TY - JOUR
AU - R. E. Nielsen
AU - H. Taipale
AU - S. Cortese
AU - E. Dragioti
AU - Du Rietz
AU - J. Firth
AU - P. Fusar-Poli
AU - C. Hartman
AU - R. I. Holt
AU - A. Høye
AU - A. Koyanagi
AU - H. Larsson
AU - K. Lehto
AU - P. Lindgren
AU - M. Manchia
AU - M. Nordentoft
AU - K. Skonieczna-Żydecka
AU - B. Stubbs
AU - D. Vancampfort
AU - L. Brandt
AU - W. Marx
AU - E. Reininghaus
AU - E. Vieta
AU - M. De Prisco
AU - L. Boyer
AU - C. U. Correll
AU - M. Solmi
A1 - 
AB - Individuals with severe mental illness (SMI) face significantly reduced life expectancy, mainly driven by natural causes such as cardiovascular disease, pulmonary disease, cancer, and stroke. Although medical care has advanced, the mortality gap between individuals with SMI and the general population has continued to expand in many countries over recent decades. This disparity is exacerbated by systemic healthcare inequities, fragmented healthcare, insufficient use of preventive measures, and the burden of multimorbidity. This paper proposes six actionable strategies to reduce the excess mortality associated with SMI by integrating physical healthcare into psychiatric services. Across all recommendations, we explicitly embed lifestyle interventions, especially structured physical activity given its comparatively stronger evidence base in SMI, alongside sleep and nutrition support delivered through pragmatic, accessible programs. First, psychoeducation should be expanded to include physical health literacy. Second, structured smoking cessation programs must be implemented. Third, early identification and management of obesity, including pharmacological interventions, should be prioritized. Fourth, hypertension should be routinely screened and treated within psychiatric settings. Fifth, dyslipidaemia and diabetes require systematic monitoring and timely initiation of statins, metformin and GLP-1 receptor agonists. Sixth, these interventions must be delivered through integrated care models that ensure continuity, optimal self-management, and long-term outcome monitoring. Together, these six approaches offer a framework to narrow the mortality gap between people with SMI and the general population, as well as support a shift toward holistic, person-centered care. We synthesise the evidence on physical health disparities in SMI and provide practical, evidence-based recommendations for psychiatric settings. Together, these strategies offer a feasible, person-centered framework to improve health outcomes and reduce premature mortality in individuals with SMI.
AD - Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.; Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark.; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.; Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden.; Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland.; School of Pharmacy, University of Eastern Finland, Kuopio, Finland.; Developmental EPI (Evidence Synthesis, Prediction, Implementation) Lab, Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.; Hampshire and Isle of Wight Healthcare NHS Foundation Trust, Southampton, UK.; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK.; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA.; DiMePRe-J-Department of Precision and Rigenerative Medicine-Jonic Area, University of Bari "Aldo Moro", Bari, Italy.; University of Ioannina, Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, Ioannina, Greece.; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.; Division of Psychology and Mental Health, The University of Manchester, Manchester, UK.; Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.; South London and Maudsley NHS Foundation Trust, London, UK.; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.; University of Groningen, University Medical Center Groningen, Interdisciplinary Centre Psychopathology and Emotion Regulation, the Netherlands.; Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.; Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK.; Department of Clinical Medicine, UiT the Arctic University of Norway and Department of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø, Norway.; Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830, Barcelona, Spain.; ICREA, Pg. Lluis Companys 23, 08010, Barcelona, Spain.; School of Medical Sciences, Örebro University, Örebro, Sweden.; Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia.; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.; The Swedish Institute for Health Economics, Lund, Sweden.; Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy.; Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada.; Mental Health Centre Copenhagen, Department of Clinical Medicine, Copenhagen University Hospital, Denmark.; Department of Biochemical Science, Pomeranian Medical University in Szczecin, 71-460, Szczecin, Poland.; Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria.; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, 1090 Vienna, Austria.; Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.; University Psychiatric Centre KU Leuven, Kortenberg, Leuven, Belgium.; Charité - Universitätsmedizin Berlin, Department of Psychiatry and Neurosciences, Berlin, Germany.; German Center for Mental Health (DZPG) - Partner Site Berlin-Potsdam, Berlin, Germany.; Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Deakin University, Barwon Health, Geelong, Victoria, Australia, 3220.; Division of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Graz, Austria.; Department of Medicine, Faculty of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), C. Casanova, 143, 08036, Barcelona, Catalonia, Spain.; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036, Barcelona, Catalonia, Spain.; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036, Barcelona, Catalonia, Spain.; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.; CEReSS-Health Services Research and Quality of Life Center, Aix-Marseille University, France.; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.; Department of Psychiatry, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA.; Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.; Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.; Department of Mental Health, Ottawa Hospital, Ottawa, ON, Canada.; Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program, University of Ottawa, Ottawa, ON, Canada.; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
AN - 41852684
BT - Neurosci Appl
C5 - Healthcare Disparities; Education & Workforce
DO - 10.1016/j.nsa.2026.106993
DP - NLM
ET - 20260228
JF - Neurosci Appl
LA - eng
N2 - Individuals with severe mental illness (SMI) face significantly reduced life expectancy, mainly driven by natural causes such as cardiovascular disease, pulmonary disease, cancer, and stroke. Although medical care has advanced, the mortality gap between individuals with SMI and the general population has continued to expand in many countries over recent decades. This disparity is exacerbated by systemic healthcare inequities, fragmented healthcare, insufficient use of preventive measures, and the burden of multimorbidity. This paper proposes six actionable strategies to reduce the excess mortality associated with SMI by integrating physical healthcare into psychiatric services. Across all recommendations, we explicitly embed lifestyle interventions, especially structured physical activity given its comparatively stronger evidence base in SMI, alongside sleep and nutrition support delivered through pragmatic, accessible programs. First, psychoeducation should be expanded to include physical health literacy. Second, structured smoking cessation programs must be implemented. Third, early identification and management of obesity, including pharmacological interventions, should be prioritized. Fourth, hypertension should be routinely screened and treated within psychiatric settings. Fifth, dyslipidaemia and diabetes require systematic monitoring and timely initiation of statins, metformin and GLP-1 receptor agonists. Sixth, these interventions must be delivered through integrated care models that ensure continuity, optimal self-management, and long-term outcome monitoring. Together, these six approaches offer a framework to narrow the mortality gap between people with SMI and the general population, as well as support a shift toward holistic, person-centered care. We synthesise the evidence on physical health disparities in SMI and provide practical, evidence-based recommendations for psychiatric settings. Together, these strategies offer a feasible, person-centered framework to improve health outcomes and reduce premature mortality in individuals with SMI.
PY - 2026
SN - 2772-4085
SP - 106993
ST - Integrating physical healthcare into psychiatry for severe mental illness: A narrative review and position statement from the ECNP PAN-Health group
T1 - Integrating physical healthcare into psychiatry for severe mental illness: A narrative review and position statement from the ECNP PAN-Health group
T2 - Neurosci Appl
TI - Integrating physical healthcare into psychiatry for severe mental illness: A narrative review and position statement from the ECNP PAN-Health group
U1 - Healthcare Disparities; Education & Workforce
U3 - 10.1016/j.nsa.2026.106993
VL - 5
VO - 2772-4085
Y1 - 2026
ER -