High rates of respiratory symptoms and airway disease in mental health inpatients in a tertiary centre

Intern Med J. 2018 Apr;48(4):433-438. doi: 10.1111/imj.13594.


Background: People with severe mental illness (SMI) have a lower life expectancy due in part to a higher prevalence of cardiac and metabolic disease. Less is known of the prevalence of respiratory disease in this group.

Aims: This cross-sectional, observational study aimed to assess the prevalence of symptoms associated with respiratory disease in patients admitted to an inpatient mental health unit.

Methods: A convenience sample of 82 inpatients had a structured interview and questionnaire completed. The questionnaire included self-reported diagnoses of common diseases and screening questions designed to detect respiratory disease and sleep disordered breathing. Targeted spirometry was performed on the basis of symptoms and smoking status.

Results: Patients reported high rates of respiratory symptoms, including wheezing (38%) and dyspnoea (44%); 52% of patients reported daily tobacco use. Productive cough was significantly associated with tobacco use (P < 0.005). Ten patients (18%) had spirometry consistent with chronic obstructive pulmonary disease (COPD) of whom six did not have a formal diagnosis of COPD previously.

Conclusions: People with SMI have high rates of respiratory symptoms with a high prevalence of COPD on spirometry. Half of the COPD cases were not previously diagnosed, suggesting a hidden burden of respiratory disease in patients with SMI.

Keywords: COPD; OSA; mental illness; respiratory illness; sleep apnoea.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Mental Disorders / diagnosis*
  • Mental Disorders / epidemiology*
  • Mental Health / trends*
  • Middle Aged
  • Patient Admission / trends
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Respiration Disorders / diagnosis*
  • Respiration Disorders / epidemiology*
  • Smoking / epidemiology
  • Smoking / trends
  • Spirometry / trends
  • Tertiary Care Centers / trends*
  • Young Adult