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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“…should commence or continue their active engagement in physical improving physical health and health behaviours such as mental illness stigma (De Hert et al., 2011 ), consumer disengagement (Powell et al., 2021), reluctance (Bartlem et al., 2018), and amotivation (Every-Palmer et al., 2018 ).”
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WPA educational activities
Belfort, E. (2013) · World Psychiatry · doi:10.1002/wps.20047 · Cited by 3
The characteristics, content, performance, and impact of the WPA website (www.wpanet.org)
Küey, L. (2013) · World Psychiatry · doi:10.1002/wps.20023 · Cited by 3
“An educational module and two sets of slides on physical illness in patients with severe mental disorders, developed by the WPA (4,5), are also posted on the website.”
Background
An update on lipid profile screening in second-generation antipsychotic users in the USA
Morrato, E. H. (2012) · Clinical Lipidology · doi:10.2217/clp.12.51 · Cited by 2
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Cross-sectional mixed-methods study protocol exploring the enablers and barriers for people with severe and enduring mental illness in Jamaica when accessing healthcare for chronic physical illness
Whitehorne-Smith, P., Burns, S. K., Milbourn, B. T., Abel, W., & Martin, R. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-038245 · Cited by 3
Methodology for Development of a Community Level Intervention Module for Physical Illness in Persons with Mental Illness (CLIPMI)
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Community socioeconomic disadvantage drives type of 30-day medical-surgical revisits among patients with serious mental illness
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Schizophrene Psychosen
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“Our findings on dental health among individuals with SMI may reflect lower levels of standard health care received by these individuals in the UK generally (Chesney et al., 2014; de Hert et al., 2011; Lawrence & Kisely, 2010).”
Influential
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“There is a substantial body of compelling evidence demonstrating that individuals with schizophrenia are more likely to experience barriers in receiving evidence-based care generally, including treat-ment following sentinel health events [16–18].”
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“19,20 Obesity and other metabolic abnormalities are significant risk factors for CVD, 21 which are particularly common in patients with SMI.”
Background
Effets métaboliques indésirables des antipsychotiques
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“Le risque de syndrome métabolique est plus marqué avec la chlorpromazine, l’olanzapine et la clozapine ; il est intermédiaire avec la quetiapine, modéré avec la risperidone, le sertindole et l’amisulpride, et faible avec la ziprazidone et l’aripiprazole [3,19].”
Background
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‘The patient is medically cleared’
Beale, C., & Turner, T. H. (2013) · British Journal of Hospital Medicine · doi:10.12968/hmed.2013.74.9.492 · Cited by 3
The Dialogue on Diabetes and Depression African Nursing Training Programme: A Collaborative Training Initiative to Improve the Recognition and Management of Diabetes and Depression in Sub-Saharan Africa
Millar, H. L., Cimino, L., & van der Merwe, A. S. (2014) · Key issues in mental health (Online)/Key issues in mental health (Print) · doi:10.1159/000365599 · Cited by 3
Non-pharmacological interventions reduce antipsychotic-associated weight gain in outpatients
Gaughran, F., & Lally, J. (2012) · Evidence-Based Mental Health · doi:10.1136/eb-2012-101072 · Cited by 3
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Utilization of somatic specialist services among psychiatric immigrant patients: the Norwegian patient registry study
Abebe, D., Elstad, J. I., & Lien, L. (2018) · BMC Health Services Research · doi:10.1186/s12913-018-3672-y · Cited by 3
“Mental disorder patients are also subject to unacceptably high levels of disparity in healthcare access and utilization, which contribute to poor somatic health outcomes [16].”
Background
The role of key workers in improving physical health in first episode psychosis: A scoping review
Lim, J., McCombe, G., Harrold, Á., Brown, K., Clarke, M., Hanlon, D., Hennessy, L., O’Brien, S., Lyne, J., Corcoran, C., et al. (2020) · Early Intervention in Psychiatry · doi:10.1111/eip.12937 · Cited by 3
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Bressington, D. T., Li, Y., Hulbert, S., & Mak, Y. W. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17103564 · Cited by 3
“However, the screening and assessment of physical fitness in these individuals remains unclear, even in well-developed countries [14].”
Background
Appraisal of physical health guidelines for severe mental illness
Friend, N., Hughes, J. P., Kisely, S. R., Kumar, R., & Siskind, D. J. (2020) · Australian Health Review · doi:10.1071/ah20080 · Cited by 4
Determining rates of death in custody in England and Wales
Botchway, S., & Fazel, S. (2021) · Journal of Forensic Psychiatry and Psychology · doi:10.1080/14789949.2021.1991979 · Cited by 3
“The highest rate was in psychiatric hospitals, and the underlying causes of this have been discussed (De Hert et al. 2011; De Hert, Correll et al. 2011).”
Background
Willingness to be vaccinated against COVID-19 is equal in individuals with affective disorders and healthy controls
Fellendorf, F. T., Bonkat, N., Platzer, M., Schönthaler, E. M. D., Ratzenhofer, M., Bengesser, S., Dalkner, N., & Reininghaus, E. Z. (2022) · Vaccine X · doi:10.1016/j.jvacx.2022.100186 · Cited by 3
“Additionally, struggling with obtaining health care, stigma, discrimination, reduced communication between patients and physicians as well as inadequacies of health providers in being able to handle emo-https tional problems of individuals with mental disorders increases vulnerability [8,9].”
Experiences and Daily Life Attitudes of Women With Severe Mental Disorders: Integrative Review of Associated Factors
Caçapava, J. R., Hoga, L. A. K., Reis-Queiroz, J., & Jamas, M. T. (2015) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2015.03.003 · Cited by 3
“Listening to patients carefully in order to identify the women's individual perspectives and providing these supportive and nurture care requirements were considered to be important strategies to empowering them and reducing mental health stigma (Birch et al., 2005; De Hert et al., 2011).”
BackgroundInfluential

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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