Fortuna Karen L, Williams Ashley, Mois George, Jason Kendra, Bianco Cynthia L
Dartmouth Centers for Health and Aging, Lebanon, New Hampshire.
School of Social Work, University of New Hampshire.
Perspect Psychol Sci. 2022 Jan;17(1):183-190. doi: 10.1177/1745691621990613. Epub 2021 Jul 15.
Individuals with serious mental illness (SMI) experience a 10- to 25-year reduced life expectancy compared with the general population. Early mortality for people with SMI has mainly been attributed to unhealthy behaviors (e.g., poor diet, sedentary lifestyle), which has led to the development of health promotion and self-management interventions specifically for people with SMI to promote health behavior change. Yet after decades of research, the mortality gap between people with SMI and the general population is increasing. To address this early mortality disparity for individuals with SMI, a new paradigm must be explored. In this article, we present the paradigm, which highlights the powerful role of social processes in shaping the health and health behaviors of people with SMI. This paradigm explores how loneliness, stigma (social and self), trauma, social exclusion, social isolation, and social norms are related to early mortality in people with SMI. This new paradigm is an important step in understanding and potentially addressing early mortality in people with SMI.
与普通人群相比，患有严重精神疾病（SMI）的个体预期寿命缩短10至25年。SMI患者的过早死亡主要归因于不健康行为（如不良饮食、久坐不动的生活方式），这促使专门针对SMI患者开展健康促进和自我管理干预措施，以促进健康行为改变。然而，经过数十年的研究，SMI患者与普通人群之间的死亡率差距仍在扩大。为解决SMI患者的过早死亡差异问题，必须探索一种新的范式。在本文中，我们提出了这一范式，它强调了社会过程在塑造SMI患者的健康和健康行为方面的强大作用。该范式探讨了孤独、耻辱感（社会和自我层面）、创伤、社会排斥、社会隔离以及社会规范如何与SMI患者的过早死亡相关联。这一新范式是理解并有可能解决SMI患者过早死亡问题的重要一步。
