Showing posts with label mental health. Show all posts
Showing posts with label mental health. Show all posts

Thursday, July 6, 2017

Lancet - Prevalence and risk factors for HIV, hepatitis B, and hepatitis C in people with severe mental illness: a total population study of Sweden

The Lancet Psychiatry
Prevalence and risk factors for HIV, hepatitis B, and hepatitis C in people with severe mental illness: a total population study of Sweden
Clarissa Bauer-Staeb, MSc, Lena J├Ârgensen, PhL, Prof Glyn Lewis, PhD, Prof Christina Dalman, PhD, Prof David P J Osborn, PhD, Dr Joseph F Hayes, MB ChB

Published: 04 July 2017

Introduction
Severe mental illness is commonly defined as a mental disorder that is persistent and disabling in nature, such as schizophrenia, schizoaffective disorder, bipolar disorder, and other psychoses.1 Increased mortality rates of 2–3 times the general population are well documented among people with severe mental illness, and translate into a reduction in life expectancy of up to 20 years.2 Approximately 60% of this excess in mortality has been attributed to poor physical health.2 Although much attention has been focused on addressing cardiovascular, respiratory, and cancer health inequalities, infectious diseases have been largely neglected in mental health research and policy.3 This situation is problematic as meta-analytic evidence suggests blood-borne virus (BBV) prevalence is elevated amongst individuals with severe mental illness.3 In North America, the pooled prevalence of BBVs in populations with severe mental illness is estimated to be as high as 6% for HIV, 2·2% for hepatitis B virus (HBV), and 17·4% for hepatitis C virus (HCV).3 Therefore, HIV and HCV are ten times, and HBV around five times, more common in people with severe mental illness than in the general population.4 Although lower, similar patterns are evident in people with severe mental illness in European countries (Germany, Belgium, Spain, Greece, Italy), with combined prevalence estimates of 1·9% for HIV, 2·7% for HBV, and 4·9% for HCV.3 However, the true scale of the problem is unclear, because previous studies have used small, unrepresentative convenience samples recruited from treatment settings.3 As far as we are aware, no population-based studies have been done of BBV prevalence in severe mental illness, and no studies have examined prevalence in northern European countries.3 Additionally, literature on risk factors for BBV in individuals with severe mental illness is limited, but high prevalence of substance misuse has been identified as a particular concern in this group.5

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