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Heart and head

Doctors urged to pay greater attention to the physical health of the mentally ill

Leading European mental health organisations have called for action to address the physical ill health that affects patients with bipolar disorder and schizophrenia.

The call from the Global Alliance of Mental Illness Advocacy Networks (GAMIAN-Europe) and the European Federation of Associations of Families of People with Mental Illness (EUFAMI) follows the results of one of the largest ever global patient and carer surveys in psychiatry, Understanding patients' Needs, Interactions, Treatment & Expectations (UNITE). Supported by Pfizer, it revealed that almost 75 per cent of people surveyed with schizophrenia and biopolar disorder reported experiencing significant weight gain after being diagnosed with their mental illness.

Some 50 per cent of those surveyed also said that in addition to an increase in weight, they suffered from other health complications, which included a rise in cholesterol levels, diabetes and high blood pressure. This is the first time that the patient voice has been heard with regard to this issue, said Rodney Elgie, past president of GAMIAN-Europe.

We hope that the survey will raise awareness among physicians of the importance of treating the patient holistically. It is no longer acceptable to maintain an artificial division of above and below the neck when considering the treatment of a patient with severe mental illness, he added.

There is growing evidence that the risks of cardiovascular disease, diabetes and death in this patient group are increased significantly through the use of antipsychotic drugs. However, while the link between anti-psychotics and these risks has been acknowledged for a number of years and addressed in treatment guidelines, the survey results revealed that daily prescribing practices are vastly different.

Dr Marc de Hert, clinical psychiatrist and psychotherapist at the University Psychiatric Centre, Katholieke Universiteit, Belgium, said: The researchÖ has been there for years, there is an increased prevalence of obesity, dislipidaemia and glucose abnormalities in people with severe mental illness and this results in a greatly increased risk of cardiovascular disease.

A minority of respondents said they received adequate physical health checkups; less than one third of patients with schizophrenia and bipolar disorder in Europe have their blood pressure checked, while just 25 per cent reported being weighed regularly.

Around 40 per cent of people with schizophrenia and 30 per cent of those patients with bipolar disorder said they gained too much weight to consider continuing with the treatment.

Kevin Jones, secretary general at EUFAMI, said that the treatment of physical disease affecting patients with severe mental illness needed to be addressed urgently, to ensure that sufferers get the best level of overall care. People with schizophrenia and bipolar are already extremely vulnerable from their condition, he noted.

Both GAMIAN-Europe and EUFAMI, along with leading European psychiatrists, hope that the results from the UNITE survey will help in raising awareness of metabolic-related co-morbidities in people with schizophrenia and bipolar disorder.

2nd September 2008

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