MENTAL ILLNESS AND METABOLIC DISORDERS

MENTAL ILLNESS AND METABOLIC DISORDERS
Name of Student
Institution affiliation

Abstract
Objective of the study: To identify the relationship between low income mental patients, and metabolic disorders among the 235,000 patients who have been diagnosed with mental health issues. The study did not target any specific mental health disorder i.e. it conducted a general study of the mentally ill patients in-order to be in a position whereby they could investigate the relationship.
Design: Prospective analysis Methods:
Primary and secondary analysis was used to collect the data that was used in this study. The data that was collected was analyzed using the SPSS program in a bid to look at the X² test, d.f., and the p-value based on the poverty level, age, gender, and rate for metabolic disorders.
Main Outcome Measures: Patients experiencing metabolic disorders leading to chronic diseases such as CVD.
Results: Based on the statistics that the study was able to achieve it showed that there was a direct relationship between low income mental patients, and metabolic disorders. There is a direct correlation between poverty among the mental ill patients, and their prevalence of getting metabolic disorders.
Conclusion: The statistics in this study showed that there was a direct relationship between mentally ill patients, and metabolic disorders. It showed that mentally ill patients who were suffering from metabolic disorders were more likely to be low-income earners. This coupled with factors such as; they rarely sought medical attention unless they were in a critical situation, therefore they were rarely screened for other diseases.

Table of Contents
Introduction 3
Literature Review 3
Methodology 8
Results 10
Discussion 12
Conclusion 16
References 17

