Skip to main content

Advertisement

Log in

A double-edged sword: review of the interplay between physical health and mental health

  • Review Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

It is widely acknowledged that there is interplay between physical and mental health, with causality in both directions. A common theme across countries is the uncertainty surrounding who should act as gatekeeper for physical health matters in psychiatry. Much of the metabolic monitoring is carried out by psychiatrists who often feel ill equipped to treat medical problems such as abnormal cholesterol or disturbances of glucose metabolism. However many patients do not attend primary care on a regular basis and may not be likely to follow through on referral to primary care. This review aims to examine the interplay between co-morbid physical and mental health conditions, identify the physical health conditions particularly associated with severe affective and psychotic illness and briefly discuss interventions and recommendations in this area. As people with severe mental illness die 10–20 years younger than their peers, with much of this premature mortality due to cardiovascular disease, this topic is emerging as one of great importance amongst clinicians and policymakers internationally.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Langan J, Mercer SW, Smith DJ (2013) Multimorbidity and mental health: can psychiatry rise to the challenge? Br J Psychiatry 202:391–393

    Article  PubMed  Google Scholar 

  2. Barnett K, Mercer SW, Norbury M et al (2012) Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. The Lancet 380(9836):37–43

    Article  Google Scholar 

  3. Emanuel EJ (2012) Where are the health care cost savings? JAMA 307(1):39–40

    Article  CAS  PubMed  Google Scholar 

  4. Naylor C, Parsonage M, McDaid D et al. (2012) Long-term conditions and mental health: The cost of co-morbidities. The King’s Fund

  5. Williams S, Dale J (2006) The effectiveness of treatment for depression/depressive symptoms in adults with cancer: a systematic review. Br J Cancer 94(3):372–390

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Chapman DP, Perry GS, Strine TW (2005) The vital link between chronic disease and depressive disorders. Prev Chronic Dis. 2(1):A14

    PubMed Central  PubMed  Google Scholar 

  7. McNamee L, Mead G, MacGillivray S et al (2013) Schizophrenia, poor physical health and physical activity: evidence-based interventions are required to reduce major health inequalities. Br J Psychiatry 203:239–241

    Article  PubMed  Google Scholar 

  8. A vision for change (2006) Report of the expert group on mental health policy. Dublin http://www.dohc.ie/publications/pdf/vision_for_change.pdf. Accessed 21 Feb 2013

  9. Schizophrenia: Core interventions in the treatment and management of adults with schizophrenia in primary and secondary care. NICE Clinical Guideline 178 (2014) London: NICE http://www.nice.org.uk/nicemedia/live/11786/43608/43608.pdf. Accessed 21 Feb 2013

  10. De Hert M, Cohen D, Bobes J et al (2011) Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level. World Psychiatry 10(2):138–151

    PubMed  Google Scholar 

  11. Cradock-O’Leary J, Young AS, Yano EM et al (2002) Use of general medical services by VA patients with psychiatric disorders. Psychiatr Serv 53(7):874–878

    Article  PubMed  Google Scholar 

  12. Lawrence D, Kisely S (2010) Inequalities in healthcare provision for people with severe mental illness. J Psychopharmacol 24(4 Suppl):61–68

    Article  PubMed Central  PubMed  Google Scholar 

  13. Royal College of Psychiatrists (2012) Report of the national audit of schizophrenia (NAS) 2012. Healthcare Quality Improvement Partnership, London

    Google Scholar 

  14. Kessler RC, Berglund P, Demler O et al (2003) National comorbidity survey replication. The epidemiology of major depressive disorder: results from the national comorbidity survey replication (NCS-R). JAMA 289(23):3095–3105

    Article  PubMed  Google Scholar 

  15. Musselman DL, Evans DL, Nemeroff CB (1998) The relationship of depression to cardiovascular disease: epidemiology, biology, and treatment. Arch Gen Psychiatry 55(7):580–592

    Article  CAS  PubMed  Google Scholar 

  16. Benton T, Staab J, Evans DL (2007) Medical co-morbidity in depressive disorders. Ann Clin Psychiatry 19(4):289–303

    Article  PubMed  Google Scholar 

  17. Pan A, Lucas M, Sun Q et al (2010) Bidirectional association between depression and type 2 diabetes mellitus in women. Arch Intern Med 170(21):1884–1891

    Article  PubMed Central  PubMed  Google Scholar 

  18. Patten SB, Williams JV, Lavorato DH et al (2009) Major depression as a risk factor for high blood pressure: epidemiologic evidence from a national longitudinal study. Psychosom Med 71(3):273–279

    Article  PubMed  Google Scholar 

  19. Sullivan MD, Katon WJ, Lovato LC et al (2013) Association of depression with accelerated cognitive decline among patients with type 2 diabetes in the ACCORD-MIND trial. JAMA Psychiatry 10:1041–1047

    Article  Google Scholar 

  20. MacHale S (2002) Managing depression in physical illness. Adv Psychiatr Treat 8(4):297–305

    Article  Google Scholar 

  21. Yusuf S, Hawken S, Ounpuu S et al (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 364(9438):937–952

    Article  PubMed  Google Scholar 

  22. Healthy active lives (HeAL): keeping the body in mind in youth with psychosis (2013) http://www.iphys.org.au/HeAL_declaration.pdf

  23. The Schizophrenia Commission (2012) The abandoned illness: a report from the Schizophrenia Commission. Rethink Mental Illness, London

    Google Scholar 

  24. Andreassen OA, Djurovic S, Thompson WK et al (2013) Improved detection of common variants associated with schizophrenia by leveraging pleiotropy with cardiovascular-disease risk factors. Am J Hum Genet 92(2):197–209

