Physical health management in psychiatric settings.
Severe mental disorders have a chronic course associated with a high risk for co-morbid somatic illnesses and premature mortality, but despite this increased risk, general health care needs in this population are often neglected. Over recent years, several groups have developed screening and monitoring guidelines for metabolic and cardiovascular risk assessment in patients treated with antipsychotics. The psychiatrist needs to be aware of the potential metabolic side-effects of antipsychotic medication and to include them in the risk/benefit assessment when choosing a specific antipsychotic. He should also be responsible for the implementation of the necessary screening assessments and referral for treatment of any physical illness. Multidisciplinary assessment of psychiatric and medical conditions is needed. The somatic treatments offered to people with severe and enduring mental illness should be at par with general health care in the non-psychiatrically ill population. In our University Centre, a structured and elaborate screening and monitoring protocol was introduced in late 2003. This paper describes the practical aspects of this monitoring protocol and the results obtained 4 years after its implementation.
De Hert
M
M
University Psychiatric Center, Katholieke Universiteit Leuven, Campus Kortenberg, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium. marc.de.hert@uc-kortenberg.be
van Winkel
R
R
Silic
A
A
Van Eyck
D
D
Peuskens
J
J
D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control; D015897:Comorbidity; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control; D016903:Drug Monitoring; D006305:Health Status Indicators; D006801:Humans; D033183:Interdisciplinary Communication; D008403:Mass Screening; D024821:Metabolic Syndrome / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control; D010348:Patient Care Team; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology; D012017:Referral and Consultation / Q000706:statistics & numerical data
D014150:Antipsychotic Agents