Metabolic control and prolactin in severe mental illness. Nursing interventions

Abstract

Patients with severe mental illness (SMI) present greater morbidity and mortality, and antipsychotics can induce metabolic syndrome and hyperprolactinaemia (HPRL), effects that are frequently underdiagnosed and affect sexuality, overall health and treatment adherence. In this context, the mental health teams of the Provincial Hospital of Ávila set out to promote physical health care as an integral part of treatment, launching a programme to monitor physical parameters and prolactin levels, with computerized records integrated into the clinical history and checks at the start of treatment and at 3, 6, 12 and 24 months. From the programme, a retrospective observational study (2015-2017) of 202 patients with SMI emerges: 26.7% presented HPRL (more frequent and severe with polytherapy and in women), and the administration of aripiprazole produced a significant decrease in prolactin levels. It is concluded that physical health control must be integrated into treatment, that nursing must prioritize the assessment of adherence, and that the metabolic effects associated with antipsychotics are reversible.