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Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC)
Abstract
People with severe mental illnesses, such as schizophrenia, depression or bipolar disorder, have worse physical health and reduced life expectancy compared to the general population. The excess cardiovascular mortality associated with schizophrenia and bipolar disorder is attributed in part to an increased risk of the modifiable coronary heart disease risk factors; obesity, smoking, diabetes, hypertension and dyslipidaemia. Antipsychotic medication and possibly other psychotropic medication like antidepressants can induce weight gain or worsen other metabolic cardiovascular risk factors. Patients may have limited access to general healthcare with less opportunity for cardiovascular risk screening and prevention than would be expected in a non-psychiatric population. The European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC) published this statement with the aim of improving the care of patients suffering from severe mental illness. The intention is to initiate cooperation and shared care between the different healthcare professionals and to increase the awareness of psychiatrists and primary care physicians caring for patients with severe mental illness to screen and treat cardiovascular risk factors and diabetes.
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“Research into the health effects of recession has suggested that consequences will be most severe for the poorest groups in society and will have the most impact where social safety-nets are lacking and public hardship grows rapidly.64,65”
From Mortality gap for people with bipolar disorder and schizophrenia: UK-based cohort study 2000–2014 (2017) · cites this paper as [65]
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“The efficacy of such multidisciplinary lifestyle interventions in reducing the risk of cardiometabolic-related morbidity in the general population is well established.189”
From The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness (2019) · cites this paper as [189]
In the citing paper
“Metformin reduces the risk of transition from pre-diabetes to T2D 189,190”
From The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness (2019) · cites this paper as [189]
In the citing paper
“An example of gold-standard lifestyle intervention in the general population is the Diabetes Prevention Program (DPP) developed and evaluated in the USA.189”
From The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness (2019) · cites this paper as [189]
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Metadata
- Authors
- De Hert, M., Dekker, J. M., Wood, D., Kahl, K. G., Holt, R. I. G., & Möller, H.-J.
- Affiliations
- KU Leuven (BE)
- Imperial College London (GB)
- Medizinische Hochschule Hannover (DE)
- University of Southampton (GB)
- Ludwig-Maximilians-Universität München (DE)
- ORCID
- Venue
- European Psychiatry
- Publisher
- Cambridge University Press (CUP)
- Published
- 2009-09
- Volume
- 24
- Issue
- 6
- Pages
- 412-424
- ISSN
- 0924-9338 (ISSN-L)
- 1778-3585
- OpenAlex
- W2154493342
- Cited by
- 951
- References
- 152
- Citations by year
- 2026: 27 · 2025: 32 · 2024: 37 · 2023: 61 · 2022: 42 · 2021: 64 · 2020: 59 · 2019: 62 · 2018: 46 · 2017: 44 · 2016: 69 · 2015: 63 · 2014: 71 · 2013: 66 · 2012: 65
- FWCI
- 42.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- Lirias (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Bristol-Myers Squibb
- European Society of Cardiology
- European Association for the Study of Diabetes
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- severe mental illness, cardiovascular disease, diabetes mellitus, schizophrenia, bipolar disorder, depression, cardiovascular risk factors, antipsychotic-induced weight gain, psychotropic drugs, cardiovascular risk screening, cardiovascular disease prevention, shared care, life expectancy, coronary artery disease
- MeSH terms
- Bipolar Disorder, Cardiovascular Diseases, Cause of Death, Cross-Sectional Studies, Major Depressive Disorder, Diabetes Mellitus, Follow-Up Studies, Humans, Mass Screening, Obesity, Psychotic Disorders, Psychotropic Drugs, Risk Factors, Schizophrenia, Societies, Medical, Comorbidity, Practice Guidelines as Topic
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