Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care

  title={Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care},
  author={Marc De Hert and Christoph U. Correll and Julio Bobes and Marcelo G Cetkovich-Bakmas and Dan Cohen and Itsuo Asai and Johan Detraux and Shiv Shankar Gautam and Hans-J{\"u}rgen M{\"o}ller and David Musyimi Ndetei and John W. Newcomer and Richard Uwakwe and Stefan Leucht},
  journal={World Psychiatry},
The lifespan of people with severe mental illness (SMI) is shorter compared to the general population. [] Key Method We searched MEDLINE (1966 - August 2010) combining the MeSH terms of schizophrenia, bipolar disorder and major depressive disorder with the different MeSH terms of general physical disease categories to select pertinent reviews and additional relevant studies through cross-referencing to identify prevalence figures and factors contributing to the excess morbidity and mortality rates…

Are metabolic disorders part of a severe mental illness? Historical and current perspective

SMI seems to be part of a metabolic disorder, which mostly results from the lifestyle, pharmacological treatment, and also the genetic factors, and it should be taken into account that the treatment of SMI always requires monitoring of metabolic indicators.

Physical illness in patients with severe mental disorders . II . Barriers to care , monitoring and treatment guidelines , plus recommendations at the system and individual level

A confluence of patient, provider, treatment and system factors has created a situation in which access to and quality of health care is problematic for individuals with SMI, and Table 1 summarizes the barriers to the recognition and management of somatic illnesses in SMI patients.

Reducing health inequalities for people with serious mental illness.

  • N. HallettHelen Rees
  • Medicine
    Nursing standard (Royal College of Nursing (Great Britain) : 1987)
  • 2017
Nurses in all practice settings can use health promotion, assessment and treatment to improve the physical health of people with SMI in relation to four areas of health: metabolic syndrome, smoking, oral health and sexual health.

Physical morbidity and mortality in people with mental illness

A broad range of clinician and organisational factors prevent access to adequate physical healthcare that in turn compounds the above problems.

Health Care and Mortality among Persons with Severe Mental Illness

In Israel, a country with a national health insurance and a rehabilitation law for persons with mental disabilities, service users with bipolar disorder receive equitable levels of general health care, compared with other countries with universal health insurance.

Physical Comorbidity According to Diagnoses and Sex among Psychiatric Inpatients in South Korea

Male and female patients with schizophrenia-related disorders showed similar comorbidity prevalence patterns by sex, and liver disease was most prevalent in males and third-most in females, and hypothyroidism in females.

Somatic Problems and Dual Disorder Patients

There is sufficient evidence that dual disorder patients have a significantly greater medical comorbidity than SMI patients without an SUD, and this is confirmed by additional research on major medical diseases in these patients.

Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder

To what degree medication‐specific and patient‐specific risk factors interact, and how adverse outcomes can be minimized, allowing patients to derive maximum benefits from these medications, requires adequate clinical attention and further research.


This project used a programme of research to evaluate the impact of the HIP Programme on care processes and patient outcomes and identified that it was possible to identify comorbidities in people with SMI using the structured health check in secondary care and that change in health behaviours and outcomes was possible.

Multiple physical healthcare needs among outpatients with schizophrenia: findings from a health examination study

Health examinations for outpatients with schizophrenia revealed numerous physical healthcare needs, and prevention and treatment of obesity and smoking should be given priority in order to diminish somatic comorbidities in schizophrenia.



The effects of undertreated chronic medical illnesses in patients with severe mental disorders.

Implementing behavioral interventions into clinical practice may help patients improve their overall health and prevent chronic medical conditions.

Diabetes and cardiovascular risk in severe mental illness: a missed opportunity and challenge for the future.

Health care professionals within psychiatry, general practice and medical specialties need to work together to reduce the burden of physical health problems in people with SMI.

Comparing the safety and efficacy of atypical antipsychotics in psychiatric patients with comorbid medical illnesses.

  • J. Newcomer
  • Medicine, Psychology
    The Journal of clinical psychiatry
  • 2009
Patients with severe mental illnesses have a higher risk of premature mortality than the general US population and clinicians involved in the care of this patient population should screen and monitor for cardiometabolic side effects and risk factors.

Bipolar disorder and diabetes mellitus: epidemiology, etiology, and treatment implications.

Preliminary investigations indicate that patients who suffer from BD with comorbid DM have a more severe course and outcome, lower quality of life, higher prevalence of medicalcomorbidity and higher cost of illness.

Inequalities in healthcare provision for people with severe mental illness

To tackle systemic barriers to healthcare provision integrated care models could be employed including co-location of physical and mental health services or the use of case managers or other staff to undertake a co-ordination or liaison role between services.

The impact of mental illness on cardiac outcomes: a review for the cardiologist.

Quality of Care for Cardiovascular Disease-related Conditions in Patients with and without Mental Disorders

Quality of care for major chronic conditions associated with premature CVD-related mortality is suboptimal for VA patients with SMI, especially for procedures requiring care by a specialist.

Treatment decisions in major mental illness: weighing the outcomes.

Monitoring and treatment guidelines are underutilized in people with SMI; increased use of these guidelines could help to detect and possibly prevent some cardiometabolic problems.

Premature mortality from general medical illnesses among persons with bipolar disorder: a review.

The available evidence suggests that bipolar spectrum disorders are associated with increased premature mortality secondary to general medical illnesses, and unhealthy lifestyle, biological factors, adverse pharmacologic effects, and disparities in health care are possible underlying causes.

Metabolic disease and cardiovascular risk in people treated with antipsychotics in the community.

People with severe mental illness treated with antipsychotics have excess metabolic dysfunction and heightened risk for cardiovascular disease.