Cited by 870Schizophrenia research and treatmentMental Health Treatment and AccessPsychiatric care and mental health services

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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

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DE HERT, MARC, COHEN, DAN, BOBES, JULIO, CETKOVICH‐BAKMAS, MARCELO, LEUCHT, STEFAN, NDETEI, DAVID M., NEWCOMER, JOHN W., UWAKWE, RICHARD, ASAI, ITSUO, MÖLLER, HANS‐JURGEN, GAUTAM, SHIV, DETRAUX, JOHAN, CORRELL, CHRISTOPH U.·2011·World Psychiatry

DOI 10.1002/j.2051-5545.2011.tb00036.xPMC PMC3104888

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Abstract

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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Developing an Evidence-Based Specialist Nursing Role to Improve the Physical Health Care of People with Mental Illness
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“Literature exploring the attitudes of mental health professionals suggests they do not have adequate expertise in cardiometabolic health and tend to identify mental health issues as holding far greater importance than physical health (De Hert et al., 2011; Gray & Brown, 2017).”
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Impact of the COVID-19 pandemic on non-COVID-19 hospital mortality in patients with schizophrenia: a nationwide population-based cohort study
Boyer, L., Fond, G. B., Pauly, V., Orléans, V., Auquier, P., Solmi, M., Correll, C. U., Yon, D. K., Llorca, P., Baumstarck, K., et al. (2022) · Molecular Psychiatry · doi:10.1038/s41380-022-01803-4 · Cited by 24
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Provision of health promotion programmes to people with serious mental illness: a mapping exercise of four S outh L ondon boroughs
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Comparing tolerability profile of quetiapine, risperidone, aripiprazole and ziprasidone in schizophrenia and affective disorders: a meta-analysis
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“The SGAs side effects on physical health have become an important issue in mental illnesses’ treatment [20].”
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Improvements in Somatic Complaints Among Individuals With Serious Mental Illness Receiving Treatment in a Psychiatric Hospital
Madan, A., Clapp, J. D., Osborne, P. J., Walker, C. R., Frueh, B. C., Allen, J. G., Oldham, J. M., & Fowler, J. C. (2016) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000298 · Cited by 20
“, smoking), psychotropic medications, psychiatric symptoms, and disparities in access to and receipt of health care in general (17).”
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The opinions of Turkish mental health nurses on physical health care for individuals with mental illness: A qualitative study
İnce, S. Ç., Günüşen, N. P., & Serçe, Ö. (2018) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.12456 · Cited by 20
Oral Health Is a Challenging Problem for Patients with Schizophrenia: A Narrative Review
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“In response to the increase in chronic diseases, the very high rate of treatment non-observance and the need for more patient autonomy, the partner patient concept is gradually emerging as a healthcare approach (35-54).”
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Health Effects of an Individualized Lifestyle Intervention for People with Psychotic Disorders in Psychiatric Outpatient Services: A Two Year Follow-up
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BackgroundInfluential
Better care for less money: cost‐effectiveness of integrated care in multi‐episode patients with severe psychosis
Karow, A., Brettschneider, C., König, H. ‐., Correll, C. U., Schöttle, D., Lüdecke, D., Rohenkohl, A. C., Ruppelt, F., Kraft, V., Gallinat, J., et al. (2019) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.13139 · Cited by 19
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Indicators of quality of diabetes care in persons with type 2 diabetes with and without severe mental illness: a Danish nationwide register-based cohort study
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Risk factors for poor COVID-19 outcomes in patients with psychiatric disorders
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Vitamin D status and correlates of low vitamin D in schizophrenia, other psychoses and non-psychotic depression – The Northern Finland Birth Cohort 1966 study
Ikonen, H., Palaniswamy, S., Nordström, T., Järvelin, M., Herzig, K., Jääskeläinen, E., Seppälä, J., Miettunen, J., & Sebert, S. P. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.02.060 · Cited by 19
