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People with Mental Illness are under treated for common medical conditions

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People with Mental Illness are under treated for common medical conditions

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Published by University of Leicester Press Office for University of Leicester in Health and also in Communities, Education

University of Leicester of academic leads team into mental health research

Patients with severe mental illness are less likely to be prescribed medication to treat common medical conditions such as high blood pressure, according to a new paper published online today by the British Journal of Psychiatry.

The researchers have called for better monitoring systems to ensure that the medical care of people with mental illness is not overlooked.

The research team, led by Dr Alex J Mitchell, honorary senior lecturer at the University of Leicester and a consultant at Leicestershire Partnership NHS Trust, carried out a meta-analysis of 61 studies relating to the prescribing of medication for physical health problems. These included cardiovascular disease, diabetes, cancer, arthritis, osteoporosis and HIV.

They found that patients with severe mental illness, such as schizophrenia, received lower than expected prescriptions for essential drugs to treat high blood pressure, including ACE inhibitors, beta-blockers and statins. People with affective disorders, such as bipolar disorder, were also less likely to receive beta-blockers and drugs to control cholesterol, though this was not statistically significant.

Overall, it was estimated that the rate of under-treatment for medical conditions was 10% for those with severe mental illness.

Dr Mitchell said: “We previously showed that patients with mental illness receive lower rates of general medical care* and lower rates of medical interventions** now extend this to show that people with severe mental illness appear to be receiving significantly less medication for medical disorders, particularly for cardiovascular problems.

“The inequality seems to result from prescribing differences not compliance issues, and there may be several reasons for this. Mental health professionals may not feel confident in prescribing medication to treat physical problems and hospital specialists may be worried about interactions of mental health medication. However we cannot rule out the possibility that medical conditions are being under-treated where they co-exist with mental health problems.”

Dr Mitchell concluded: “We suggest that the treatment of physical illness is prioritised in people with mental health problems, and closely monitored. Clinicians who care for patients with physical and mental illness should take particular care to ensure the best treatment is maintained in both areas, and that patients do not receive inferior medical care or inferior mental health care.”

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