Research Topic

Reducing the Mortality Gap in People with Severe Mental Disorders: the Role of Lifestyle Psychosocial Interventions

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Patients with severe mental disorders, namely schizophrenia, depression and bipolar disorder, have an unacceptable reduced life expectancy of 10-25 year compared to the general population, mainly due to the co-occurrence of many physical diseases, such as hypertension, coronary heart disease, stroke, chronic ...

Patients with severe mental disorders, namely schizophrenia, depression and bipolar disorder, have an unacceptable reduced life expectancy of 10-25 year compared to the general population, mainly due to the co-occurrence of many physical diseases, such as hypertension, coronary heart disease, stroke, chronic obstructive pulmonary disease, tuberculosis, hepatitis and HIV.

The increased morbidity and mortality seen in these patients are largely due to the higher prevalence of risk factors, including socio-economic disadvantage, poor access to screening procedures and therapies for physical illnesses, use of psychotropic drugs. The most important factors seem to be related to individual lifestyle’s behaviours, particularly unhealthy diet, insufficient physical exercise, heavy smoking, alcohol and drugs abuse, risky sexual behaviours, dysregulation of circadian rhythms, reduced adherence to medications.

The attempts made to reduce this mortality gap have acted at three levels: health system level, physician level, patient level. The third-level interventions range from electronic alerts through smartphones and web-based platforms to intensive case management treatments, and from promotion of healthy habits to complex psychosocial interventions. These lifestyle-oriented interventions, consisting of behavioral, educational, and psychological components, have been tested for efficacy in randomized control trials (RCT). However, these interventions have been conducted mainly in research settings and are not easily applicable in ordinary clinical conditions, or have not been tested for efficacy. Moreover, physicians often consider the physical health of people with severe mental disorders not as a priority and patients themselves often shows a low interest for their own health. It is clinically and ethically relevant to develop, validate and perform interventions to improve lifestyle’s behaviors of patients with severe mental disorders, to reduce the presence of comorbidities and to improve their life expectancy.

In this Research Topic we would like to summarize the available knowledge of the efficacy and effectiveness of available psychosocial interventions aimed at improving healthy lifestyle behaviors and at promoting physical health of patients with severe mental disorders. All forms of submissions are welcomed: original research articles, review articles, method articles, clinical trials, case reports, mini review articles, general commentaries, perspectives, hypotheses & theories.


Keywords: Physical health, mental health, Lifestyle psychosocial interventions, mortality gap


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