Association between cognitive impairment and cardiovascular burden in patients with severe mental disorder.

Introduction: Cognitive impairment is related to an increase in cardiovascular risk (CVR) in the general population. However, in severe mental disorder (SMD), the evidence is less consistent. Few studies have evaluated the relationship between cognition and vascular burden in SMD. This study determines the relationship between cognition and vascular burden in patients with SMD.Methods: Sixty SMD patients (61% men, mean age: 46) attending a psychosocial rehabilitation centre were included. We evaluated sociodemographic, clinical, laboratory, quality of life and functionality characteristics. And we analysed the association between cognitive performance and vascular burden.Results: SMD diagnoses were: 41.7% schizophrenia, 20.0% bipolar, 5.0% schizoaffective, 21.7% depressive and 11.7% other. Cognitive impairment was present in 55% of the cases. The average vascular burden was 3.2. Patients with cognitive impairment have a significantly higher vascular burden than patients without cognitive impairment (p < 0.05). The speed of processing had a moderate correlation with vascular burden (r = -0.457, p = 0.001).Conclusions: Patients with cognitive impairment had a significantly higher vascular burden than patients without cognitive impairment. There are two practical clinical implications: CVR should be evaluated in all SMD patients; and psychoeducation programmes for CVR should be performed and adapted to the cognitive deficits.

[Medication adherence and use of health services in patients with psychosis in the region of Osona (Catalonia, Spain)]. / Adherencia al tratamiento y utilización de servicios de salud pacientes con psicosis.

OBJECTIVE: To describe and analyze sociodemographic and clinical characteristics, medication adherence and use of health resources by country of birth of psychosis diagnosed patients treated with long-term antipsychotic injectable drugs in the region of Osona (Catalonia, Spain). METHOD: Descriptive observational study in psychosis diagnosed patients over 18 years old, receiving long-term antipsychotic injectable treatment and treated at a Mental Health Center for adults in Vic (Catalonia, Spain). RESULTS: 185 patients were included, of them: 163 (88.1%) were born in Spain and 22 (17.9%) abroad. The sample was gender homogeneous with differences in age, employment status, family situation and diagnosis (p < 0.05). Findings about medication adherence to long-term antipsychotic injectable ambulatory treatment reflected good compliance in both populations. 57.7% of Spain-born patients and 9.1% of abroad-born patients received the injectable treatment at Primary Care Center (p < 0.001). The rest of them received the treatment at Mental Health Center for adults. 22 patients (711.9%) were admitted at psychiatry hospitalization ward, 16 (9.8%) of them were born in Spain and 6 (27.3%) abroad (p = 0.012). CONCLUSIONS: All patients diagnosed with psychosis, either born or not in Spain, describe good adherence to long-term antipsychotic injectable treatment, with similar use of health resources from a quantitative point of view and some differences in the type of visits.