The physical health of people with serious mental illnesses such as schizophrenia or bipolar disorder is worse than that of the healthy population. People affected by this group of diseases have an increased cardiovascular mortality, attributed to a risk from 1 to 5 times higher than present modifiable coronary risk factors such as obesity, smoking, diabetes, hypertension and dyslipidemia. Specifically, in the case of schizophrenia life expectancy is shortened by up to ten years.
This is one of the main conclusions of consensus “Cardiovascular disease and diabetes in people with severe mental illness, which in Spain is supported by the Spanish Society of Biological Psychiatry, together with the Spanish Society of Psychiatry, the Spanish Society of Diabetes and Spanish Society of Cardiology.
This pioneering initiative in our country, has been launched to improve care for patients suffering from severe mental illness. For Dr. Julio Bobes, President of the Spanish Society of Biological Psychiatry, “The consensus aims to initiate cooperation and joint attention between different professionals and enhance awareness of the psychiatrists who care for severely mentally ill regard to the screening and treatment of this increased incidence of cardiovascular risk factors and diabetes. ”
“This is warning of a problem that has largely been ignored until now. We have to consider that mental health is not just fighting a set of psychiatric symptoms, but health as a whole. The physical must accompany the mental and we can not neglect this aspect of such significance that accompanies this group of diseases, “says Dr. Jerome Saiz Ruiz, President of the Spanish Society of Psychiatry.
“The presence of schizophrenia or bipolar disorder significantly raises the risk of cardiovascular disease and also significantly increases the risk of premature death due to any cardiovascular complication. It is estimated that patients with schizophrenia have twice the risk of dying from a cardiovascular problem, the first cause of death in this group, “says Dr. Carlos Macaya, President of the Spanish Society of Cardiology.
The cardiovascular risk profile of people with serious mental illness is influenced by an unhealthy lifestyle such as smoking, poor diet or sedentary lifestyle. There is also a direct effect of the disease and / or antipsychotic treatment in the progressive development of cardiometabolic risk factors, since some medication induced weight gain and increased risk of adverse metabolic effects.
“Psychopharmacological treatments affect not only the brain but throughout the body, modifying the patient’s lifestyle and metabolism. However, not all drugs produce the same effect cardiometabolic, some are more neutral and more influence measure. Several studies have shown that while some antipsychotics cause weight gain, and impaired glucose and lipid metabolism, others have a minor or negligible effect on these parameters, “says Dr. Bobes.
With regard to diabetes, is shown an increased prevalence of this disease in patients with schizophrenia and bipolar disorder. Not only the prevalence is higher but the secondary complications of diabetes occur more frequently. “Therefore, in cases where we know they have a higher risk of developing diabetes or by family history, obesity and lack of exercise, it would be advisable to use those antipsychotics with lower metabolic risk,” said Dr. Edelmiro Menendez, Second Vice President of the Spanish Society of Diabetes. “The important thing is the approach to the multidisciplinary treatment of a form with a close collaboration between psychiatrists and endocrinologists, internists or family physicians,” concludes Dr. Menendez.
To prevent and reduce the impact of cardiovascular disease in this group, which is proposed from the consensus is “monitoring the overall health of patients diagnosed with serious mental illness periodically conduct a comprehensive patient intervention and those that present factors risk, both metabolic and cardiovascular diseases, assess the antipsychotic treatment based on your medical history, “concludes Dr. Bobe
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