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LETTER TO EDITOR
Year : 2019  |  Volume : 20  |  Issue : 1  |  Page : 30-31

Ensuring better management of physical health conditions among people with severe mental disorders: World Health Organization


1 Vice Principal Curriculum, Department of Community Medicine, Member of the Medical Education Unit and Institute Research Council, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Tamil Nadu, India
2 Associate Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Tamil Nadu, India

Date of Web Publication20-Jun-2019

Correspondence Address:
Dr. Saurabh RamBihariLal Shrivastava
Department of Community Medicine, 3rd Floor, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/AMH.AMH_47_18

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How to cite this article:
Shrivastava SR, Shrivastava PS. Ensuring better management of physical health conditions among people with severe mental disorders: World Health Organization. Arch Ment Health 2019;20:30-1

How to cite this URL:
Shrivastava SR, Shrivastava PS. Ensuring better management of physical health conditions among people with severe mental disorders: World Health Organization. Arch Ment Health [serial online] 2019 [cited 2019 Nov 15];20:30-1. Available from: http://www.amhonline.org/text.asp?2019/20/1/30/260775



Sir,

The available global estimates depict that the overall burden of disease due to mental disorders is on the rise and it accounts for almost 7% of the total disease burden.[1],[2] The majority of the increasing burden has been reported in low- and middle-income nations, which is a direct indicator of the wide gap between the need and the delivery of health-care services.[1],[2] As a matter of fact, severe mental disorders (SMDs) (viz., moderate-to-severe depression, bipolar mood disorders, and schizophrenia) have been associated with poor health outcomes and 2–3 times higher risk of mortality in comparison with the normal population.[1]

It has been estimated that most of the deaths among people diagnosed with SMDs are due to physical health conditions, including both infectious and lifestyle disorders.[1],[3] Further, these individuals are more likely to get involved in high-risk behaviors (such as tobacco intake, unhealthy dietary practices, and reduced physical activity), which in turn enhances the risk of lifestyle disorders.[3] There is no doubt that most of the premature deaths or adverse health outcomes due to physical conditions can be ameliorated by improving the access to quality health-care services.[3],[4]

However, in reality, most of the people with SMD do not have equitable access to comprehensive health services or receive substandard health promotion, prevention, screening, and treatment services.[2],[3] To accomplish universal health coverage, it is high time that all the existing disparities in health-care access should be addressed and it should be ensured that all the affected individuals should be offered at least similar kind of treatment for their physical health conditions and associated risk factors as that of the general population.[1],[2],[3]

Acknowledging the frequent association between mental and physical health conditions and the role of physical conditions in determining the outcome of the disorders, the World Health Organization has released specific and tailor-made recommendations.[1] With reference to tobacco cessation, it has been advocated to offer both drug therapy and behavioral intervention program.[1] For the management of weight among people with SMD, the first line of approach should be through promotion of healthy diet and physical activity, and if these do not deliver the desired results, the drug can be added as a second-line approach.[1]

For the management of cardiovascular disease and associated risk among people suffering with SMD, the standard drug therapy has been advocated.[1],[4] In addition, lifestyle modifications and multisectoral approach, including better doctor–patient communication, have been envisaged.[4] Similar recommendations have been made even for people having coexisting diabetes.[1] Finally, for people suffering with HIV/AIDS or tuberculosis, the standard treatment regimen should be initiated and continued.[1] Nevertheless, they should be offered additional psychosocial support for ensuring better treatment adherence.[1] Thus, these guidelines provide evidence-based recommendations for the management of most important physical health conditions and the associated risk factors.[1]

In conclusion, mental disorders are a major global public health concern, and thus, it is our responsibility to take appropriate measures to ensure that the neglected physical health component can be better addressed and eventually the premature mortality can be reduced.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
World Health Organization. Management of Physical Health Conditions in Adults with Severe Mental Disorders. Geneva: WHO Press; 2018. p. 1-17.  Back to cited text no. 1
    
2.
Shrivastava SR, Shrivastava PS, Ramasamy J. The public health concern of mental illnesses: Strengthening of the mental health sector. Ann Trop Med Public Health 2017;10:307-8.  Back to cited text no. 2
  [Full text]  
3.
Ivbijaro G. Excess mortality in severe mental disorder: The need for an integrated approach. World Psychiatry 2017;16:48-9.  Back to cited text no. 3
    
4.
Foguet Boreu Q, Roura Poch P, Bullón Chia A, Mauri Martin C, Gordo Serra N, Cecília Costa R, et al. Cardiovascular risk factors, cardiovascular risk and quality of life in patients with a severe mental disorder. Aten Primaria 2013;45:141-8.  Back to cited text no. 4
    




 

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