Around the world, people with mental illness die up to twenty years before the general population, and they are complete report It suggests that governments and health providers should do more to stop the dead.
"The disparities in the physical health outcomes of people with mental illness are currently considered a human rights scandal," said Joseph Firth, a researcher at the University of Manchester and chairman of the Lancet Psychiatry Commission, who published the research
His team analyzed nearly 100 studies and found that most people with mental illness die soon not because of suicide, although they represent approximately 17% of non-natural deaths, but because of "bad physical health "that could be largely avoidable.
Researchers have found that people with mental health disorders are at risk of suffering from cardiometabolic diseases such as diabetes and stroke. For people with depression, for example, the risk of heart disease, diabetes or obesity is about 40% higher than the general population.
Mental illness can increase the risk of physical illness and the same physical illness increases the risk of mental illness, according to Firth. "Obesity or diabetes increases your risk of developing a psychiatric illness and vice versa."
Sometimes, it is because treatments for mental illness can cause or worsen physical health problems. The report found, for example, that many medications used to treat mental illnesses, including antidepressants, antipsychotics and mood stabilizers, can have adverse effects on metabolism and heart health.
"As a result, weight gain patients have a reduction in adherence to treatment, which can lead to relapse and poor mental health outcomes," the report said. Medications "still do more than harm," Firth added, but emphasized that doctors should control and manage adverse effects.
People with mental illness receive poorer attention
Almost all mental illnesses also associate some lifestyle risk factors: behaviors that make illnesses such as heart disease closer – and "people with mental illness tend to have more lifestyles Healthy compared to the general population, "he found the report.
According to the researchers, people with major depression are more likely to smoke and rely on nicotine, for example, and have a much worse diet than the general population. Almost one in five people with anxiety disorders abuses alcohol and people with social phobia report less physical activity.
But even after controlling the risk factors such as smoking, physical activity and body mass index, the report found that the deaths were higher in people with mental illness. This suggests that people with mental illness receive poorer attention than those who do not have psychiatric problems, according to the researchers.
For example, the report found that people with severe mental illness are less likely to physically examine their peers. They also have more visits to the emergency department and hospital admissions for conditions that should be avoidable could be avoided with adequate primary care.
It is not clear why this is exactly the case, but a possible explanation is that doctors mistakenly attribute physical symptoms to underlying psychiatric problems, which causes a missed diagnosis.
The report also found that people with mental illness are less likely to receive medical and surgical interventions that are offered to the general population. And health services may be intolerant to people with mental illness, or at least perceived as such, according to the report.
Healthy body, healthy mind
"More must be done to address stigmatizing attitudes towards mental health, and the education and practice of healthcare providers must be reoriented towards the integration of mental and physical health care," he said. write Rakhi Dandona, clinical professor of health sciences. University of Washington, in an accompanying editorial.
"In some areas, it is clear that there has been a voluntary abandonment of mental patients due to the stigma and discrimination of these populations, because people really do not care," said Firth, who worked with more than 40 experts to compile them. the most recent report.
"You can see the amount of funding, for example, dedicated to the search of mental health and mental health compared to all aspects of health, and you can see that there are large disparities," he added.
But health systems are working to offer better care, Firth said. "There are more and more global health authorities and national health agencies that really do everything possible to address these health problems," he said, both to help patients and to reduce costs.
"We have to start tackling the mind and body together," said Firth. "It seems a very old phrase from" healthy body, healthy mind. "But looking at the data, it is so well supported that it is almost impossible to imagine an effective treatment system where we keep these two separate things."
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