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GPs go forth

Patients with severe mental illness have worse physical health, GP data reveal

Patients with severe mental illness experience poorer physical health than the general population, according to an analysis of GP practice data.

Public Health England's analysis used a representative primary care database to determine the proportion of patients with severe mental illness, including bipolar affective disorder, schizophrenia or episodes of psychosis, who had a comorbid physical condition, as defined by the QOF register.

They found that obesity was nearly twice as prevalent in patients with severe mental illness compared to the general population. Diabetes and COPD were also around twice as prevalent, with stroke and heart failure around 1.5 times as prevalent.

Younger people were even more likely to have a comorbid physical condition, with severely mentally ill patients aged between 15 and 34 three times as likely as the general population to be obese, and nearly four times as likely to have diabetes.

The report said the findings could partly be explained by the fact that practices use QOF registers to monitor the physical health of patients with severe mental illness. However, as the level of inequality between mentally ill patients and the general population is high, the report said that more research was needed to understand all the causes.

Professor Tim Kendall, national clinical director for mental health at NHS England, said: 'Improving the life expectancy of people with serious mental health issues needs coordinated action, and this report adds to our knowledge, reinforcing the need for a continued focus on closing the physical health outcomes gap.

'The NHS is already increasing early detection and expanding access to evidence based physical care assessment and follow-up care, with more than 280,000 people set to get help by 2020/21, while the NHS long-term plan will set out further priorities for the years ahead.'

Readers' comments (3)

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  • Never never would have guessed.

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  • To address the tragic premature deaths and serious morbidity in those diagnosed (and misdiagnosed) as suffering from severe mental illness (SMI) - it is necessary to consider the multi-systems toxicities of the drugs they are compelled to take.

    "Antipsychotics" and "Mood Stabilisers" are marketing terms, they are not strictly accurate pharmacological classifications.

    The brain/neurotoxicity, endocrine, metabolic/obesity/diabetes, cardiac/cardiovascular, gastro-intestinal, thermo-regulatory and genito-urinary/sexual dysfunction toxicities are prescription drug induced injuries.

    The "psychiatric" ADRs - (including some 50% antipsychotic prevalence of clinically significant akathisia and its sequelae) - are in fact neurotoxic injuries.

    These common ADRs are vulnerable to misinterpretation as further evidence of S.M.I. or emergent "psychiatric co-morbidites", leading to combination antipsychotic use and further increased risk of morbidity/premature death.

    The vastly increased prevalence of cigarette smoking has been reported to be a compensatory alleviation for the adverse effects of antipsychotic drugs on dopamine receptors.

    Their increased unemployment, social isolation, lost relationship opportunities, economic detriment, and their SMI diagnosis-induced societal rejection are further major adversities.

    SMI diagnoses are "Labels for Life" - albeit likely a foreshortened life.

    For parity to be achievable, surely the above factors are a necessary consideration?

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