Citation

Barber S, Thornicroft G. Front. Psychiatry 2018; 9: e463.

Affiliation

Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.

Copyright

(Copyright © 2018, Frontiers Media)

DOI

10.3389/fpsyt.2018.00463

PMID

30323773

PMCID

PMC6172296

Abstract

This mini-review considers the mortality gap in persons with severe mental disorder (SMD) globally. Current estimates of 10-20 years of potential life lost may be too conservative, both in high (HIC) and low and middle-income countries (LMICs). There is an emerging consensus that natural causes account for the majority of deaths in persons with SMD in both resource settings. In HICs, cardiovascular causes predominate, and can be attributed to individual, health-system and societal level risk factors. Psychosocial lifestyle interventions target behavior specific risk factors for physical ill-health. There is good evidence for tailored weight-loss programmes, but mixed evidence for smoking cessation, substance misuse and risky sexual behavior. In terms of supporting persons with SMD, nurse-led services and the utilization of peer-support are showing promise. Future research efforts must focus on effective interventions and health system models for both high and low resource settings to address this startling health inequality.

Language: en

Keywords

bipolar disorder; depression; excess mortality; lifestyle psychosocial interventions; low-and-middle income countries; physical health; schizophrenia; severe mental disorders