• severe mental illness;
  • dyslipidaemia;
  • diabetes;
  • obesity;
  • smoking;
  • cardiovascular disease;
  • antipsychotics


Schizophrenia and bipolar illness are severe mental illnesses that affect around 1–2% of the population. They are associated with premature mortality with a reduced life-expectancy of 10–20 years. Although suicide and trauma contribute the highest relative risk of mortality, physical illness accounts for around three-quarters of all deaths, with cardiovascular disease being the most common cause of death. Traditional cardiovascular risk factors including diabetes, dyslipidaemia, obesity and smoking are all more common in people with severe mental illness (SMI).

Although there has been an increasing awareness of physical health issues in people with SMI, the level of screening for and management of cardiovascular risk factors has remained low. A number of national and international bodies have developed guidelines to address the challenge of physical morbidity in SMI. The principles of screening for and managing cardiovascular disease in people with SMI are similar to those in the general population, but there are additional challenges. Health care professionals within psychiatry, general practice and medical specialties need to work together to reduce the burden of physical health problems in people with SMI. Copyright © 2010 John Wiley & Sons.