De Hert M, Dekker J M, Wood D, Kahl K G, Holt R I G, Möller H-J
University Psychiatric, Centre Catholic University, Leuven campus Kortenberg, Leuvensesteenweg 517, 3070 Kortenberg, Belgium.
Eur Psychiatry. 2009 Sep;24(6):412-24. doi: 10.1016/j.eurpsy.2009.01.005. Epub 2009 Aug 13.
People with severe mental illnesses, such as schizophrenia, depression or bipolar disorder, have worse physical health and reduced life expectancy compared to the general population. The excess cardiovascular mortality associated with schizophrenia and bipolar disorder is attributed in part to an increased risk of the modifiable coronary heart disease risk factors; obesity, smoking, diabetes, hypertension and dyslipidaemia. Antipsychotic medication and possibly other psychotropic medication like antidepressants can induce weight gain or worsen other metabolic cardiovascular risk factors. Patients may have limited access to general healthcare with less opportunity for cardiovascular risk screening and prevention than would be expected in a non-psychiatric population. The European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC) published this statement with the aim of improving the care of patients suffering from severe mental illness. The intention is to initiate cooperation and shared care between the different healthcare professionals and to increase the awareness of psychiatrists and primary care physicians caring for patients with severe mental illness to screen and treat cardiovascular risk factors and diabetes.
与普通人群相比,患有严重精神疾病(如精神分裂症、抑郁症或双相情感障碍)的人身体健康状况更差,预期寿命缩短。与精神分裂症和双相情感障碍相关的心血管疾病死亡率过高,部分原因是可改变的冠心病危险因素风险增加,这些因素包括肥胖、吸烟、糖尿病、高血压和血脂异常。抗精神病药物以及可能的其他精神药物(如抗抑郁药)会导致体重增加或使其他代谢性心血管危险因素恶化。与非精神科人群相比,患者获得普通医疗保健的机会有限,进行心血管疾病风险筛查和预防的机会也较少。在欧洲糖尿病研究协会(EASD)和欧洲心脏病学会(ESC)的支持下,欧洲精神病学协会(EPA)发表了本声明,旨在改善对患有严重精神疾病患者的护理。目的是启动不同医疗专业人员之间的合作和共同护理,并提高照顾严重精神疾病患者的精神科医生和初级保健医生对心血管疾病危险因素和糖尿病进行筛查和治疗的意识。