Association of Psychiatric Illness and Obesity, Physical Inactivity, and Smoking among a National Sample of Veterans

Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA.
Psychosomatics (Impact Factor: 1.86). 05/2011; 52(3):230-6. DOI: 10.1016/j.psym.2010.12.009
Source: PubMed


Increased cardiovascular morbidity and mortality have been reported across a number of chronic psychiatric illnesses. Interventions to decrease cardiovascular risk have focused on single health behaviors.
To evaluate the co-occurrence of multiple poor health behaviors that increase cardiovascular risk among veterans with psychiatric diagnoses.
Using data from the 1999 Large Health Survey of Veterans (n=501,161), multivariate logistic regression was used to evaluate the associations between current smoking, no regular exercise, and obesity with each of six Axis I diagnoses.
There were statistically increased odds of co-occurrence of obesity, current tobacco use, and no regular exercise among veterans with each of the psychiatric diagnoses, with the exception of drug use disorders (which was not significantly different from 1). The highest odds were among veterans with schizophrenia, PTSD, and bipolar disorder [OR (95% CI) of 1.37 (1.29, 1.45); 1.26 (1.20, 1.32); and 1.19 (1.11, 1.25), respectively]. The OR for depression was not significant after adjustment for medical comorbidity.
Veterans with psychiatric illnesses, and particularly those with schizophrenia, PTSD, and bipolar disorder, are much more likely to have multiple poor health behaviors that increase their cardiovascular risk. Interventions to decrease cardiovascular risk among veterans with serious mental illness need to target multiple health behaviors.

Download full-text


Available from: Lydia Chwastiak, Jul 25, 2014
29 Reads
    • "behaviors , such as lack of physical activity , unhealthy diet , and smoking , are highly frequent among people suffering from PTSD ( Chwastiak et al. 2011 ; Hirth et al . 2011).Therefore,peoplewithPTSDmay haveanincreasedprevalenceofmetabolicsyndrome.Theobjectiveofthischapteristoanalyzeavailable scientificliteratureontheassociationbetweenmetabolicsyndrome–anditssubcomponents–andPTSD. "
    Comprehensive Guide to Post-Traumatic Stress Disorder, Edited by Colin R. Martin, Victor R. Preedy, Vinood B. Patel, 06/2015; Springer International Publishing., ISBN: 978-3-319-08613-2
  • Source
    • "Results from the BRFSS indicate that the age-adjusted prevalence of current smoking was 27.0% among veterans, but the prevalence was even higher among younger veterans, between 36% and 40%, whereas the prevalence of smoking among younger nonveterans was between 22% and 30% [2]. Veterans with mental health diagnoses are also more likely to smoke [146] "
    [Show abstract] [Hide abstract]
    ABSTRACT: Lifestyle and health-related factors are critical components of the risk for cognitive aging among veterans. Because dementia has a prolonged prodromal phase, understanding effects across the life course could help focus the timing and duration of prevention targets. This perspective may be especially relevant for veterans and health behaviors. Military service may promote development and maintenance of healthy lifestyle behaviors, but the period directly after active duty has ended could be an important transition stage and opportunity to address some important risk factors. Targeting multiple pathways in one intervention may maximize efficiency and benefits for veterans. A recent review of modifiable risk factors for Alzheimer's disease estimated that a 25% reduction of a combination of seven modifiable risk factors including diabetes, hypertension, obesity, depression, physical inactivity, smoking, and education/cognitive inactivity could prevent up to 3 million cases worldwide and 492,000 cases in the United States. Lifestyle interventions to address cardiovascular health in veterans may serve as useful models with both physical and cognitive activity components, dietary intervention, and vascular risk factor management. Although the evidence is accumulating for lifestyle and health-related risk factors as well as military risk factors, more studies are needed to characterize these factors in veterans and to examine the potential interactions between them.
    Alzheimer's and Dementia 06/2014; 10(3):S111–S121. DOI:10.1016/j.jalz.2014.04.010 · 12.41 Impact Factor
  • Source
    • "These limitations may be of particular relevance in men, who may present increased BMI related to muscle hypertrophy and not fat. Therefore, the use of BMI may not reflect a simple increase in total fat, and this finding may be an important confounding bias in several studies that fail to find correlations between BMI and psychiatric disorders [21,22]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Several studies point to a correlation between obesity and the severity of depressive and anxiety symptoms in children and adults, but there are still some controversial points about this association. The aim of this study is to investigate the relationship between body composition and the severity of anxiety/depressive symptoms in overweight and obese individuals with Metabolic Syndrome (MS). Fifty patients, 18-50 years old, overweight or obese and with the diagnosis of MS based on the International Diabetes Federation (IDF) criteria were selected for this study. Body composition was evaluated using Dual Energy X-ray Absorptiometry (DXA). Depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS-Depression) and the Beck Depression Inventory (BDI). Anxiety symptoms were evaluated using HADS-Anxiety. No correlation was found between depressive symptoms (HADS-Depression or BDI) and Body Mass Index (BMI) (r = 0.01; p = 0.94 and r = -0.12, p = 0.38; respectively), Waist Circumference (WC) (r = -0.06, p = 0.67 and r = -0.22, p = 0.12; respectively), and Waist-to-Hip Ratio (WHR) (r = -0.12, p = 0.40 and r = -0.17, p = 0.23; respectively). Additionally, no correlation was found among anxiety symptoms (HADS-Anxiety) and BMI (r = -0.15, p = 0.27), and WHR (r = -0.17, p = 0.24). In contrast, a significant correlation was found between percentage of total fat (DXA) and HADS-Depression (r = 0.34, p = 0.019) and HADS-Anxiety (r = 0.30, p = 0.039). Additionally, an inverse and strong correlation was found between lean mass (in grams) and HADS-Depression (r = -0.42, p = 0.004), HADS anxiety (r = -0.57, p < 0.0001), and BDI (r = -0.44, p = 0.026). In individuals with MS, the percentage of body fat, and not central fat, BMI, WC, or WHR, was associated with an increased severity of anxiety and depressive symptoms. In contrast, total lean mass was strongly associated with fewer anxiety/depressive symptoms, suggesting that body composition might be related to psychiatric comorbidity in overweight individuals with MS.
    Diabetology and Metabolic Syndrome 12/2013; 5(1):82. DOI:10.1186/1758-5996-5-82 · 2.17 Impact Factor
Show more