Out‐of‐Hospital Cardiac Arrest in Patients With and Without Psychiatric Disorders: Differences in Use of Coronary Angiography, Coronary Revascularization, and Implantable Cardioverter‐Defibrillator and Survival
Barcella, C. A., Mohr, G. H., Kragholm, K. H., Gerds, T. A., Jensen, S. E., Polcwiartek, C., Wissenberg, M., Lippert, F. K., Torp-Pedersen, C. T., Kessing, L. V., et al. (2019) · Journal of the American Heart Association · doi:10.1161/jaha.119.012708 · Cited by 19
Experiences With the Mental Health Service System of Family Caregivers of Individuals With an Intellectual/Developmental Disability Referred to START
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Physical symptoms as psychiatric manifestations in medical spaces: A qualitative study
Spurrier, G. F., Shulman, K. S., Dibich, S., Benoit, L., Duckworth, K. S., & Martin, A. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.1074424 · Cited by 18
“To tackle these physical health disparities in patients with mental illness, several prior pieces of literature have suggested more integrated and collaborative health care (4, 5, 14, 17, 35).”
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Association of severe mental illness and septic shock case fatality rate in patients admitted to the intensive care unit: A national population-based cohort study
Lakbar, I., Léone, M., Pauly, V., Orléans, V., Srougbo, K. J., Diao, S., Llorca, P., Solmi, M., Correll, C. U., Fernandes, S., et al. (2023) · PLoS Medicine · doi:10.1371/journal.pmed.1004202 · Cited by 18
“Among somatic diseases, infections are disproportionately more frequent in patients with SMI than in the general population, representing a potentially avoidable contributor to early death [2,7,8].”
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Effects and Feasibility of the “Traffic Light Method for Somatic Screening and Lifestyle” in Patients With Severe Mental Illness: A Pilot Study
van Meijel, B., van Hamersveld, S., van Gool, R., van der Bijl, J., & van Harten, P. N. (2014) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12071 · Cited by 18
“Psychiatrists (De Hert et al., 2009, 2011a; Marder et al., 2004) and mental health nurses (Brunero & Lamont, 2009; Ohlsen, Peacock, & Smith, 2005; Shuel, White, Jones, & Gray, 2010; Usher, Foster, & Park, 2006) have developed a number of guidelines and tools aimed at better screening and monitoring…”
Mental health consumers' with medical co‐morbidity experience of the transition through tertiary medical services to primary care
Cranwell, K., Polacsek, M., & McCann, T. V. (2016) · International Journal of Mental Health Nursing · doi:10.1111/inm.12174 · Cited by 18
“Third, poor access to primary and tertiary medical care; concern about the quality of care, including underdiagnosis and inadequate screening; assessment and treatment of serious illnesses (De Hert et al .”
Measurement of Metabolic Monitoring in Youth and Adult Medicaid Recipients Prescribed Antipsychotics
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Impact of Co-occurring Mental Disorders and Chronic Physical Illnesses on Frequency of Emergency Department Use and Hospitalization for Mental Health Reasons
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“Other studies reported that patients with MD-CPI were less likely than others to receive care for CPI from their GP (61, 62), suggesting that they may have used psychiatric ED for medical issues.”
Background
Dietary Intake, Adherence to Mediterranean Diet and Lifestyle-Related Factors in People with Schizophrenia
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“Anthropometric characteristics revealed that only a small number of participants presents a normal weight status as well as an ideal waist circumference, values that are consistent with the literature (De Hert et al., 2011).”
BackgroundResult

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: COHEN, DAN
BOBES, JULIO
LEUCHT, STEFAN
NDETEI, DAVID M.
NEWCOMER, JOHN W.
UWAKWE, RICHARD
DETRAUX, JOHAN
CORRELL, CHRISTOPH U.
Venue: World Psychiatry
Publisher: Wiley
Published: 2011-06
Volume: 10
Issue: 2
Pages: 138-151
ISSN: 1723-8617 (ISSN-L)
2051-5545
DOI: 10.1002/j.2051-5545.2011.tb00036.x
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
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 650 d)
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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Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level

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