Comorbid somatic illnesses in patients with severe mental disorders: clinical, policy, and research challenges.
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.


METHODS
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.


METHODS
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.


METHODS
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.
Fleischhacker
W Wolfgang
WW
Department of Biological Psychiatry, Medical University Innsbruck, Innsbruck, Austria. wolfgang.fleischhacker@i-med.ac.at
Cetkovich-Bakmas
Marcelo
M
De Hert
Marc
M
Hennekens
Charles H
CH
Lambert
Martin
M
Leucht
Stefan
S
Maj
Mario
M
McIntyre
Roger S
RS
Naber
Dieter
D
Newcomer
John W
JW
Olfson
Mark
M
Osby
Urban
U
Sartorius
Norman
N
Lieberman
Jeffrey A
JA
D035843:Biomedical Research / Q000331:legislation & jurisprudence*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality; D015897:Comorbidity; D003479:Curriculum; D019049:Developed Countries / Q000706:statistics & numerical data; D004501:Education, Medical / Q000592:standards; D006282:Health Personnel / Q000193:education; D006291:Health Policy; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006298:Health Services Administration; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D008017:Life Expectancy; D008605:Mental Health Services / Q000331:legislation & jurisprudence*; D009765:Obesity; D011361:Professional Competence; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*