27 October 2014 - Science Daily - People with mental health disorders twice as likely to have heart disease or stroke

Using data from the Canadian Community Health Survey, Dr. Goldie explored the associations between cardiovascular risk and disease, mental health disorders and the use of psychiatric medication.

The study found that:

• People who have had a mental health disorder at any point in their life were twice as likely to have had heart disease or have experienced a stroke.
• Those who haven't developed heart disease or had a stroke are more likely to be at a high long-term risk of developing cardiovascular disease, when compared to the general population.
• People who used psychiatric medications were twice as likely to have heart disease and three times as likely to have had a stroke compared to those not taking these medications.

The study included people with schizophrenia, bipolar disorders, major depressive and anxiety disorders. Among the psychiatric drugs examined were antipsychotic, antidepressant, benzodiazepine and mood-stabilizing medications.

What accounts for the elevated risk? Dr. Goldie mentions three main factors:

First, people with mental health disorders often exhibit behavioural risk factors, including tobacco and alcohol use, poor diet and physical inactivity. For instance, she says 40 to 90 per cent of people with mental illness use tobacco, compared to 20 per cent of the general Canadian population.

Psychiatric medications can induce weight gain and impair the breakdown of fats and sugars by the body. This can lead to obesity, high cholesterol and diabetes. "The medications themselves account for a lot of risk in this group," she says.

A third issue is access to health care. Patients with mental health disorders may have difficulty communicating their health needs. "Or they may not even seek care because of the symptoms of their disorder," says Dr. Goldie. "A separation between primary and mental health services can also challenge these patients' care. We need improved integration and collaboration."