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  25. Lahti M, Tiihonen J, Wildgust H et al (2012) Cardiovascular morbidity, mortality and pharmacotherapy in patients with schizophrenia. Psychol Med 42:1–11

    Article  Google Scholar 

  26. Dee A, Perry IJ, Staines A et al (2012) Executive summary: the cost of overweight and obesity on the island of Ireland. http://www.safefood.eu/SafeFood/media/SafeFoodLibrary/Documents/Publications/Research%20Reports/Final-Exec-Summary-The-Economic-Cost-of-Obesity.pdf. Accessed 01/02/2013

  27. Behan C, McGlade N, Haq F et al (2008) Physical health and attendance at primary care in people with schizophrenia. Ir J Psychol Med 25(2):57–60

    Google Scholar 

  28. de Vegt F, Dekker JM, Jager A et al (2001) Relation of impaired fasting and postload glucose with incident type 2 diabetes in a Dutch population: the Hoorn Study. JAMA 285(16):2109–2113

    Article  PubMed  Google Scholar 

  29. Jagun O, Chan G, Tee WJ et al (2013) Guesstimating body mass index (BMI): how good are we really? Gut 62:A38. doi:10.1136/gutjnl-2013-305143.91

    Article  Google Scholar 

  30. Husin M, Kasim S, Tuthill A (2012) Accuracy of visual estimation in diagnosing obese individuals-a blinded study. Br J Med Pract 5(2)

  31. Vancampfort D, Knapen J, De Hert M et al (2009) Cardiometabolic effects of physical activity interventions for people with schizophrenia. Physical Ther Rev 14(6):388–398

    Article  Google Scholar 

  32. McCreadie RG (2003) Diet, smoking and cardiovascular risk in people with schizophrenia: descriptive study. Br J Psychiatry 183:534–539

    Article  CAS  PubMed  Google Scholar 

  33. Craft LL, Perna FM (2004) The benefits of exercise for the clinically depressed. Prim Care Companion J Clin Psychiatry 6(3):104–111

    Article  PubMed Central  PubMed  Google Scholar 

  34. Barry MM, van Lente E, Molcho M et al (2009) SLÁN 2007: Survey of lifestyle, attitudes and nutrition in Ireland: Mental health and social well-being report. Department of Health and Children. The Stationery Office, Dublin

    Google Scholar 

  35. Myles N, Newall HD, Curtis J et al (2012) Tobacco use before, at, and after first-episode psychosis: a systematic meta-analysis. J Clin Psychiatry 73(4):468–475

    Article  PubMed  Google Scholar 

  36. De Hert M, Dekker JM, Wood D et al (2009) Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC). Eur Psychiatry 24(6):412–424

    Article  PubMed  Google Scholar 

  37. Zhang XY, Chen DC, Xiu MH et al (2012) Cigarette smoking, psychopathology and cognitive function in first-episode drug-naive patients with schizophrenia: a case-control study. Psychol Med 1–10

  38. McNeill A (2001) Smoking and mental health: a review of the literature. In Symposium report: Smoking and mental health. Smoke-free London

  39. Campion J, Checinski K, Nurse J (2008) Review of smoking cessation treatments for people with mental illness. Adv Psychiatr Treat 14(3):208–216

    Article  Google Scholar 

  40. Winterbourne S (2012) Preventing future physical morbidity and premature mortality in first-episode psychosis patients: an economic evaluation of smoking cessation interventions. Dissertation London School of Economics and Social Policy

  41. Holt RIG, Peveler RC (2010) Diabetes and cardiovascular risk in severe mental illness: a missed opportunity and challenge for the future. Pract Diabetes Internatl 27(2):79–84

    Article  Google Scholar 

  42. Ryan MC, Collins P, Thakore JH (2003) Impaired fasting glucose tolerance in first-episode, drug-naive patients with schizophrenia. Am J Psychiatry 160(2):284–289

    Article  PubMed  Google Scholar 

  43. Fiedorowicz JG, Miller DD, Bishop JR et al (2012) Systematic review and meta-analysis of pharmacological interventions for weight gain from antipsychotics and mood stabilizers. Curr Psychiatry Rev 8(1):25–36

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  44. Gorczynski P, Faulkner G (2010) Exercise therapy for schizophrenia. Schizophr Bull 36(4):665–666

    Article  PubMed Central  PubMed  Google Scholar 

  45. Smith SM, Soubhi H, Fortin M et al (2012) Managing patients with multimorbidity: systematic review of interventions in primary care and community settings. BMJ 345:e5205

    Article  PubMed Central  PubMed  Google Scholar 

  46. Hasnain M, Fredrickson SK, Vieweg WVR et al (2010) Metabolic syndrome associated with schizophrenia and atypical antipsychotics. Curr Diab Rep 10(3):209–216

    Article  PubMed  Google Scholar 

  47. Corrigan PW, Larson JE, Ruesch N (2009) Self-stigma and the “why try” effect: impact on life goals and evidence-based practices. World Psychiatry 8(2):75–81

    PubMed Central  PubMed  Google Scholar 

  48. Thornicroft G (2011) Physical health disparities and mental illness: the scandal of premature mortality. Br J Psychiatry 199:441–442

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C. Behan.

Additional information

Dr Shiers, previously joint clinical lead for the development of early intervention in psychosis (2004–2010), is a member of the Guidance Development Group (GDG) reviewing the NICE guidance for adults with psychosis and schizophrenia; the views expressed are not those of the GDG, NCCMH or NICE.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Behan, C., Doyle, R., Masterson, S. et al. A double-edged sword: review of the interplay between physical health and mental health. Ir J Med Sci 184, 107–112 (2015). https://doi.org/10.1007/s11845-014-1205-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-014-1205-1

Keywords

Navigation