Abstract
People with severe mental illness (SMI) have high rates of chronic disease and premature death. To explore the strength of evidence for interventions to reduce risk of mortality in people with SMI. 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). 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. Improved adherence to pharmacological and physical health management guidelines is indicated.
Highlights
People with severe mental illness (SMI) have high rates of chronic disease and premature death
As the major causes of excess deaths in these people are chronic diseases, we focused on interventions that might have an impact on physiological health indicators for these conditions
We focused on existing syntheses of the literature in which authors had looked at the effects of health interventions in people with SMI, generally defined in the mental and physical health literature as psychotic disorders, bipolar disorder and severe major depression,[14] and where mortality or physiological health parameters were reported as a primary outcome
Summary
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)
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