Socioeconomic Disparities and Metabolic Risk in Veterans with Serious Mental Illness

• Published in: Community mental health journal Vol. 54; no. 6; pp. 725 - 734
• Main Authors: Caroff, Stanley N., Leong, Shirley H., Ng-Mak, Daisy, Campbell, E. Cabrina, Berkowitz, Rosalind M., Rajagopalan, Krithika, Chuang, Chien-Chia, Loebel, Antony
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.08.2018; Springer Nature B.V
• Subjects: Adult; African Americans; Aged; Anticonvulsants; Anticonvulsants - therapeutic use; Antidepressants; Antidepressive Agents - therapeutic use; Antipsychotic Agents - therapeutic use; Antipsychotics; Bipolar disorder; Bipolar Disorder - complications; Bipolar Disorder - drug therapy; Cardiovascular disease; Cardiovascular diseases; Cerebrovascular disease; Chi-square test; Cohort Studies; Community and Environmental Psychology; Coronary artery disease; Cross-sectional studies; Diabetes; Disability pensions; Drugs; Female; Health status; Health Status Disparities; Homeless people; Hospitalization; Humans; Logistic Models; Male; Medical screening; Medicine; Medicine & Public Health; Mental depression; Mental disorders; Mental health; Metabolic disorders; Metabolic syndrome; Metabolic Syndrome - complications; Metabolic Syndrome - epidemiology; Middle Aged; Mortality; Mortality rates; Older people; Original Paper; Patients; Pensions; Psychiatric hospitals; Psychiatry; Risk assessment; Risk Factors; Schizophrenia; Schizophrenia - complications; Schizophrenia - drug therapy; Socioeconomic Factors; Socioeconomic status; Tests; United States - epidemiology; United States Department of Veterans Affairs; Veterans; United States; Schizophrenia; Antipsychotics; Bipolar disorder; Diabetes; Metabolic syndrome; Antidepressants
• ISSN: 0010-3853; 1573-2789
• DOI: 10.1007/s10597-017-0215-7

Socioeconomic disparities were assessed in predicting metabolic risk among veterans with serious mental illness. Veterans with schizophrenia, schizoaffective, or bipolar disorders were identified in VISN 4 facilities from 10/1/2010 to 9/30/2012. Differences between patients with and without metabolic syndrome were compared using t-tests, Chi square tests and multivariate logistic regressions. Among 10,132 veterans with mental illness, 48.8% had metabolic syndrome. Multivariate logistic regression analysis confirmed that patients with metabolic syndrome were significantly more likely to be older, male, African-American, married, and receiving disability pensions but less likely to be homeless. They were more likely to receive antipsychotics, antidepressants, or anticonvulsants. Bivariate cross-sectional analysis revealed that patients with metabolic syndrome had higher rates of coronary artery disease, cerebrovascular disease, and mortality, and that metabolic syndrome was more often associated with emergency visits and psychiatric or medical hospitalizations. Demographics, socioeconomic status and medications are independent predictors of metabolic syndrome and should be considered in broader screening of risk factors in order to provide preventive interventions for metabolic syndrome.