Treatment Online

Mental Illness Often Translates into Drastically Shorter Life Expectancy
> 1/16/2007 11:02:54 AM

In an editorial from the January issue of Current Psychiatry, the magazine's editor-in-chief, Henry A. Nasrallah, MD, trumpets an issue that too often gets overlooked and underplayed: the early deaths of individuals diagnosed with mental health problems. Entitled "Dying too young," the piece looks particularly at the toll that heart attacks play in contributing to the average 20% loss in life expectancy for those dealing with mental illness. Nasrallah points to several papers, including this one published by the CDC, that highlight this drastic differences in life expectancy.

As the writer mentions, schizophrenia has long been associated with heart disease, but bipolar disorder and depression also present correlation. He writes:

Persons with serious mental illness often have risk factors associated with preventable causes of heart disease and stroke, including smoking, obesity, sedentary life styles, and poor nutrition. In addition, the metabolic syndrome�obesity, hypertension, hyperglycemia, and dyslipidemia�is highly associated with schizophrenia, bipolar disorder, and unipolar depression.

On top of this, those suffering from particularly detrimental afflictions will be less likely to see a general practitioner, or perhaps even a therapist, who might help keep these cardiovascular disease risk factors in check. Meanwhile, without the effort put in by the client, the health care system can do little to help. Nasrallah says that the message is clear, that practitioners must be more aware when meeting with schizophrenic clients of the risks to the client's physical well being. The current issue also includes an evidence-based article on providing comprehensive care to schizophrenic outpatients.

What Nasrallah doesn't hit upon is the importance of open discussion with schizophrenic clients, as well as those diagnosed with bipolar disorder or depression, about the physical health implications of their diagnosis. No doctor or therapist will be able to arrest cardiovascular risk behaviors on their own, but working with the client, they can inform and explain the necessary changes to routine, medication and care. While not necessarily in this case, there is the implication in other media outlets, sometimes passive, sometimes overt, that these clients cannot help themselves, or be party to their own treatment. That is simply not the case. Through working with the client, clinicians have the ability to empower schizophrenic individuals to make sure they do not fall victim to early death because of cardiovascular disease.

Comments
I have to say that I find this knowledge a relief. I know it's sad but when you are dealing with chronic and sometimes severe mental illness, it's hard to watch your diet. Problems have a cascade effect. Anxiety about shopping and about money means avoidance. Avoidance means eating out more and spending more money and eating unhealthy food. If I cook for myself, by the time I decide, cook and eat, there is no energy for cleanup. This makes me feel worse about myself.Worrying about my weight only makes me want to eat more. It's a vicious cycle and a losing proposition.I look forward to an early death.Lily

Posted by: Lily 1/17/2007 10:38:58 AM
It's important that you discuss the "vicious cycle" that you've described with your therapist or doctor. Your situation, like everyone else's, is not hopeless. It's just about finding the treatment and the routine that will help you manage these issues effectively. The take-away message here is not that an early death is necessary or good, but that it is in fact preventable.

Posted by: TheEditorInChief 1/18/2007 10:55:07 AM