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Diabetes and cardiovascular risk in severe mental illness: a missed opportunity and challenge for the future


  • RIG Holt PhD, FRCP,

    Corresponding author
    1. Endocrinology and Metabolism Sub-Division, Developmental Origins of Adult Health and Disease Division
    • The Institute of Developmental Sciences (IDS Building), MP887, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
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  • RC Peveler DPhil, FRCPsych

    1. Clinical Neurosciences Division University of Southampton School of Medicine, UK
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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.