MedicalResearch.com Interview with:
Dr. Christina Mangurian MD
Associate Professor of Clinical Psychiatry
UCSF School of Medicine and the
UCSF Department of Psychiatry’s first Director of Diversity
Medical Research: What is the background for this study? What are the main findings?
Dr. Mangurian: People with severe mental illness (SMI, e.g., schizophrenia and bipolar disorder) die 25 years earlier than the general population, often from cardiovascular disease. The ADA and APA guidelines recommend annual diabetes screening of this population when taking certain antipsychotic medications. Despite these guidelines, nearly 70% of this population remain unscreened. This has huge public health implications and likely costs our public health system a tremendous amount in undiagnosed disease.
Medical Research: What should clinicians and patients take away from your report?
Dr. Mangurian: If I could, I would want a primary care provider to think of a diagnosis of schizophrenia like they would a diagnosis of tobacco dependence. By this, I mean that I would want them to use the diagnosis that they have in hand to risk-stratify their patients and consider them—regardless of age—high risk for cardiovascular disease. I want them to screen the 23 year-old woman with schizophrenia on risperidone for diabetes, hypertension, and dyslipidemia because we have a real opportunity to prevent disease in this woman and allow her to live a long and productive life.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Mangurian: Research is desperately needed to find the best integration of care models for people served in community mental health clinics. Currently, there is excellent research on how to improve depression screening in primary care (collaborative care); but a paucity of research on this population with SMI. We need to work together to provide high quality care for this underserved population.
Dr. Christina Mangurian MD (2015). Mental Health Patients Poorly Screened for Cardiovascular Disease