Diagnostic tests and treatment procedures performed prior to cardiovascular death in individuals with severe mental illness

Objective: To examine whether severe mental illnesses (i.e., schizophrenia or bipolar disorder) affected diagnostic testing and treatment for cardiovascular diseases in primary and specialized health care. Methods: We performed a nationwide study of 72 385 individuals who died from cardiovascular di...

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Bibliographic Details
Published in:Acta Psychiatrica Scandinavica
Main Authors: Heiberg, Ina Heidi, Nesvåg, Ragnar, Balteskard, Lise, Bramness, Jørgen Gustav, Hultman, Christina M., Næss, Øyvind, Reichborn-Kjennerud, Ted, Ystrøm, Eivind, Jacobsen, Bjarne K., Høye, Anne
Format: Article in Journal/Newspaper
Language:English
Published: 2020
Subjects:
bipolar disorder
cardiovascular diseases
death
delivery of health care/standards
schizophrenia
Norway
Northern Norway
Online Access:https://hdl.handle.net/11250/2679748
https://doi.org/10.1111/acps.13157
Description
Summary:Objective: To examine whether severe mental illnesses (i.e., schizophrenia or bipolar disorder) affected diagnostic testing and treatment for cardiovascular diseases in primary and specialized health care. Methods: We performed a nationwide study of 72 385 individuals who died from cardiovascular disease, of whom 1487 had been diagnosed with severe mental illnesses. Log-binomial regression analysis was applied to study the impact of severe mental illnesses on the uptake of diagnostic tests (e.g., 24-h blood pressure, glucose/HbA1c measurements, electrocardiography, echocardiography, coronary angiography, and ultrasound of peripheral vessels) and invasive cardiovascular treatments (i.e., revascularization, arrhythmia treatment, and vascular surgery). Results: Patients with and without severe mental illnesses had similar prevalences of cardiovascular diagnostic tests performed in primary care, but patients with schizophrenia had lower prevalences of specialized cardiovascular examinations (prevalence ratio (PR) 0.78; 95% CI 0.73-0.85). Subjects with severe mental illnesses had lower prevalences of invasive cardiovascular treatments (schizophrenia, PR 0.58; 95% CI 0.49-0.70, bipolar disorder, PR 0.78; 95% CI 0.66-0.92). The prevalence of invasive cardiovascular treatments was similar in patients with and without severe mental illnesses when cardiovascular disease was diagnosed before death. Conclusion: Better access to specialized cardiovascular examinations is important to ensure equal cardiovascular treatments among individuals with severe mental illnesses. This study was supported by a research grant from the Northern Norway Regional Health Authority (PFP1236-15). publishedVersion

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