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Psychiatrists Urge Integrated Care for Mental and Physical Health
People with serious mental illnesses can also have problems with their bodies, such as diabetes or heart disease.
These risks can come from many things, including the illness, family traits, habits, sleep and sometimes medicines.
Doctors say it is not always correct to blame medicine alone.
Patients should not stop psychiatric medicine by themselves, because their illness could get worse again.
Instead, they should talk with their doctors about any concerns.
Regular checks of weight, blood pressure, blood sugar and cholesterol can help spot problems.
Mental and physical health should be treated together.
Families can help patients attend appointments and notice symptoms.
People with schizophrenia and bipolar disorder face increased risks of diabetes, obesity, hypertension and cardiovascular disease.
Severe mental illness is associated with a 10–20-year shorter life expectancy and higher cardiovascular risks, according to Dr Raju Boosa.
Contributing factors can include the illness itself, biological and genetic influences, smoking, substance use, sleep, activity levels and some medication effects.
Psychiatrists caution patients not to stop or change antipsychotic medication without consulting their doctors, because treatment interruption can lead to relapse.
Doctors recommend regular physical-health checks and coordinated psychiatric and medical care, with families helping patients access appointments.
- Who
- People with severe mental illnesses, including schizophrenia and bipolar disorder; psychiatrists cited include Dr Raju Boosa, Dr Sai Krishna Tikka and Dr Divya Nellur.
- What
- Psychiatrists say these patients face elevated physical-health risks and should receive regular monitoring and coordinated medical and psychiatric care.
- Where
- Hyderabad; doctors quoted are affiliated with the Institute of Mental Health in Erragadda and AIIMS Bibinagar.
- When
- Why
- Physical-health risks can be associated with the illnesses themselves, biological and genetic factors, lifestyle factors and, for some patients, medication effects.
Illness and broader risk factors
Medication-related effects
What contributes to metabolic and cardiovascular risk?
Illness and broader risk factors
The psychiatrists say severe mental illnesses may themselves be linked to metabolic conditions, alongside genetic and biological factors and habits such as smoking, substance use, disrupted sleep and reduced activity.
Medication-related effects
Some antipsychotic medicines can cause weight gain and metabolic changes in susceptible patients, but the doctors caution that medication alone does not explain the increased risk.
Managing psychiatric medication when physical illness develops
Illness and broader risk factors
Effective psychiatric treatment should continue, since stopping or reducing medication without medical advice can lead to relapse.
Medication-related effects
Medication effects may need to be considered when a patient develops physical-health problems; any change should be discussed with the treating psychiatrist and other doctors rather than made independently.
Key facts
- Life expectancy
- People with severe mental illnesses may have a life expectancy 10–20 years shorter than the general population, according to Dr Raju Boosa.
- Cardiovascular morbidity
- About 1.5 times higher, according to Dr Boosa.
- Cardiovascular mortality
- About 1.8 times higher, according to Dr Boosa.
- Conditions noted
- Diabetes, obesity, hypertension, cardiovascular disease, metabolic syndrome and abnormal cholesterol.
- Recommended checks
- Weight, blood pressure, blood sugar and cholesterol.
- Medication advice
- Do not stop or reduce psychiatric medication without consulting the treating psychiatrist and other doctors.
- Care approach
- Continue psychiatric and medical treatment together; involve family or caregivers where helpful.
Sources
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