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Reducing excess mortality due to chronic disease in people with severe mental illness: Meta-review of health interventions

  • Amanda J. Baxter (a1), Meredith G. Harris (a1), Yasmin Khatib (a2), Traolach S. Brugha (a3), Heidrun Bien (a2) and Kamaldeep Bhui (a2)...
Abstract
Background

People with severe mental illness (SMI) have high rates of chronic disease and premature death.

Aims

To explore the strength of evidence for interventions to reduce risk of mortality in people with SMI.

Method

In a meta-review of 16 systematic reviews of controlled studies, mortality was the primary outcome (8 reviews). Physiological health measures (body mass index, weight, glucose levels, lipid profiles and blood pressure) were secondary outcomes (14 reviews).

Results

Antipsychotic and antidepressant medications had some protective effect on mortality, subject to treatment adherence. Integrative community care programmes may reduce physical morbidity and excess deaths, but the effective ingredients are unknown. Interventions to improve unhealthy lifestyles and risky behaviours can improve risk factor profiles, but longer follow-up is needed. Preventive interventions and improved medical care for comorbid chronic disease may reduce excess mortality, but data are lacking.

Conclusions

Improved adherence to pharmacological and physical health management guidelines is indicated.

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Copyright
Corresponding author
Amanda Baxter, Queensland Centre for Mental Health Research, Locked Bag 500, Sumner Park BC, Queensland 4074, Australia. Email: amanda_baxter@qcmhr.uq.edu.au
Footnotes
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Declaration of interest

K.B. is Editor of the British Journal of Psychiatry. He was not involved in the decision to publish this paper.

Footnotes
References
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Reducing excess mortality due to chronic disease in people with severe mental illness: Meta-review of health interventions

  • Amanda J. Baxter (a1), Meredith G. Harris (a1), Yasmin Khatib (a2), Traolach S. Brugha (a3), Heidrun Bien (a2) and Kamaldeep Bhui (a2)...
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