Introduction
Over the last few years, there has been an upsurge in the increasing rate of global obesity. This has led to the belief by many people that the availability of refined and highly appetizing food has been a root cause of this. The availability of food has resulted in the development of food addiction by most individuals who in the end suffer from obesity. Previous research on the history of eating has shown that the consumption of huge amounts of food in a short period of time may result in behavior in an individual which is similar to that exhibited by those who abuse drugs. One of the behaviors that have been exhibited by these individuals is an eating disorder known as the binge eating behavior.
Literature Review
Binge eating involves the excessive consumption of food by individuals. Excessive consumption of food has been far and wide acknowledged to be problematic mostly because of the health problems that are associated with it. Binge eating has resulted in obesity among as well as a number of other related health problems such as a poor heart rate. Looking at the health concerns associated with binge eating, the awareness of the problems caused by food addiction are being raised as it has become a public health
Past caloric restriction and stress have been identified as being the root cause of binge eating behavior. These two factors play a huge role in contributing to the behavior of binge eating. Eating disorders normally cause the body to undergo changes which might be harmful to an individual. In safeguarding the eating disorders, dieting has come in handy most of the times (Markou et al, 1998). Dieting usually helps in dealing with the stress-induced overeating in humans. This way, the human beings are able to control their eating patterns and avoid indulging in the binge eating patterns. The failure to control these eating patterns results in the developments of neural changes which may affect an individual’s neural system.
The neural changes that are associated with binge eating have largely been attributed to different individual perceptions towards food, eating, body weight, and body self-image. These perceptions are what make the different individuals choose to either have a small or large food intake when eating (Leshner, 1998). The different metabolic activities in the body witnessed by different individuals normally result in changes in neuronal movement. The regulation of one’s eating appetite comes as a result of the cognitive measurements that are connected to it. Research has also indicated that the neural changes which are seen to accompany binge-eating are similar to those that are witnessed following the use of drugs by certain individuals. Just like drug use, binge eating is considered to be an addiction to individuals (Leshner, 1998).
Binge eaters also exhibit changes concerning their neural stimuli. The external stimuli of the binge eaters, especially the environmental cues, usually affect them very much. The external food sensitivity exhibited by these binge eaters may act as disposing elements that result in desires for food as well as food consumption. Such is exhibited through triggers given off by an individual at the sight, smell, or even suggestion of food (Spear, 2000). In addition to this, external food sensitivity is also related to overeating and a preference for the appetizing foods. The individuals who suffer from the binge-eating disorders usually show distorted attitudes when it comes to eating, shape and weight. They also exhibit mood symptoms and may as well posses personality disorders. This disorder has been recorded to affect about two percent of the general population. A further eight percent of the obese people in the population also suffer from this disorder.
There are a lot of similarities between the individuals suffering from binge eating disorders and those suffering from drug addictions. Binge eating and drug addiction are both characterized by a pathological attachment. These two are also both characterized by obsessive thoughts about food and the urge to have more food to eat than the rest of the people in similar circumstances (Markou et al, 1998). When having the binge episodes, these individuals usually find themselves having a lot of distress, feelings of guilt, a certain amount of disgust as well as depression. Previous studies have been done to establish the relationship between these binge eaters and the drug users in order to reveal the similarities. These studies have shown that the low levels of dopamine D2 receptors which are found in the individuals addicted to different types of drugs such as cocaine, alcohol and heroine, are also exhibited by the binge eaters. Thus, this clearly shows how serious this condition is and why there is need for societal change with regards to it. Educating individuals on how to eat healthy will ensure that there is a better society, free of medical conditions such as binge eating disorder (Thanos et al, 2002).
Raising awareness is part of the important concepts from the course that helps with the societal change. Creation of awareness in the society about a certain epidemic or a condition that is affecting the lives of many in the community helps to eliminate the ignorance that might have taken over the minds of individuals. Most of the time, individuals in the society are not usually aware of the reasons as to why they suffer from some conditions, especially with regards to their health status. This is because they have either not been exposed to the right information regarding these health issues or they are ignorant about the subject and have not been keen to try and find out the causes. This is where raising awareness in the community comes in handy as a concept that can help with creating a social change.
In the creation of this awareness, I have written an article about “Binge Eating Disorder”. This article can be printed in magazines, newspapers and can even be reproduced as posters which are to be displayed at convenient areas such as the hospital hallways or the pharmacies. Creating awareness on the binge eating disorder can really help with the reduction and even elimination of the rising numbers of people with this health condition. As we have seen in the article, the Binge eating disorder is responsible for health conditions such as obesity and high blood pressure.
The article has outlined that according to statistics from the health journals, there is a growing number of individuals suffering from obesity on the United States. This situation has basically been as a result of poor eating habits such as the binge eating disorder. The people in the society are quick to consume products to satisfy their hunger even without considering the long terms effects that these products could have on their health status. This is the ignorance that sadly has befallen our society. Thus, in order to make individuals aware of the serious threats that such behaviors can cause to their lives, the creation of awareness goes a long way in doing so. In our case, raising the awareness about the binge eating disorder will help with the reduction of the cases of obesity and high blood pressure resulting from this eating behavior.
