Citation

Spivak S, Cullen BA, Eaton W, Nugent KL, Rodriguez K, Mojtabai R. Psychiatr. Serv. 2018; 69(4): 479-482.

Affiliation

Dr. Spivak, Dr. Cullen, and Dr. Mojtabai are with the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore. Dr. Cullen and Dr. Mojtabai are also with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, where Dr. Eaton and Ms. Rodriguez are affiliated. Dr. Nugent is with the Center for Military Psychiatry and Neurosciences, Walter Reed Army Institute of Research, Silver Spring, Maryland.

Copyright

(Copyright © 2018, American Psychiatric Association)

DOI

10.1176/appi.ps.201700327

PMID

29446333

Abstract

OBJECTIVE: The study explored the association of delays in seeking general medical care with elevated blood pressure and metabolic abnormalities among individuals with serious mental illness.

METHODS: Association of delays in medical care with blood pressure, serum hemoglobin A1c (HbA1C), and lipids was assessed among patients at two inner-city community mental health centers.

RESULTS: Of 271 participants, 62% reported delays in seeking general medical care due to attitudinal and financial barriers. Care delay was associated with abnormalities in measured blood pressure (adjusted odds ratio [AOR]=2.14, p=.029) and HbA1c (AOR=3.18, p=.026). Care delay was not associated with abnormalities in lipid profiles.

CONCLUSIONS: This study found that delays in seeking general medical care are common and are associated with clinical markers linked with common medical conditions. The results may help to explain the elevated morbidity and mortality associated with serious mental illness.

Language: en

Keywords

Barriers to care; Community psychiatry; General Medical Care Delay; Medical morbidity and mortality in psychiatric patients; Prevention; Public health