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Patterns of somatic disease in residential psychiatric patients : surveys of dyspepsia, diabetes and skin disease

(2011) Mookhoek, Evert Jan

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Therapy of physical disease is an important part of the overall medical treatment of Severe Mentally Ill patients (SMI). Somatic disease in SMI may follow a different pattern. General medical guidelines for disease management must be reconsidered for SMI, concludes Evert Jan Mookhoek.

He has identified the gaps in the knowledge on the occurrence of somatic complications in (SMI) and has filled out some of the open spaces for dyspepsia, diabetes mellitus and skin diseases.

He found a lack of knowledge regarding the epidemiology and disease burden of a number of important somatic disease groups in SMI.

More than 50% of the SMI have ample dyspeptic complaints. In 80% this concerns reflux-like complaints. Over 1/3 of the SMI use medication for dyspepsia on a daily base. An association was found by Mookhoek between dyspepsia and the use of clozapine, laxatives and smoking. We found a drug-drug interaction between clozapine and omeprazole.

Diabetes is present in 15% of the SMI and a latent diabetes in another 14%. There is a direct relation between diabetes and overweight and an indirect association with psychiatric medication.

69% Of the SMI have skin complaints and 77% have skin disorders. In 37% of the patients skin disorders were present which were not mentioned in the interview. Patients with diabetes have skin infections 10 times more often. Decubitus ulcers were related to addiction. Dermatitis was associated with depression. The length of hospital stay had no influence on the occurrence of skin problems.

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