Comorbid Somatic Illnesses in Patients With Severe Mental Disorders

Fleischhacker, W. Wolfgang; Cetkovich-Bakmas, Marcelo; Hert, Marc De; Hennekens, Charles H.; Lambert, Martin; Leucht, Stefan; Maj, Mario; McIntyre, Roger S.; Naber, Dieter; Newcomer, John W.; Olfson, Mark; Ösby, Urban; Sartorius, Norman; Lieberman, Jeffrey A.

doi:10.4088/jcp.v69n0401

Cited by 291 publications

(207 citation statements)

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“…[61][62][63][64] In one VA study from 2001-2005, only 11 % of people with comorbid diabetes and SMI received medications to treat diabetes. 36 In a community sample, among people with schizophrenia who reported they had diabetes, 41 % reported not receiving antihyperglycemic treatment.…”

Section: Management Of Type 2 Diabetes and Other Cardiovascular Diseamentioning

confidence: 99%

“…Thankfully, there has been a renewed emphasis on this reintegration in the context of health care reform. 62,107 However, a recent Cochrane review has failed to identify a leading evidence-based model to improve the medical care for people with severe mental illness. 108 It is worth considering whether CMHCs should be the primary care medical home for this patient population.…”

Section: Clinical and Policy Implicationsmentioning

confidence: 99%

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Diabetes and Cardiovascular Care Among People with Severe Mental Illness: A Literature Review

et al. 2016

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Close to 19 million US adults have severe mental illnesses (SMI), and they die, on average, 25 years earlier than the general population, most often from cardiovascular disease (CVD). Many of the antipsychotic medications used to treat SMI contribute to CVD risk by increasing risk for obesity, type 2 diabetes, dyslipidemia, and hypertension. Based on compelling evidence, the American Diabetes Association and the American Psychiatric Association developed guidelines for metabolic screening and monitoring during use of these medications. In this manuscript, we have reviewed the evidence on diabetes and other CVD risk screening, prevalence, and management among populations with SMI. We also review differences in screening among subpopulations with SMI (e.g., racial/ethnic minorities, women, and children). We found that despite national guidelines for screening for diabetes and other cardiovascular risk factors, up to 70 % of people taking antipsychotics remain unscreened and untreated. Based on estimates that 20 % of the 19 million US adults with SMI have diabetes and 70 % of them are not screened; it is likely that over 2 million Americans with SMI have unidentified diabetes. Given that undiagnosed diabetes costs over $4,000 per person, this failure to identify diabetes among people with SMI represents a missed opportunity to prevent morbidity and translates to over $8 billion in annual preventable costs to our healthcare system. Given the high burden of disease and significant evidence of suboptimal medical care received by people with SMI, we propose several clinical and policy recommendations to improve diabetes and other CVD risk screening and care for this highly vulnerable population. These recommendations include reducing antipsychotic medication dose or switching antipsychotic medications, enhancing smoking cessation efforts, sharing electronic health records between physical and mental health care systems, and promoting integration of care.KEY WORDS: mental illness; diabetes; integration of care.

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Section: Management Of Type 2 Diabetes and Other Cardiovascular Diseamentioning

confidence: 99%

Section: Clinical and Policy Implicationsmentioning

confidence: 99%

Diabetes and Cardiovascular Care Among People with Severe Mental Illness: A Literature Review

et al. 2016

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“…Long term use of antipsychotics (AP) is associated with increased mortality risk in people with SMI [16,17]. In general, it is concluded that AP add to the increased mortality risk of people with SMI either through direct cardio toxic effects or by impacting on weight gain [8,18].…”

Section: Introductionmentioning

confidence: 99%

“…In general, the life expectancy of patients with Severe Mental Illness (SMI) is reduced compared with the general population [8]. In SMI patients, overweight and obesity are more prevalent compared to the general population [9], whilst risk of developing cardiovascular diseases is substantially increased [9,10].…”

Section: Introductionmentioning

confidence: 99%

Almost all antipsychotics result in weight gain: A meta-analysis

Bak¹

2016

J Obes Weight Loss Ther

149

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“…Este consenso viene a unirse a otros consensos promovidos por otras sociedades científicas en el resto del mundo 18,19 .…”

Section: Introductionunclassified

Consenso Español de Salud Física del Paciente con Trastorno Bipolar

Bobes

Ruiz

Montes

et al. 2008

Revista de Psiquiatría y Salud Mental

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ResumenIntroducción y objetivos: Los pacientes con trastorno bipolar presentan una morbilidad físi-ca y una mortalidad muy superior a la de la población general. Además de una mayor mortalidad por suicidio, tienen también una mayor prevalencia de enfermedades físicas. El objetivo de este consenso, promovido por las Sociedades Españolas de Psiquiatría y Psiquiatría Biológica, en colaboración con las sociedades de médicos de asistencia primaria, es establecer recomendaciones prácticas sobre los procedimientos de detección, prevención e intervención en las enfermedades somáticas que coexisten con el trastorno bipolar para mejorar la calidad y esperanza de vida de estos pacientes. Método: Las Sociedades Españolas de Psiquiatría y Psiquiatría Biológica eligieron un ComitéCientífico que seleccionó a su vez a 32 psiquiatras expertos y 10 médicos expertos en otras especialidades médicas. Se crearon grupos de trabajo para cada especialidad con la finalidad de adaptar las guías aplicadas en la población general a pacientes con trastorno bipolar. Partiendo de una revisión sistemática sobre la comorbilidad médica y la mortalidad en el trastorno bipolar se realizaron dos reuniones para acordar el consenso. Resultados: En la revisión bibliográfica se detectó un riesgo aumentado, entre los pacientes con trastorno bipolar, de presentar hipertensión arterial, obesidad, tabaquismo, enfermedades pulmonares, migraña e infección por virus de la inmunodeficiencia humana (VIH). También se encontró evidencia de un aumento de mortalidad por enfermedades cardiovasculares, respiratorias e infecciones, además del suicidio. El grupo de expertos alcanzó el consenso en una serie de medidas básicas para la detección de comorbilidad médica aplicables a la monitorización de estos pacientes. Las recomendaciones resultantes serán asumidas y divulgadas por las sociedades promotoras. Conclusiones: El decálogo generado en el Consenso Español de Salud Física del Paciente con Trastorno Bipolar recoge los aspectos más relevantes para la mejora del funcionamiento psicosocial, la calidad y la esperanza de vida en los pacientes con esta patología.

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Comorbid Somatic Illnesses in Patients With Severe Mental Disorders

Cited by 291 publications

References 0 publications

Diabetes and Cardiovascular Care Among People with Severe Mental Illness: A Literature Review

Diabetes and Cardiovascular Care Among People with Severe Mental Illness: A Literature Review

Almost all antipsychotics result in weight gain: A meta-analysis

Consenso Español de Salud Física del Paciente con Trastorno Bipolar

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