Previously undetected metabolic syndromes and infectious diseases among psychiatric inpatients

Objective: This study identified previously undetected metabolic and infectious disease among persons with serious mental illness who were admitted to psychiatric inpatient units. Methods: Observational-naturalistic methods were used to simulate universal screening in order to document evidence of undetected disease among 588 adult psychiatric patients. Data were obtained from medical records and laboratory tests. Results: Laboratory results showed that 10% of patients had HIV, 32% had hepatitis B, and 21% had hepatitis C. Glucose levels were elevated in 7%, and total cholesterol levels were elevated in 22%. Nearly 60% had body mass indices above 25. The treatment team missed a considerable proportion of infectious disease (95% of hepatitis B cases, 50% of hepatitis C cases, and 21% of HIV cases) and metabolic disorders (89% of cases with elevated total cholesterol levels and 97% of cases with elevated triglyceride levels). By contrast, only 18% of cases with elevated glucose levels were missed. Conclusions: This study demonstrated very high prevalence of both metabolic disorders and infectious diseases in a psychiatric inpatient population.