Somatic Disorder in People with Severe Mental Illness
DOI:
https://doi.org/10.51338/rppsm.375Keywords:
mental disorders, delivery of healthcare, social stigmaAbstract
Since the beginning of the 20th century, several authors have found that people with severe mental illness (SMI) have higher rates of chronic medical illnesses and mortality in relation to the general population. With this work, we intended to perform a narrative review concerning the particularities of somatic disease and mortality in people with SMI, disparities in access to healthcare and interventions to be carried out in this population.
The literature is consensual in the recognition that people with SMI have higher rates of chronic medical illnesses and premature mortality, which leads to an average life expectancy 10 to 30 years lower than the general population. Suicide does not explain these differences. People with SMI are especially affected by cardiovascular, metabolic and neoplastic diseases. Although these diseases are also highly prevalent in the general population, their impact is significantly greater in individuals with mental illness. If part of this discrepancy can be attributed to functional limitations directly caused by SMI, it is recognized that discrimination and stigma also play an important role in these inequalities.
People with SMI have worse access to healthcare, leading to high rates of underdiagnosis and undertreatment. There are few studies in the literature aimed at interventions or programs that can decrease the inequality of health care in this population. The particularities of the expression of somatic disease in people with SMI lack adapted prevention strategies at the primary, secondary and tertiary levels that should be prioritized in clinical research and integrated into national health programs.
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