DESCRIPTIVE AND CORRELATIONAL STUDY OF PHYSICAL HEALTH, RISK FACTORS, AND PSYCHOSOCIAL VARIABLES AMONG SEVERELY MENTALLY ILL VETERANS IN A DAY TREATMENT PROGRAM.
Contributors: University of Utah.
Published: 1994
Number of pages: 479
Subjects: Health Sciences, Education.; Health Sciences, Mental Health.; Health Sciences, Nursing.
Description: Persistence of unexplained, excessive rates of medical illnesses among clients with severe mental illness argued for a closer look at types of illnesses and risk factors, considering factors such as age and psychosocial conditions that may covary with physical health status. A sample of 73 Veterans Administration clients who attended a day treatment program responded to questionnaires, and 72 were given physical examinations.

One hundred eighty-nine major health problems were identified among 62 subjects (86%). Forty-seven percent (n = 89) had not been recognized previously. Unrecognized problems occurred in 69% (n = 50) of subjects. Minor unrecognized health problems occurred in 89% (n = 64) of subjects (79%, or 181 conditions). Major problems requiring attention were found in 76% of subjects. These rates are consistent with rates previously reported, but are in excess of rates for the population in general. Of major health problems, 59% were considered treatable by better control of chronic conditions and health counseling (secondary and tertiary prevention).

Rates for smoking, chronic drinking, sedentary lifestyle, obesity, hypertension, and hypercholesterolemia significantly exceeded estimated rates for Utah. The rate of smoking for Veterans Administration subjects at 55% exceeded Utah and national rates, but was less than the 70% to 88% rate reported for psychiatric clients in general.

Major health problems were correlated significantly (p $\le$.01) with age, diagnoses of nonpsychotic disorders (n = 21, 29%) and depression, taking antidepressant drugs, low functional health, low perceived health, high risk factor scores, and reporting weakness and fatigue. The best set of independent variables predicted 56% of variance in number of major health problems. These variables were low functional health, taking antidepressants, perceiving problems with exercise, not taking antipsychotics, and age.

Nonpsychotic compared with psychotic subjects were more likely to be married, have higher health support scores, but also to report significantly more frustration, stress, weakness, and fatigue. Ambiguous symptoms can be confused with depression or anxiety, or with side effects from neuroleptic drugs, and may mask medical conditions.

Subjects' need for health prevention and promotion programs seems indisputable; however, prevention may be superseded by mental health and supportive service needs. Reasons for high rates of health conditions and risk factors, theoretical implications, recommendations for improving health care, and suggestions for further study are discussed.
Notes: Source: Dissertation Abstracts International, Volume: 55-02, Section: B, page: 0355.

Thesis (PH.D.)--THE UNIVERSITY OF UTAH, 1994.

School code: 0240.