Bridging the Gap Between Mental and Physical Health

Vreeland, Betty

doi:10.1177/107839030401000303

Cited by 50 publications

(66 citation statements)

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“…Bridging the gap between mental and physical health truly requires a multidisciplinary approach because of the higher rates of morbidity and premature mortality compared with the general population [89]. People with serious mental illness are more likely to engage in unhealthy lifestyle practices, such as lack of physical activity, poor nutrition and overeating, smoking and other substance abuse, irregular and inadequate sleep, and failure to visit healthcare providers on a regular basis.…”

Section: Discussionmentioning

confidence: 99%

Review of posttraumatic stress disorder and chronic pain: The path to integrated care

Gibson¹

2012

JRRD

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Abstract-With the large number of Veterans experiencing posttraumatic stress disorder (PTSD) and chronic pain, the purpose of this article is to review the prevalence of PTSD and chronic pain, the theoretical models that explain the maintenance of both conditions, and the challenges faced by providers and families who care for these patients. The Department of Veterans Affairs (VA)/Department of Defense (DOD) VA/DOD Clinical Practice Guideline for Management of Post-Traumatic Stress with special attention to chronic pain is presented. Limited scientific evidence supports specific care and treatment of PTSD and chronic pain, and this challenges providers to investigate and research potential treatment options. Integrated care models designed for working with these patients are reviewed, including a focus on the techniques and strategies to address not only PTSD and chronic pain, but other conditions, including substance dependence and depression. A specific focus on headaches, back pain, and neuropathic pain follows, including treatment recommendations such as pharmacological, psychotherapeutic, and complementary approaches, given the high rates of these pain complaints for Veterans in PTSD clinical programs. Integrated care is presented as a viable solution and approach that challenges clinicians and researchers to develop innovative, scientifically based therapeutics and treatments to enhance the recovery and quality of life for Veterans with PTSD and chronic pain.

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Section: Discussionmentioning

confidence: 99%

Review of posttraumatic stress disorder and chronic pain: The path to integrated care

Gibson¹

2012

JRRD

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“…There is a role for individual needs assessment and more flexible models to deliver equitable services and change the current status quo (Druss et al 2001;Vreeland, 2007;Crompton et al 2010). These could include longer consultation times, adjunct nurse led appointments to support education and shared clinics with mental health workers to support individuals whose engagement may be affected by positive, cognitive or negative symptoms associated with psychosis.…”

Section: Alterative Care Modelsmentioning

confidence: 99%

Strategies to deal with comorbid physical illness in psychosis

Docherty

Stubbs

Gaughran

2016

Epidemiol Psychiatr Sci

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Individuals with serious mental illnesses such as psychosis still experience higher mortality rates than the general population, decades after data have linked the gap to increased rates of physical illness, delayed diagnosis, low treatment rates and worse outcomes from treatment received. The nature of the relationship between psychosis and comorbid physical illness is complex. Multiple strategies directed at different levels of disease process, health care systems and stakeholder culture are likely required to make sustained progress in reducing the mortality gap. Evidence for strategies that effectively reduce the burden of physical co-morbidity and lead to improved health outcomes are still in their infancy but growing at a reassuringly fast rate. This editorial considers the existing evidence base and makes suggestions for the development and future direction of this urgent research agenda and how this knowledge can be implemented in clinical practice.

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“…preventable with adequate health promotion policies), such as cardiovascular and unnatural causes for both genders (Hansen et al 2001) and for suicide (Mortensen & Juel, 1993 ;Martiello et al 2006). Vreeland (2007) stated that the problem of increased morbidity and premature death in people with serious mental illness needed to be addressed with a transformation of the current mental health system and the integration of physical and mental health care, towards a system that uses a coordinated, multidisciplinary holistic approach. This should overcome some of the multiple barriers that make it difficult for individuals with serious mental illness to access quality health care.…”

Section: Introductionmentioning

confidence: 99%

Mortality and cause of death among psychiatric patients: a 20-year case-register study in an area with a community-based system of care

et al. 2009

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Background. Most mortality studies of psychiatric patients published to date have been conducted in hospital-based systems of care. This paper describes a study of the causes of death and associated risk factors among psychiatric patients who were followed up over a 20-year period in an area where psychiatric care is entirely provided by community-based psychiatric services.Method. All subjects in contact with the South Verona Community-based Mental Health Service (CMHS) over a 20-year period with an ICD-10 psychiatric diagnosis were included. Of these 6956 patients, 938 died during the study period. Standardized mortality ratios (SMRs) and Poisson multiple regressions were used to assess the excess of mortality in the sample compared with the general population.Results. The overall SMR of the psychiatric patients was 1.88. Mortality was significantly high among out-patients [SMR 1.71, 95 % confidence interval (CI) 1.6-1.8], and higher still following the first admission (SMR 2.61, 95 % CI 2.4-2.9). The SMR for infectious diseases was higher among younger patients and extremely high in patients with diagnoses of drug addiction (216.40, 95 % CI 142.5-328.6) and personality disorders (20.87, 95 % CI 5.2-83.4).Conclusions. This study found that psychiatric patients in contact with a CMHS have an almost twofold higher mortality rate than the general population. These findings demonstrate that, since the closure of long-stay psychiatric hospitals, the physical health care of people with mental health problems is often neglected and clearly requires greater attention by health-care policymakers, services and professionals.

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Bridging the Gap Between Mental and Physical Health

Cited by 50 publications

References 0 publications

Review of posttraumatic stress disorder and chronic pain: The path to integrated care

Review of posttraumatic stress disorder and chronic pain: The path to integrated care

Strategies to deal with comorbid physical illness in psychosis

Mortality and cause of death among psychiatric patients: a 20-year case-register study in an area with a community-based system of care

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