[Interest of admission blood sampling for the detection of somatic comorbidity in hospitalized psychiatric patients]. / Intérêt du bilan biologique d'entrée dans le dépistage de comorbidités chez les patients hospitalisés en psychiatrie.

INTRODUCTION: Elevated prevalence of somatic disorders among psychiatric patients is well known and studied since latest years. According to several studies, all-cause death risk is three to fivefold to that in the general population, and a somatic comorbidity was found in 30 to 60% of patients hospitalized in a psychiatric hospital, but was unknown in 50% of cases. OBJECTIVE: Our aim was to evaluate the interest of admission blood sampling analyses for the detection of somatic comorbidity, such as impaired glucose tolerance, diabetes mellitus, lipid abnormalities or infectious diseases among hospitalized psychiatric patients. DESIGN: During three months, laboratory tests (blood cell count, glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, sodium, potassium, chlorine, urea, creatinine, alanine aminotransferase, aspartate aminotransferase, gamma glutamyltransferase, alkaline phosphatase, and TSH) were determined in admission blood samples from 366 patients of two psychiatric hospitals. Then, according to the blood results, other biological tests (iron, ferritin, etc.) were made. RESULTS: For 194 of the 366 blood samples included (53%), at least one biological abnormality was detected. Moreover, variations in haematological variables, glucose and lipid concentrations were the most frequent. We found that 45 (10.6%) of the patients had impaired glucose tolerance (glycaemia > or =1.10 g/l), 21 (5.7%) had glycaemia > or =1.26 g/l, and 76 (23%) had dyslipidemia (HDL-cholesterol < or =0.40 g/l, LDL-cholesterol > or =1.60 g/l, or triglycerides > or =1.50 g/l). None of them had used glucose or cholesterol lowering drugs before the blood sampling. Furthermore, low haemoglobin concentrations were detected in 34 patients (9.3%) and high white cell counts (above 12 g/l) in 26 patients (7.1%). CONCLUSION: Despite methodological limits, these results showed the frequency of somatic comorbidity in patients hospitalized in psychiatric hospitals. Thus, admission blood sampling would be likely to improve the detection of somatic disorders, such as diabetes mellitus, dyslipidemia, or infectious diseases.