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The relationship Between Glycemic Control and Food Insecurity in People with Diabetes Mellitus and Comorbid Psychosis
Journal of the Academy of Consultation-Liaison Psychiatry ; 63:S64-S65, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-1966672
ABSTRACT
Background/

Significance:

In the US, adults with psychosis have increased mortality mostly due to cardiovascular disease (CVD) (Olfson 2015). Diabetes mellitus (DM) is a potent CVD risk factor, which occurs in 28% of individuals with serious mental illnesses (Mangurian 2018). Little is understood of the contribution of social and environmental factors to diabetes health disparities experienced by people with psychosis. Food insecurity has been shown to be an independent risk factor for poor glycemic control (Seligman 2012).

Methods:

This IRB-approved cross-sectional survey aims to describe the prevalence and correlates of food insecurity among adults with DM and co-morbid psychosis who receive primary care through 12 clinics affiliated with a large academic healthcare system in Washington state. Administrative data was utilized to identify eligible patients age 18-65;one inpatient or two outpatient diagnoses of schizophrenia (F20-29), bipolar disorder (F31), or major depressive disorder with psychotic features (F32.3;F33.3) and one inpatient or two outpatient diagnoses of DM (E08-E13.9). Patients with diagnoses of dementia or intellectual disability were excluded. All eligible patients were sent a letter with a unique link to a survey in Research Electronic Data Capture. The survey included questions related to diabetes clinical characteristics, self-care behaviors, and psychosis symptom severity in addition to demographics. Food insecurity was measured with the validated USDA’s Food Security Survey Module. Consistent with previous studies, participants will be considered food-insecure if two or more responses are affirmative. We compared food insecure and food secure particpants with level of social support and frequency of psychiatry symptoms. •Regression analysis was applied to examine the associations between food security status, social support, and mental health symptoms.

Results:

624 patients with diabetes and psychosis were identified. 156 patients responded, giving a response rate of 26%. 25% of respondents were found to be food insecure. 16% of respondents demonstrated low social support while 43% showed moderate social support and 41% showed high social support. Mean CSI was 19.36, which suggests participants experienced symptoms several times per month (versus daily or weekly). Significantly lower social support was found in participants with food insecurity compared to those without (p=0.008). This relationship was driven by lower social support from family (p<0.001) compared to friends (p=0.61) or significant others (p=0.192). Additionally, greater psychiatric symptom severity was found in people with food insecurity (p <0.001). Regression analysis showed that social support did not significantly moderate the relationship between food security and frequency of psychiatric symptoms.

Discussion:

This study showed that food insecurity was significantly associated with both low perceived social support and more frequent psychiatric symptoms. However, no evidence of a moderating effect of social support on the relationship between food insecurity and psychiatric symptom severity was found. Rate of food insecurity was found to be lower than previous studies, which showed approximately 50% of individuals who used public mental health services faced food insecurity (Adams et al., 2021). The study sample was not limited to public mental health service users, which is the likely cause of this lower rate. Conclusion/Implications Food insecurity is associated with poorer mental health outcomes, which have been associated with poorer health outcomes. The presence of perceived social support does not mitigate the need for addressing food insecurity. There is a need for both medical and mental health providers who care for people with co-morbid diabetes and psychosis to specifically address food insecurity. References 1. Adams WE, Rogers ES, Edwards JP, Lord EM, McKnight L, Barbone M. Impact of COVID-19 on Peer Support Specialists in the United States Findings From a Cross-Sectional Online Survey. Psychiatr c Services. 2021 Jun 23appi-ps. 2. Coleman-Jensen AJ. US food insecurity status toward a refined definition. Social Indicators Research. 2010 Jan 1;95(2)215-30. 3. Hammami N, Leatherdale ST, Elgar FJ. Does social support moderate the association between hunger and mental health in youth? A gender-specific investigation from the Canadian Health Behaviour in School-aged Children study. Nutrition journal. 2020 Dec;19(1)1-1. 4. Mangurian CV et al. Diabetes and prediabetes prevalence by race and ethnicity. Diabetes care. 2018 Jul 1;41(7)e119-20. 5. Na M, Miller M, Ballard T, Mitchell DC, Hung YW, Melgar-Quiñonez H. Does social support modify the relationship between food insecurity and poor mental health? Evidence from thirty-nine sub-Saharan African countries. Public health nutrition. 2019 Apr;22(5)874-81. 6. Olfson M et al. Premature mortality among adults with schizophrenia in the United States. JAMA psychiatry. 2015 Dec 1;72(12)1172-81. Seligman HK et al. Food insecurity and glycemic control among low-income patients with type 2 diabetes. Diabetes care. 2012 Feb 1;35(2)233-8. Stubbs B, Vancampfort D, De Hert M, Mitchell AJ.Acta Psychiatr Scand. 2015 Aug;132(2)144-57. Regression analysis showed that social support did not significantly moderate the relationship between food security and frequency of psychiatric symptoms.
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Texto completo: Disponível Coleções: Bases de dados de organismos internacionais Base de dados: EMBASE Idioma: Inglês Revista: Journal of the Academy of Consultation-Liaison Psychiatry Ano de publicação: 2022 Tipo de documento: Artigo

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Texto completo: Disponível Coleções: Bases de dados de organismos internacionais Base de dados: EMBASE Idioma: Inglês Revista: Journal of the Academy of Consultation-Liaison Psychiatry Ano de publicação: 2022 Tipo de documento: Artigo