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Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level
Open accessAbstract
Physical disorders are, compared to the general population, more prevalent in people with severe mental illness (SMI). Although this excess morbidity and mortality is largely due to modifiable lifestyle risk factors, the screening and assessment of physical health aspects remains poor, even in developed countries. Moreover, specific patient, provider, treatment and system factors act as barriers to the recognition and to the management of physical diseases in people with SMI. Psychiatrists can play a pivotal role in the improvement of the physical health of these patients by expanding their task from clinical psychiatric care to the monitoring and treatment of crucial physical parameters. At a system level, actions are not easy to realize, especially for developing countries. However, at an individual level, even simple and very basic monitoring and treatment actions, undertaken by the treating clinician, can already improve the problem of suboptimal medical care in this population. Adhering to monitoring and treatment guidelines will result in a substantial enhancement of physical health outcomes. Furthermore, psychiatrists can help educate and motivate people with SMI to address their suboptimal lifestyle, including smoking, unhealthy diet and lack of exercise. The adoption of the recommendations presented in this paper across health care systems throughout the world will contribute to a significant improvement in the medical and related psychiatric health outcomes of patients with SMI.
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“Professional barriers to screening within mental health settings may in their turn reflect lack of clarity about whose clinical responsibility the screening is, lack of understanding about what should be measured and when, uncertainity about how to interpret results, and lack of access to necessary equipment 41 , as well as incomplete communication between primary and secondary care.”
From Diabetes mellitus in people with schizophrenia, bipolar disorder and major depressive disorder: a systematic review and large scale meta‐analysis (2016) · cites this paper as [41]
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“…the concern about under recognition of pain conditions in persons with schizophrenia is heightened by findings that their medical care can be fragmented or inconsistent, further contributing to inadequate care for this vulnerable clinical group (De Hert et al., 2011c; Vancampfort et al., 2011b).”
BackgroundSelf-citationObesity: Its Epidemiology, Comorbidities, and Management
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Self-citationMental Disorders Across the Adult Life Course and Future Coronary Heart Disease
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EPA guidance on the quality of mental health services
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“…high levels of smoking, alcohol use, a sedentary lifestyle (Vancampfort et al., 2010), limited access to healthcare and exercise facilities (Vancampfort et al., 2011b; De Hert et al., 2011) and in particular high levels of cardio-metabolic diseases (Vancampfort et al., 2013d; Stubbs et al., 2015).”
BackgroundElucidating the diagnostic odyssey of 22q11.2 deletion syndrome
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“There are general issues with clinicians operating within “silos” of medical expertise (De Hert et al., 2011; Horvitz-Lennon, Kilbourne, & Pincus, 2006), and the many terms (e.g., velocardiofacial and DiGeorge syndrome) for 22q11.”
Background
Metadata
- Authors
- DE HERT, M., COHEN, D., BOBES, J., CETKOVICH‐BAKMAS, M., LEUCHT, S., NDETEI, D. M., NEWCOMER, J. W., UWAKWE, R., ASAI, I., MÖLLER, H., GAUTAM, S., DETRAUX, J., & CORRELL, C. U.
- Affiliations
- University of Groningen (NL)
- Universidad de Oviedo (ES)
- Technical University of Munich (DE)
- University of Nairobi (KE)
- Washington University in St. Louis (US)
- Nnamdi Azikiwe University (NG)
- SMS Medical College (IN)
- KU Leuven (BE)
- Albert Einstein College of Medicine (US)
- ORCID
- Venue
- World Psychiatry
- Publisher
- Wiley
- Published
- 2011-06
- Volume
- 10
- Issue
- 2
- Pages
- 138-151
- ISSN
- 1723-8617 (ISSN-L)
- 2051-5545
- PMC
- PMC3104888
- OpenAlex
- W1828019950
- Cited by
- 870
- References
- 150
- Citations by year
- 2026: 39 · 2025: 50 · 2024: 50 · 2023: 57 · 2022: 68 · 2021: 54 · 2020: 72 · 2019: 76 · 2018: 68 · 2017: 56 · 2016: 79 · 2015: 57 · 2014: 37 · 2013: 57 · 2012: 39
- FWCI
- 31.70
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- World Psychiatry (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Lirias (submittedVersion)
- mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Funders
- Bristol-Myers Squibb
- Pfizer
- Società Italiana di Psichiatria Biologica
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- physical illness, severe mental illness, barriers to care, physical health screening, treatment guidelines, lifestyle risk factors, smoking, diet, physical activity, developing countries
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