Mental illness can lead to premature death

"Disparities in the physical health outcomes of people suffering from mental illness are currently considered a human rights scandal," said Joseph Firth, a researcher at the University of Manchester and chairman of the Commission. of Lancet Psychiatry, who published the research.

His team has badyzed nearly 100 studies and found that most people with mental illness die prematurely not by suicide – although they account for about 17% of non-natural deaths – but by "poor physical health" which could be in much avoidable.

The researchers found that people with mental disorders were twice as likely to be exposed to cardiometabolic diseases such as diabetes and stroke. In people with depression, for example, the risk of heart disease, diabetes or obesity is about 40% higher than in the general population.

Mental illness can increase the risk of physical illness, and physical illness itself increases the risk of mental illness, Firth said. "Obesity or diabetes increases your risk of developing psychiatric illness, and vice versa."

Sometimes this is because treatments for mental illness can trigger or aggravate physical health problems. The report found, for example, that many drugs used to treat mental illnesses, including antidepressants, antipsychotics and mood stabilizers, can have adverse effects on metabolism and heart health.

"As a result, patients who gain weight have less adherence to treatment, which can lead to relapse and poor mental health outcomes," the report says. Drugs "always do more good than harm," Firth added, but he said doctors must monitor and manage all side effects.

People with mental illness receive poorer care

Almost all mental illnesses are also badociated with some lifestyle risk factors – behaviors that make diseases such as heart disease more likely – and "people with mental illness tend to have more lifestyle choices. unhealthy than the general population ".

According to the researchers, people with major depression are more likely to smoke and depend on nicotine, for example. Their diet is much worse than that of the general population. Nearly one in five people with anxiety disorders consume alcohol and people with social phobia report less physical activity.

But even after controlling for risk factors such as smoking, physical activity and body mbad index, the report found that the number of deaths remained higher among people with mental illness. This suggests that people with mental illness receive poorer care than those without psychiatric problems, researchers said.

For example, the report found that people with severe mental illness are less likely to have a physical exam than their peers. They also have more visits to emergency services and hospitalizations for conditions that should be preventable and could be avoided with appropriate primary care.

It's unclear why, but one possible explanation is that doctors mistakenly attribute physical symptoms to underlying psychiatric problems, leading to missed diagnoses, researchers said.

The report also found that people with mental illness are less likely to have proposed medical and surgical interventions to the general population. And health services may be intolerant to people with mental illness, or at least be perceived as such, the report said.

Healthy body, healthy mind

"More needs to be done to combat stigmatizing attitudes toward mental health, and the education and practice of health care providers must be reoriented toward integrating health care. physical and mental, "wrote Rakhi Dandona, clinical professor of health measurement science at the University of Washington, in an accompanying editorial.

"In some areas, it is clear that the mentally ill have been deliberately abandoned because of the stigma and discrimination of these populations, due to the fact that they do not really care," Firth said. , who has worked with more than 40 other experts to compile the latest report.

"You can compare the amount of money, for example, spent on mental health care and mental health research, in relation to all aspects of health, and find great disparities," he added.

But health systems are working to provide better care, Firth said. "More and more global health authorities and national health agencies are doing their best to try to address these health issues," he said, both to help patients and their families. to reduce costs.

"We need to start talking to the mind and the body together," said Firth. "It sounds like a very old saying," healthy body, healthy mind. "But if you look at the data, they're so well-supported that it's almost impossible to imagine an effective treatment system in which we separate these two elements. "