Publishing this article will help people in the society learn the causes of binge eating behavior and learn how they can avoid them. In humans, binge eating is largely contributed to the strict dietary restraint. It is also as a result of the distortionary abstinence from eating certain foods which are forbidden. Availing a lot of sugars to the rats will create an addiction and the sudden withdrawal will provide a deprivation of the same. Thus, the results obtained from this experiment will also give evidence that food deprivation can result to not just food addiction, but also binge eating.
Food addiction largely contributes to chronic overeating and obesity too. A background research on food addiction gives a clear revelation of its existence. Thus, when these eating disorders awareness is created and the various individuals who suffer from food addiction given knowledge about them, it will help with the reduction of the number of people who suffer from conditions resulting from binge eating such as obesity. This article will also help with the discovery of the underlying basis of food addiction and how these can be very helpful to the society. This will not only help in changing the perception by the society towards those who are obese and overweight, but will also be of great help in creating the policies regarding to health and nutrition. The treatment of the binge eating disorder is important in rescuing those who are at risk of contracting the disorder due to their eating habits.
The reduction of this behavior in the society will help bring about change in the community. There will be better, healthier individuals in the society and this will create a more jovial community to live in. This article can be printed in many forms and thus it is very easy to distribute it in the society. The article can also be shared among various individuals with the information being passed from one party to another. Thus, this will make it easier for the creation of awareness on the binge eating behavior and the people in the community will learn how they can maintain their bodies in healthy conditions. This way, by writing down and publishing this article, I will have played a role in creating change in the society.
Methodology
In the collection of data for this research, both primary and secondary data were used to provide the information needed for the research. The primary data that was used in this study was collected directly from the patients in the form of interviews, and questionnaires. When conducting the interviews, it was essential that the researchers use recorders, as this would be very crucial and critical in the collection of the data (Laursen TM, 2011). The secondary data used in this study was from scholarly articles and journals which contained information relevant to this case. The reason why these methods were used was to ensure that effective analysis was conducted in regards to the case that the researchers were looking at. Interviews were meant to get first-hand information from the patients in relation to their lifestyles, treatment at the hospital, the metabolic disorders, and their yearly net income.
The researchers also conducted interviews on the medical staff of two hospital institutions whereby; the patients were receiving their treatments. The medical staff was interviewed because they could provide an expert opinion in relation to the relationship between metabolic disorders, and the low-income mental patients.
This was very important because it ensured that the study would not have assumptions, and most of the information that was going to be used would be based on facts (MARC DE HERT, 2009). On the other hand, the data that was used in this study was collected from the multiyear survey of Medical Expenditure Panel Survey (MEPS) from 2004 to 2010. This was very important because it used the information that had been collected in the past, and used the information in relation to the topic that was been discussed in this study. As it was stated before, the target population of this study was people who were in the age range of 18 to 40 years. The number of patients that were used in this study in total was 235,000.
Interviews
During the interviews, there were various sets of questions that were asked to the patients and the medical personnel. This was in-order to get first-hand information from the medical personnel, and the patients to be in a position to see the relationship between the mental illness and metabolic disorders. The set of questions that was asked to the patients were meant to show the experiences that the patients who were in hospital received while they were under the care of the medical staff. It was centered on the quality of the medical assistance that these patients received while they were under the hospital care.
The questions focused on the number of times they went to the hospital to receive treatment, the type of care that they received, the number of hours they had to wait before being treated, the type of medication that they were being provided with, and whether the patients were screened while they were under the care of the medical personnel. The medical staff was asked questions in relation to the care they provided the patients, and whether it was now becoming a common thing in relation to mental patients being diagnosed with metabolic disorders. This was very imperative in this study because; it would show whether there was any relation between mental patients, and metabolic disorders (C. D. Saha S,2007).
During these two sets of interviews, it was established that; most of the mental patients did not receive adequate care while they were in the hospital. Screening of the patients in terms of looking for other diseases was not conducted, and they were only treated for the mental illness. The medical staff especially the nurses stated that they were seeing a trend in terms of patients coming to the hospital to receive mental health treatment, and after a short while they are also diagnosed with metabolic disorders. This is becoming a source of concern in most of the hospitals; because instead of the patients improving in terms of health, their situation is becoming worse. The medical staff stated that screening should be conducted for the mentally ill patients as one of the methods to reduce metabolic disorders.
The secondary data that was used was from Medical Expenditure Panel Survey (MEPS) from 2004 to 2010. The data was from the previous studies that have been conducted in relation to metabolic disorders and mental patients. It showed the analysis and the findings of the previous researches, and showed the recommendations that were found from the studies.
Results
The target population was 18 to 40 years old, and in all the patients, they were diagnosed with either schizophrenia, or the bipolar disorder. In 85% of all the participants in this study, they were treated with antipsychotic medication such as olanzapine, quetiapine, and clozapine. Based on this study, 55% of the targeted group met the criteria of having the metabolic syndrome. In 85% of the patients who had been diagnosed with the bipolar disease, it was found out that they had metabolic disorders. The table below presents the results of this study (Sartorius,2007).

