Tuesday , November 24 2020

The WHO guidelines refer to the management of physical health in severe mental illness



Graham Thornicroft

Graham Thornicroft

The WHO has published evidence-based guidelines for the management of physical health in adults with severe mental disorders, according to a press release.

The guidelines contain recommendations for maintaining a healthy lifestyle (eg a healthier diet, more physical activity and stopping smoking), psychosocial support and consideration of possible interactions between the various drugs recommended for mental and physical health.

"Most deaths among people with [severe mental disorders] can be attributed to physical health conditions, both non-infectious and infectious " Graham Thornicroft, PhD, FRCPsych. chairman of the guidelines development group and professor of environmental psychiatry at King & # 39; s College London, as well as colleagues in the executive summary of the WHO.

"Equitable access to comprehensive health services is beyond the reach of most people [severe mental disorders]- they continued. "Unfortunately, people from [severe mental disorders] they often do not have access to health services or receive low-quality care, including promotion and prevention, screening and treatment. It is necessary to solve the problem of differences in access to healthcare and provision of services for people with the disease [severe mental disorders]. "

The guidelines include recommendations for the treatment of people with mental illness who have cardiovascular disease, diabetes, HIV / AIDS, tuberculosis, hepatitis B and C, tobacco addiction, dependence on substance use and / or overweight / obesity. WHO has proposed these guidelines to improve the management of physical health in adults with severe mental disorders, help reduce potentially risky lifestyle behaviors in these diseases, and reduce morbidity and premature mortality among people with severe mental illness.

running on the treadmill

The WHO guidelines contain recommendations on pro-health behaviors for people with severe mental illness.

Source: Shutterstock.com

Taking into account the potential of interaction between psychotropic or antipsychotic drugs and drugs used in other states is an important feature of the guidelines.

For patients at risk of being overweight or obese, the WHO recommends starting psychotropic medications with a lower propensity to increase body weight after taking into account clinical benefits / possible side effects. In the case of people with severe mental disorders and pre-existing cardiovascular disease or cardiovascular risk factors, the WHO recommends starting psychotropic treatment with a lower propensity to cardiovascular risk.

In the case of people with severe mental disorders and diabetes, clinicians should consider initiating antipsychotic treatment with a lower propensity to produce hyperglycaemia and be aware of potential interactions. The WHO also recommends monitoring glycemic control and adjusting the dose if necessary.

In the case of infectious diseases, clinicians should consider the possibility of interaction between psychotropic drugs and antiretrovirals, anti-TB drugs and anti-hepatitis B and C. In the case of smoking cessation programs, the WHO recommends considering possible interactions between bupropion and varenicline with psychotropic drugs.

"In accordance with the principle of non-discrimination and universal health insurance, developed in order to achieve the goals of the sustainable development of the United Nations, people [severe mental disorders] at least the same level of treatment should be offered for physical health conditions and their risk factors as the general population, 'the WHO guideline group summarized. – by Savannah Demko

Reference:

WHO. Management of physical health in adults with severe mental disorders. http://apps.who.int/iris/bitstream/handle/10665/275718/9789241550383-eng.pdf?ua=1. Access to November 7, 2018


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