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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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Items 301–329 of 329
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Gomes, E. (2015) · Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) · doi:10.34626/rp0s-8s94
LOONEN, A. J. M. (2013) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12237
“For clinical practice, the need to approach the somatic health of these patients from a broad perspective has been clearly stated earlier (2).”
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Malchow, B., Schmitt, A., & Falkai, P. (2016) · Cambridge University Press eBooks · doi:10.1017/cbo9781316157565.006
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Metabolic syndrome in people with severe mental illness
Binder, M. D. (2008) · Lirias
Self-citationInfradiagnóstico de enfermedades crónicas somáticas en pacientes con trastorno mental grave
Rodriguez-Leal, C., López-Lunar, E., Carrascosa-Bernáldez, J. M., & Rivera-Villaverde, Á. (2016) · Revista Clínica Española · doi:10.1016/j.rce.2016.10.011
Een overzicht van de stand van zaken
Vancampfort, D., Knapen, J., Binder, M. D., et al. (2009)
Self-citationAntipsychotic side effects and monitoring implications
Gardner, D. M., & Teehan, M. D. (2010)
Freudenreich, O., & GOFF, D. C. (2010) · Elsevier eBooks · doi:10.1016/b978-1-4377-1927-7.00012-1
Improving physical health in patients with severe mental illness
Lee, S.-M., & Liao, D. (2020) · Taiwanese Journal of Psychiatry · doi:10.4103/tpsy.tpsy_7_20
“The reintegration of psychiatric and nonpsychiatric medical care with the ultimate goal of giving optimal services to those vulnerable SMI patients is one of the most important challenges facing psychiatry today [1].”
Mwanda, A. O. (2014) · Language arts journal of Michigan
Psychiatric Diseases in Relation to Physical Illness
Chee, T. T. (2021) · Springer eBooks · doi:10.1007/978-3-030-22009-9_423
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Chee, T. T. (2019) · Springer eBooks · doi:10.1007/978-3-319-69892-2_423-1
An, B., Sorokin, S. A., Болгов, М. И., & Smolnikova, A. O. (2023) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro202312303170
Zomer, L. J. C., van der Meer, L., van Weeghel, J., Widdershoven, G. A. M., & Voskes, Y. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13123488 · Cited by 1
“Often people have coexisting problems, for example, a combination of these disorders [22], cognitive problems, somatic problems [23,24], and functional disabilities.”
BackgroundStensballe, L. G., & Jensen, A. (2025) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.70036
Levin, J. B., Moore, D. J., Depp, C. A., Montoya, J. L., Briggs, F., Rahman, M., Stange, K. C., Einstadter, D., Weise, C., Conroy, C. M., et al. (2022) · Figshare · doi:10.6084/m9.figshare.20193408
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“Literature indicates that low BMI in schizophrenia patients can increase mortality, sometimes in association with malnutrition or medication side effects [ 23, 32].”
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“There is already convincing evidence that mental and physical health are closely entangled, especially in the most severely mentally ill [40, 41].”
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“27 28 However, ADHD, an increasingly recognised diagnosis in adults, is not addressed in these guidelines.”
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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
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