Metabolic Syndrome
(n= 205,000)
No Metabolic
Syndrome
(n=30,000)
X²-test.

P
Age, years
27
24
1.163

0.255

s.d.= 12.4
s.d.=12.2

d.f
Male, n (%)
20(42.5)
25(52.5)

98
Female n (%)
35(61.8)
22(35.5)
2.863
1
0.087
Diagnosis, n (%)

Schizophrenia
26(52)
24(45)
0.365
1
0.524
Depression
18(55.2)
14(41.5)
0.156
1
0.65
Bipolar Disorder
5(55)
4(42.4)
0.01
1
0.985
Treatment

Antipsychotic
15(55)
15(55)
0.452
1
0.472
High-dose antipsychotic
5(30.3)
10(60.3)
4.24
2
0.042
Clozapine
7(77.5)
2(20.2)
2.115
1
0.15
Olanzapine
20(60.2)
15(36.7)
0.955
1
0.321
Smoking, yes
24(56.2)
17(40)
1.323
1
0.566
Exercise>3*20min/week
19(42.2)
22(52.5)
2.542
1
0.065
Family History of CVD
20(50.2)
19(47.5)
0.171
1
0.650
Family History of
Diabetes

13(60)
7(40)
0.434
1
0.52

Discussion
The hypothesis of this study was that low-income mental health patients who suffer from metabolic disorders have a shorter life span than the general population. In this study it showed that patients who are suffering from schizophrenia and bipolar diseases are twice as likely to suffer from metabolic syndrome as the other general population. The metabolic syndrome includes things such as high blood pressure, abdominal obesity, diabetes, and cardiovascular diseases. There was high prevalence rate of metabolic syndrome in patients who were diagnosed with mental illness. Various factors were looked into in the consideration of the prevalence of the disease from mentally ill patients. For instance things such as smoking, exercising, and medical history in terms of diseases such as CVD and diabetes was checked.
The medication that was used for treatment of the mentally ill patients such as Clozapine, and Olanzapine was seen to contribute highly to metabolic disorders. In all the patients that were included in the study, for patients who smoked were seen to have a higher prevalence of metabolic disorders than the patients who did not smoke. In this study, over half of the population i.e. 65% of the target population met the criteria for the metabolic syndrome (Laursen TM, 2011).
In the study it was seen that there was a high prevalence among the patients who had been diagnosed with metabolic syndrome, they had a history of non-psychotic disorders, and psychotic disorders. The study represented a sample of the mentally ill patients who were suffering from chronic diseases. The study provides the required evidence to show that chronic mental illness should be considered as one of the major risk factors when it comes to the metabolic syndrome. It also highlights the issue that mentally ill patients especially the ones that have a low income have a high prevalence when it comes to living a sedentary lifestyle. These patients do not take care of themselves adequately meaning that; they do not exercise frequently to ensure that they have a fit body.
In the study population, it was seen that in all the patients that were diagnosed with metabolic syndrome, they loved smoking, and this can be seen as a contributing factor to their condition. Based on the results of the study, it showed that there was a high prevalence rate among patients who were being treated with antipsychotics i.e. 58% than the patients who were not undertaking antipsychotic medication i.e. 42%. In other similar studies, they showed the prevalence rate among patients suffering from metabolic syndrome to be 48% if they were being treated with the antipsychotics.
The strengths in this study are the screening of the patients who are regularly attending various medical centers for treatment of their mental health issues. It creates an ideal platform for the researchers of this study to collect the data that they will require in-order to use it for the study. The data that was collected was from different medical centers, and therefore it was a representation of the society or patients with chronic illnesses rather than being confined to a certain diagnosis. This is to say, the target population represented patients suffering from different kinds of mental health illnesses, and who were using different types of medication as opposed to if the study was confined to a particular diagnosis such as schizophrenia (Thornicroft, 2013).
The limitations of this study include lack of a control group that could have been used to counter-check the results that were achieved in this study. This meant that the study was biased, based on the target population and the results that were achieved in this study. The study failed in terms of checking the severity of the symptoms that the patients exhibited. For instance, it did not show the number of patients who had died as a result of metabolic disorders. The target population was high, and the number of researchers were few therefore it was a challenge for them to conduct an effective study. There is a high prevalence of cardiovascular risk factors among the patients with mental illness.
