Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC)

TLDR

People with severe mental illnesses such as schizophrenia, bipolar disorder, or depression experience poorer physical health, reduced life expectancy, and higher cardiovascular mortality driven by obesity, smoking, diabetes, hypertension, dyslipidaemia, and medication‑induced metabolic changes, compounded by limited access to routine cardiovascular screening. This statement aims to improve care for patients with severe mental illness by fostering cooperation between healthcare professionals and raising psychiatrists’ and primary‑care physicians’ awareness of cardiovascular risk screening and diabetes management. The European Psychiatric Association, with support from the European Association for the Study of Diabetes and the European Society of Cardiology, published this position statement to operationalize these collaborative efforts.

Abstract

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.