Health behaviour risk factors for coronary heart disease (CHD) in smokers with a psychotic disorder: baseline results

Abstract

Background. People with psychotic disorders are more likely to develop and die from coronary heart disease (CHD) than the general population.

Aims. This study aimed to explore the level of CHD risk factors (smoking, diet and physical activity) in smokers with psychosis. The second aim was to examine the reasons for smoking/quitting, and the levels of motivation and confidence to change.

Method. Forty-three smokers diagnosed with psychosis were assessed using semi-structured interviews and standardised self-report instruments. Carbon monoxide levels, blood pressure, height, weight and hip/waist measurements were assessed. Blood samples were taken for cholesterol and blood sugar levels. CHD risk percentiles were calculated using the Framingham algorithm.

Results. Participants smoked heavily (mean 30.8 cigarettes per day ±12.5). The majority reported smoking due to addiction and for stress management and many contemplated quitting, mainly due to health concerns. Participants were on average moderately obese and had a poor diet. While being physically underactive, the majority wanted to improve their fitness levels. Participants were motivated to quit smoking, improve their diet and increase their physical activity, but had little confidence in their ability to make these changes. The average calculated CHD risk percentile for the sample was 74.3 ± 23.6.

Conclusions. This sample of smokers with a psychotic disorder had multiple risk factors for CHD. They were interested and willing to make changes to their health behaviours, but lacked confidence. Shared care between psychiatrists and GP's could effectively manage these serious health issues for people with mental illness.

Keywords:

• smoking
• psychosis
• coronary heart disease
• risk factors
• motivation

Acknowledgements

This work was supported by a grant from the Australian Commonwealth Department of Health and Ageing (Canberra, ACT, Australia). We would like to thank the participants involved in this study and the services they were recruited from. Thanks to Melinda Carrington for her assistance regarding CHD risk calculation. Thanks to Dianne Harris who was a therapist in this study and to Lynda Katona for her support and supervision.