RESUMO
OBJECTIVE: To examine the risk of coronary vascular disease event (CVDE) and the prevalence metabolic syndrome (MS) and its cardiovascular risk factors (CVRF) in patients with severe mental illnesses enrolled in an assertive treatment community program (ATC) in Spain. METHOD: We carried out a cross-sectional descriptive study with all of the patients included in an ATC program in 2016 in a health area with 547,328 inhabitants in Galicia, Spain. We identified the CVRF in all the individuals, and calculated MS and 10-year CVDE. We also compared the prevalence of all traits in our cohort and the general population. RESULTS: The 10-year median of coronary vascular disease event (CVDE10) was 8.4%. The percentage of individuals with high CVDE10 (>5%) was 41.2% The CVDE10 median was higher in men than women (10.5% vs 5.1%, p<0.001). MS was detected in 50% of patients without differences between men and women (51.2% vs 48.2%). A prevalence of 68% was found for smoking, 55% for dyslipidemia, 47% for obesity, 29% for impaired glucose metabolism, and 38% for hypertension. Women showed a higher prevalence of obesity measured by elevated waist circumference (88.9% vs 55.6%, p=0.003). Men showed a higher prevalence of arterial hypertension (46.6% vs 22.2%, p=0.0001). CONCLUSIONS: The SMD Patients enrolled in ATC programs had a 1.5-times higher prevalence of MS and 8 times higher CVDE10 than those reported in the general population. Individual CVRF were also higher in the SMD patients. Prevention, early detection, and comprehensive treatment are important issues for patients with severe mental illnesses.
Assuntos
Serviços Comunitários de Saúde Mental/métodos , Doença das Coronárias/sangue , Doença das Coronárias/epidemiologia , Síndrome Metabólica/sangue , Síndrome Metabólica/epidemiologia , Adulto , Idoso , Estudos de Coortes , Doença das Coronárias/terapia , Estudos Transversais , Dislipidemias/sangue , Dislipidemias/epidemiologia , Dislipidemias/terapia , Feminino , Humanos , Hipertensão/sangue , Hipertensão/epidemiologia , Hipertensão/terapia , Masculino , Síndrome Metabólica/terapia , Pessoa de Meia-Idade , Obesidade/sangue , Obesidade/epidemiologia , Obesidade/terapia , Prevalência , Fatores de Risco , Fumar/sangue , Fumar/epidemiologia , Fumar/terapia , Espanha/epidemiologiaRESUMO
La guía trata de temas relacionados al tratamiento de la depresión, tocando temas como: las perspectivas y experiencias de los pacientes con depresión y sus familiares; evaluación y cribado de la depresión; los modelos de atención; tratamiento psicoterapéutico, tratamiento farmacológico; estrategias psicoterapéuticas y farmacológicas en la depresión resistente.
