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Comorbid Somatic Illnesses in Patients With Severe Mental Disorders: Clinical, Policy, and Research Challenges
Abstract
BACKGROUND: An increasing body of evidence suggests that, in comparison to the general population, patients with severe mental illnesses such as schizophrenia or bipolar disorder have worse physical health and a far shorter life expectancy in developed countries, due primarily to premature cardiovascular disease. PARTICIPANTS: This article is based on presentations and discussion on somatic comorbidity in psychiatric illnesses by a group of 37 international experts during 2 meetings held in 2006. CONSENSUS PROCESS: At the preparatory meeting in Paris, France, the group determined key topics for presentations and group discussions. During the meeting in Vienna, Austria, on day 1, each set of presentations was followed by discussions in small groups with the meeting participants. On day 2, conclusions reached by each discussion group were presented and used as a platform for a consensus view adopted by the meeting participants. The presentations and discussions were collated into a draft that was revised and approved by each of the bylined authors. EVIDENCE: General health care needs are commonly neglected in patients with severe mental illness, with suboptimal integration of general somatic and psychiatric care services, current lack of consensus as to which health care professionals should be responsible for the prevention and management of comorbid somatic illnesses in patients with severe mental disorders, and, at least in some countries, a paucity of funding for general somatic care for patients with severe mental disorders, especially those in long-term psychiatric treatment. CONCLUSIONS: The somatic health of patients with severe medical illnesses is too often neglected, thus contributing to an egregious health disparity. The reintegration of psychiatry and medicine, with an ultimate goal of providing optimal services to this vulnerable patient population, represents the most important challenge for psychiatry today, requiring urgent and comprehensive action from the profession toward achieving an optimal solution.
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“Self-harm is also a marker of quality of life and emotional distress in individuals with SMI.36”
From Mortality gap for people with bipolar disorder and schizophrenia: UK-based cohort study 2000–2014 (2017) · cites this paper as [36]
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Metadata
- Authors
- Fleishhacker, W. W., Cetkovich-Bakmas, M., De Hert, M., Hennekens, C. H., Lambert, M., Leucht, S., Maj, M., McIntyre, R. S., Naber, D., Newcomer, J. W., Olfson, M., Ösby, U., Sartorius, N., & Lieberman, J. A.
- Affiliations
- Innsbruck Medical University (AT)
- ORCID
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2008-04-15
- Volume
- 69
- Issue
- 4
- Pages
- 514-519
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2043197463
- Cited by
- 328
- References
- 0
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 7 · 2023: 8 · 2022: 8 · 2021: 8 · 2020: 13 · 2019: 19 · 2018: 14 · 2017: 18 · 2016: 16 · 2015: 19 · 2014: 21 · 2013: 26 · 2012: 18
- FWCI
- 51.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Lirias (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- somatic comorbidity, severe mental illness, schizophrenia, bipolar disorder, physical health, cardiovascular disease, life expectancy, health care needs, health disparities, long-term psychiatric treatment
- MeSH terms
- Bipolar Disorder, Cardiovascular Diseases, Curriculum, Education, Medical, Health Personnel, Health Policy, Health Services Accessibility, Health Services Administration, Health Services Needs and Demand, Health Status, Humans, Life Expectancy, Mental Health Services, Obesity, Professional Competence, Schizophrenia, Somatoform Disorders, Comorbidity, Developed Countries, Biomedical Research
About these checks
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.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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