs to the Special Issue Metabolic Syndrome and Mental Illness)
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11 pages, 570 KiB  
Article
Simplifying and Testing the Psychometric Psychiatric Patients’ Fall Risk Scale: An Analysis of One-Year Admissions
by Yu-Hui Shen, Chia-Chi Hsieh, Ming-Tsung Lee, Wen-Chin Lee and Bih-O Lee
Healthcare 2021, 9(9), 1119; https://doi.org/10.3390/healthcare9091119 - 30 Aug 2021
Cited by 1 | Viewed by 2411
Abstract
This study aimed to simplify the number of items evaluated by fall risk assessment scales for psychiatric patients, conduct associated reliability, validity, and receiver operating characteristic analyses, and determine fall predictors for psychiatric patients. This methodological study was conducted in a hospital specializing [...] Read more.
This study aimed to simplify the number of items evaluated by fall risk assessment scales for psychiatric patients, conduct associated reliability, validity, and receiver operating characteristic analyses, and determine fall predictors for psychiatric patients. This methodological study was conducted in a hospital specializing in psychiatry, using data from 1101 patients who were hospitalized in 2018. This fall risk assessment scale was modified by the hospital for use in psychiatric patients. The mean age of the sample population was 44.88 (SD = 12.05) years, and the mean duration of hospital stay was 44.04 (SD = 48.14) days. Men comprised 66% of the study population, and women were 34%. Item reduction, psychometric testing for validity and reliability, and receiver operating characteristic analyses were conducted. Logistic regressions were used to analyze fall predictors, including “having anti-epileptic drugs”, “need for walking aids”, and “having experienced fall occurrence within one year”. This study successfully reduced the number of items assessed by the previous scale. The optimal cutoff point was reduced, and the sensitivity and accuracy of the newly revised scale were good. Three fall predictors for psychiatric patients were identified. The revised scale can facilitate the rapid and accurate identification of high-risk, fall-prone psychiatric patients by psychiatric nurses. Hospital information screening should include each patient’s fall history. Full article
(This article belongs to the Special Issue Metabolic Syndrome and Mental Illness)
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18 pages, 1131 KiB  
Article
Use of Charlson Comorbidity Index and Nomogram to Predict Mortality in Elderly Patients with Late-Life Schizophrenia
by Mei-Chi Hsu, Shang-Chi Lee and Wen-Chen Ouyang
Healthcare 2021, 9(7), 783; https://doi.org/10.3390/healthcare9070783 - 22 Jun 2021
Cited by 2 | Viewed by 2025
Abstract
Objectives: Comorbid illness burden signifies a poor prognosis in schizophrenia. The aims of this study were to estimate the severity of comorbidities in elderly patients with schizophrenia, determine risk factors associated with mortality, and establish a reliable nomogram for predicting 1-, 3- and [...] Read more.
Objectives: Comorbid illness burden signifies a poor prognosis in schizophrenia. The aims of this study were to estimate the severity of comorbidities in elderly patients with schizophrenia, determine risk factors associated with mortality, and establish a reliable nomogram for predicting 1-, 3- and 5-year mortality and survival. Methods: This population-based study rigorously selected schizophrenia patients (≥65 years) having their first admission due to schizophrenia during the study period (2000–2013). Comorbidity was scored using the updated Charlson Comorbidity Index (CCI). Results: This study comprised 3827 subjects. The mean stay of first admission due to schizophrenia was 26 days. Mean numbers of schizophrenia and non-schizophrenia-related hospitalization (not including the first admission) were 1.80 and 3.58, respectively. Mean ages at death were 73.50, 82.14 and 89.32 years old, and the mean times from first admission to death were 4.24, 3.33, and 1.87 years in three different age groups, respectively. Nearly 30% were diagnosed with ≥3 comorbidities. The most frequent comorbidities were dementia, chronic pulmonary disease and diabetes. The estimated 1-, 3- and 5-year survival rates were 90%, 70%, and 64%, respectively. Schizophrenia patients with comorbid diseases are at increased risk of hospitalization and mortality (p < 0.05). Conclusion: The nomogram, composed of age, sex, the severity of comorbidity burden, and working type could be applied to predict mortality risk in the extremely fragile patients. Full article
(This article belongs to the Special Issue Metabolic Syndrome and Mental Illness)
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14 pages, 561 KiB  
Article
Subsequent Dyslipidemia and Factors Associated with Mortality in Schizophrenia: A Population-Based Study in Taiwan
by Mei-Chi Hsu and Wen-Chen Ouyang
Healthcare 2021, 9(5), 545; https://doi.org/10.3390/healthcare9050545 - 07 May 2021
Cited by 1 | Viewed by 1662
Abstract
Background: Persons with schizophrenia are at greater risk of developing subsequent medical conditions. To date, few studies have examined comprehensively the risks, mortality and survival rates in schizophrenia and subsequent dyslipidemia over different time periods. The objective of this study was to evaluate [...] Read more.
Background: Persons with schizophrenia are at greater risk of developing subsequent medical conditions. To date, few studies have examined comprehensively the risks, mortality and survival rates in schizophrenia and subsequent dyslipidemia over different time periods. The objective of this study was to evaluate the occurrence of subsequent dyslipidemia after the diagnosis of schizophrenia, and factors associated with mortality and survival rate in patients with schizophrenia. Methods: We used a population-based cohort from Taiwan National Health Insurance Research Database, to investigate in patients whom were first diagnosed with schizophrenia during the period from 1997 through 2009, the risk of subsequent dyslipidemia during follow-up. Cumulative incidences and hazard ratios after adjusting for competing mortality risks were calculated. Results: A total of 20,964 eligible patients were included. Risks (i.e., comorbidity) and protective factors (i.e., statin use) have significant impacts on mortality. The mortality exhibits a U-shaped pattern by age. After 50, the risk of death increases with age. Risk of mortality before 50 increases with a decrease in age. Risks differed by the duration time to subsequent dyslipidemia after schizophrenia. Mean duration was 63.55 months in the survive group, and 43.19 months in the deceased group. The 5-, 10-, and 15-year survival rates for patients with schizophrenia and subsequent dyslipidemia were 97.5, 90, and 79.18%, respectively. Conclusion: Early occurrence of subsequent dyslipidemia is associated with increased overall mortality in patients with schizophrenia. Full article
(This article belongs to the Special Issue Metabolic Syndrome and Mental Illness)
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