Despite the high risk of them suffering from a chronic disease they have an inconsistent approach in terms of their physical health care. For instance, studies have shown that for patients who have long-term mental illnesses they have a tendency of only seeking medical attention, in the event that they see that they are suffering from a certain crisis. They also tend to have very limited access to general healthcare, and this means that they will have very little opportunities when it comes to cardiovascular screening, and ultimately the prevention of the disease. This means that; if these patients took care of themselves better, they would have an opportunity to be screened, the disease is diagnosed in its early stages, and medical treatment for this patient begins earlier than in most cases for these patients. There is the need to conduct screening for each patient that is being treated for mental health issues to be in a position to detect some of these chronic diseases in the early stages, and therefore treat them (F. K. Leucht S, 2007).
In order to reduce the high prevalence rate among mental patients who are suffering from metabolic syndromes, it has been seen that one of the best ways to deal with this issue is by improving the collaboration in terms of both primary and secondary care for these individuals. The mental health services should ensure that they coordinate with General Practitioners about the conditions of the patients, and therefore device a good plan that will be used effectively to take care of the patients.
They should implement the following protocols i.e. screening, pharmacological and non-pharmacological management of the risk factors in both the primary and the secondary care of the patients. Patients who are being treated with the antipsychotic drugs should be screened on a regular basis in-order to look for possible diagnosis of the disease. 56.2% of the patients that were evaluated or undertook this study were smokers, and effective programs should be created in a bid to reduce or intervene in terms of smoking to reduce the cardiovascular risk factors.
Forty two percent, of the patients in this study rarely exercised i.e. they exercised less than 3 times a week in a span of twenty minutes. This was seen to have a negative effect on the patients in terms of developing high-risk cardiovascular diseases. Studies have shown that when people regularly exercise they are less likely to develop cardiovascular diseases or any of the metabolic disorders. In this study it showed that of the 58% who regularly exercised i.e. more than 3 times a week, they did not meet the criteria of metabolic syndrome.
As a way to counter metabolic disorders among the mentally ill patients, there is the need to implement programs that emphasize on the importance of physical health, and also provide the diet education programs as non-pharmacological interventions, which will help the patients address weight gain issues, and the other metabolic abnormalities (Nemeroff, 2005).People who suffer from mental illness are likely to be suffering from Obesity issues. This has been seen in both the developing, and the developed countries on a global scale. People who are obese have a shorter life span, and have an increase of suffering from other medical conditions such as: Type 2 Diabetes Mellitus, Cardiovascular disease, Hypertension, Respiratory difficulties, Reproductive Hormone abnormalities, various forms of cancer such as Colon cancer (Royal College of Psychiatrists, 2011). Patients who suffer from mental illnesses such as schizophrenia are more likely to suffer from metabolic diseases such as CHD and Diabetes. The SMI patients are more likely to become obese, overweight, have hypertension, hyperglycemia, and a higher mortality rate as compared to patients of the general population.
Mental health patients lose about 25 to 30 years of their life potential because of a premature cardiovascular mortality rate. An increase in terms of an increased cardio metabolic risk in this population was also blamed on issues such as reduced access to medical care, poverty, metabolic side effects because of the antipsychotic drugs. The antipsychotic drugs were directly linked with various risks such as weight gain, and changes in terms of lipid and glucose metabolism.
Conclusion
The results of this study supported the hypothesis that had been clearly illustrated in the introduction part of the paper. It showed that mentally ill patients who were suffering from metabolic disorders were more likely to be low-income earners. This coupled with factors such as; they rarely sought medical attention unless they were in a critical situation, therefore they were rarely screened for other diseases. The mentally ill patients did not also take care of their bodies in terms of exercising, and eating proper food, and this made them to be obese and increase the risk factors of acquiring cardiovascular diseases. To help the patients, they should be advised to seek regular medical checkups where they will be screened for various diseases. They should also have good dietary programs that help them eat the right types, and amounts of food.

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