Physical health monitoring in serious mental illness is a priority in psychiatry, but where is the evidence that it works?

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It is widely acknowledged that individuals with serious mental illnesses (SMI) such as schizophrenia, bipolar disorder and severe depression have increased rates of mortality, due to poor physical health. As well as reducing quality of life and function and decreasing life expectancy, physical illness can worsen these mental illnesses. The reasons for this include lifestyle [read the full story…]

Psychiatric illnesses and some chronic physical illnesses are associated with an increased risk of self-harm and suicide

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Last month, the Department of Health published the ‘Closing the Gap’ report, which highlighted the importance of better integration of physical and mental health care at every level. The report specifically flagged up the need for frontline services to respond better to people who self-harm, and cited statistics that emphasise the cyclical nature of the [read the full story…]

Extended therapy with varenicline reduces rates of smoking relapse in people with serious mental health issues

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People with serious mental health issues such as schizophrenia have higher rates of cigarette smoking than the general population, with estimates suggesting more than 50% are current smokers. When people in this population do manage to quit during treatment we then see particularly high rates of relapse after treatment ends. A new randomised control trial (Evins [read the full story…]

Cochrane review finds limited evidence to support valproate as a maintenance treatment for bipolar disorder

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Bipolar disorder is an affective disorder marked by cycles between mania and depression. It has an early onset, with mean age ranging from 19 to 29 (Offord, 2012) and a prevalence of 0.5% – 4.3% in primary care alone, stretching to 9.3% in some settings (Cerimele, Chwastiak, Dodson, & Katon, 2013). With its problematic recurring [read the full story…]

Estimating heritability in 5 psychiatric disorders: a 21st Century family study

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It has long been established that psychiatric disorders have a genetic component. In the early days of genetic research, twin and family studies were used to estimate heritability (the proportion of variance explained by genetic factors). The Psychiatric Genetics Consortium has recently published a paper in Nature Genetics to assess the heritability and co-inheritability (relationship between [read the full story…]

It’s not the combat, maybe it’s the drinking in vulnerable young men

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A cohort study published in JAMA tried to answer the question what are the risk factors for suicide in the US military. This is a hot topic as the rate of suicide has increased in US military personnel from about 11/100,000 people in 2005 to about 18/100,000 so that now deaths from suicide outnumber deaths [read the full story…]

Do interventions proven to improve cardiovascular disease outcomes work for individuals with severe mental illness?

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Individuals with severe mental illness (SMI) have shortened life expectancies compared to the general population. This is partly down to higher rates of chronic physical illness. Cardiovascular disease (CVD) is the leading cause of death among patients using mental health services. It is assumed that interventions used to reduce CVD are similarly effective in patients with [read the full story…]

Summing up suicide data in bipolar disorder

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People with bipolar disorder are found to be at greater risk of suicide compared to the general population. Clinicians should be more vigilant for signs of suicidality in this patient group. Suicide, the taking of one’s own life, sadly is the cause of death for around 5,500 people in the United Kingdom each year. In [read the full story…]

New NICE TA: Aripiprazole for treating moderate to severe manic episodes in adolescents with bipolar I disorder

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NICE has just published a new technology appraisal recommending aripiprazole as a treatment for bipolar disorder in young people. Technology Appraisals are systematic evaluations of the effectiveness of health technologies.  They do not have the broad scope of guidelines, which focus on topics rather than technologies, but they do give guidance for clinical practice on the [read the full story…]

ADHD in childhood is not linked to later development of bipolar disorder

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Bipolar disorder is considered a hereditary condition. There is emerging evidence that prodromes/early symptoms are evident in children before disorders develop. This potentially offers a chance to treat and prevent the development of mental health problems in adulthood. Being able to identifying early symptoms of the onset of this mental health disorder is clearly important, however, [read the full story…]