The World Health Organization (WHO) has published new guidelines to support the management of physical health conditions in adults with severe mental disorders (SMDs) including moderate to severe depression, bipolar disorder, schizophrenia and other psychotic disorders.
The guidelines provide recommendations in a number of areas aimed at supporting the reduction of risk factors for physical illnesses, including tobacco cessation and weight management.
It recommends combined pharmacological and non-pharmacological interventions for smoking-cessation, noting that behavioural treatment alone for tobacco smoking cessation has a low abstinence rate in SMD. Varenicline, bupropion and nicotine replacement therapy may be considered for tobacco cessation, it says, but prescribers will need to consider potential interactions with psychotropic medications.
Behavioural interventions should be considered in individuals who are, or are at risk of, becoming overweight or obese. Initiating a psychotropic medication with lower propensity for weight gain should be considered. Where lifestyle interventions and/or switching psychotropic medication do not appear successful, it says adjunctive metformin may be considered.
Recommendations are also made in areas including substance use disorders, cardiovascular disease and risk, diabetes mellitus, HIV/AIDS and other infectious diseases.
The guidelines will be reviewed in three to five years.