Behavioral Interventions to Reduce Cardiovascular Risk Among People with Severe Mental Disorder
Open accessAbstract
Cardiovascular disease (CVD) is the leading cause of death among people with severe mental disorder (SMD). CVD risk factors occur at the individual, health system, and socio-environmental levels and contribute not only to high rates of CVD but also to worsening mental health. While acknowledging this wider context, this review focuses on behavioral interventions for seven CVD risk behaviors—smoking, physical inactivity, excessive alcohol consumption, low fruit and vegetable intake, inadequate sleep, poor social participation, and poor medication adherence—that are common among people with SMD. We survey recent meta-reviews of the literature and then review additional key studies to provide clinical recommendations for behavioral interventions to reduce CVD risk among people with SMD. A transdiagnostic psychological approach from the start of mental health treatment, drawing upon multidisciplinary expertise to address multiple risk behaviors, is recommended.
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Cardiovascular disease is the leading cause of premature mortality in individuals with SMI.
“cardiovascular disease emerges as the leading cause of premature mortality in individuals with SMI, as supported by substantial evidence [19–22].”
From A retrospective and comprehensive analysis of excess life-years lost, mortality risk, and cause of death among severe mental illness in China (2025) · cites this paper as [20]
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Segan, C., Baker, A., Turner, A., & Williams, J. M. (2017) · Journal of Dual Diagnosis · doi:10.1080/15504263.2016.1276657 · Cited by 16 · see citing works
Self-citationBoniface, S., Malet-Lambert, I., Coleman, R., Deluca, P., Donoghue, K., Drummond, C., & Khadjesari, Z. (2017) · Alcohol and Alcoholism · doi:10.1093/alcalc/agx111 · Cited by 16 · see citing works
Hovhannisyan, K., Rasmussen, M., Adami, J., Wikström, M., & Tønnesen, H. (2020) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.14364 · Cited by 14 · see citing works
Baker, A., Borland, R., Bonevski, B., Segan, C., Turner, A., Brophy, L. M., McCarter, K. L., Kelly, P. J., Williams, J. M., Baird, D. E., et al. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00124 · Cited by 13 · see citing works
Self-citationGraham, H. L., Copello, A. G., Griffith, E., Clarke, L., Walsh, K., Baker, A., & Birchwood, M. J. (2018) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-017-9861-9 · Cited by 7 · see citing works
Self-citationZabeen, S., Phua, D., Mohammadi, L., & Lawn, S. (2020) · Journal of Mental Health · doi:10.1080/09638237.2020.1818194 · Cited by 6 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- Heather N. 2017. Overview of addiction as a disorder of choice and future prospects. In Addiction and Choice: Rethinking the Relationship, ed. N Heather, G Segal, pp. 463-82. Oxford, UK: Oxford Univ. Press
- Taylor G, Baker A, Fox N, Kessler D, Aveyard P, Munafò MR. 2020. Addressing concerns about smok- ing cessation and mental health: theoretical review and practical guide for healthcare professionals. Br. J. Psychiatry Adv. 27(2):85-95. https://doi.org/10.1192/bja.2020. · DOI
- A practical overview of addressing smoking in people with mental health concerns. A Current Learning Theory Approach to the Etiology and Course of Anxiety and Related Disorders · DOI
Cited by
Sorted by citations
Fang, X., Yu, H., Wu, C., Tan, J., Sun, F., Qian, N., Zhou, H., Zhou, J., & Zhang, X. (2025) · BMC Medicine · doi:10.1186/s12916-025-04380-9 · Cited by 5 · see citing works
“Numerous studies have highlighted cardiovascular diseases as a predominant cause of death among individuals with SMI [20, 39, 40].”
- Authors
- Baker, A. L., Forbes, E., Pohlman, S., & McCarter, K.
- Affiliations
- University of Newcastle Australia (AU)
- Corresponding author
- Baker, Amanda L.
- Venue
- Annual Review of Clinical Psychology
- Publisher
- Annual Reviews
- Published
- 2022-05-09
- Volume
- 18
- Issue
- 1
- Pages
- 99-124
- ISSN
- 1548-5943 (ISSN-L)
- 1548-5951
- OpenAlex
- W4212839795
- Cited by
- 9
- References
- 101
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 1 · 2013: 1
- FWCI
- 0.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annual Review of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- NOVA (University of Newcastle Australia) (submittedVersion)
- Deakin Research Online (Deakin University)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- cardiovascular disease, severe mental illness, behavioral interventions, cardiovascular risk factors, smoking, physical inactivity, alcohol consumption, fruit and vegetable intake, sleep, social participation (health and rehabilitation), medication adherence, clinical guidelines
- MeSH terms
- Heart Disease Risk Factors, Mental Disorders, Cardiovascular Diseases, Humans, Mental Health, Risk Factors
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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