Declaration of interest
K.B. is Editor of the British Journal of Psychiatry. He was not involved in the decision to publish this paper.
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.
- © The Royal College of Psychiatrists 2016.
Log in using your username and password
Log in through your institution
Purchase Short-Term Access
Pay per Article - You may access this article (and download the PDF version) for 1 day for US$30.00.
Pay per Issue - You may access this issue (from the computer you are currently using) for 365 days for US$90.00.
Pay for Admission - You may access all content in The British Journal of Psychiatry (and download the PDF version) for 1 day for US$45.00.
Regain Access - You can regain access to a recent Pay per Article, Pay per Issue, or Pay for Admission purchase if your access period has not yet expired.