Physical health of mentally ill.

READERS might find it surprising to know that people with mental illness live less long than the general population. This is the case in every country. According to one study, people with severe mental illness live up to 25 years less than the general population. Why?

The high mortality rate among people with mental illness is not due to mental illness per se, rather it is the result of the coexistence or co-morbidity of physical health problems, such as cardiovascular, respiratory, metabolic and infectious diseases and cancer.

The Lancet, the oldest peer reviewed medical journal, set up a psychiatry commission which, in 2019, published a 'blueprint for protecting physical health in people with mental illness'. Joseph Firth, Najma Siddiqi et al reviewed global evidence and reported that although for decades the higher prevalence of physical health issues among the mentally ill was well noted - earlier it was thought that premature mortality occurs only among people with severe mental illnesses such as schizophrenia (a serious mental disorder) and bipolar disorders (people with severe mood swings of depression and euphoria) - now there is evidence that individuals with any kind of mental disorder have a substantially reduced life expectancy. Indeed, suicide is more common among these people (disproportionately affecting young people and elderly women in low- and middle-income countries) as around 17 per cent of them die due to unnatural causes and it contributes to their relatively short lives.

The higher prevalence of physical health issues among the mentally ill have been well noted.

Research over the last two decades, though mostly in high-income countries, has shown that people with mental illness have up to double the chances of developing cardiometabolic diseases (a group of common but often preventable conditions including heart attack, stroke, diabetes, insulin resistance and non-alcoholic fatty liver disease) than those without mental illness. For patients with depression, the risk of developing cardiac disease, hypertension, stroke, diabetes, metabolic syndrome, or obesity is around 40pc higher than in the general population. Despite many research gaps, higher rates of infectious diseases like hepatitis B and C, HIV and syphilis are also found among people with mental illness. Research that followed those with severe mental illness over 10 years in Ethiopia noted individuals dying prematurely compared with the general population...