More Than the Mind in Mental Health Care

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Treatable physical sicknesses overtake many with psychiatric disorders

May 21, 2013 / Author:  / Reviewed by: Robert Carlson, M.D

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(dailyRx News) It's known that people diagnosed with psychiatric disorders also struggle with physical illness. Such physical illness may be leading to deaths that could be avoided.

A new study of hundreds of thousands of Australians with mental illness concluded that, as a group, they are dying of bodily diseases at increasingly higher rates than the general public.

Many of those deaths may be preventable, according to these researchers.

Results showed that about one-third of those excess deaths involved heart disease. More than one-fifth involved cancer. And more than one-fifth were suicides.

"Seek both physical and mental health care."

David Lawrence, PhD, of the University of Western Australia and the Telethon Institute for Child Health Research in Subiaco, Western Australia, was the study’s lead author.

The researchers tracked roughly 293,000 psychiatric patients registered with mental health service agencies in the state of Western Australia. The subjects included patients who had been diagnosed with depression, schizophrenia, alcohol and drug addictions, neurotic disorders, a range of psychotic disorders or other serious mental challenges.

From 1985 through 2005, the study found people without psychiatric disorders outlived those who had been diagnosed with psychiatric disorders by several additional years.

During that period, the gap in life expectancy between men with psychiatric disorders and those without such disorders widened from 13.5 years to 15.9 years. For women, the gap widened from 10.4 to 12 years, the researchers wrote. 

Several factors contributed to these gaps in life expectancy, the researchers wrote. More than three-quarters of “excess deaths” that researchers said could have been avoided resulted from a range of physical diseases among people with mental disorders that were not properly treated, the researchers concluded.

According to the researchers, much of the prior research from around the world has focused heavily on suicide rates among those with mental health disorders.

But the deaths among these people were mostly due to cardiovascular and lung diseases, cancer and other physical illnesses, not suicide, the researchers wrote.

“Public efforts should be directed towards improving physical health to reduce mortality in people with mental illness, in addition to ongoing efforts to prevent suicide,” the researchers wrote.

Also, they recommended several ways of reducing the excess deaths. They suggested that mental and physical health services should be located in the same spots. General practitioners and social service case managers should help manage and coordinate care, paying special attention to patients with complex problems.

The researchers also suggested more peer support groups and public awareness campaigns about the risks from smoking and obesity and the benefits of healthy living for those with mental diseases.

Darold Treffert, MD, a psychiatrist and University of Wisconsin Medical School professor who reviewed the study, said it does well in spotlighting how much mental and physical wellness are linked.

Many healthcare systems need to better monitor both the psychiatric and physical problems facing this group of patients, he said.

Dr. Treffert continued, “That gap in longevity is contributed to, as well, by a broken mental health system for the seriously mentally ill. The largest mental ‘hospitals’ in the US are now the jails and prisons or the streets, instead of real hospitals or facilities that can provide the comprehensive mental and physical care the seriously mentally ill require.” 

This study was published May 21 in BMJ, previously known as the British Medical Journal.

The Griffith Institute for Health and Medical Research helped fund the study. The researchers said their funding did not influence study design or outcomes.

One researcher, they reported, was paid additionally by Griffith for the submitted work. The researchers reported no financial gain or investment that would affect the study.