TY - JOUR T1 - Physical health in severe mental illness JF - British Journal of General Practice JO - Br J Gen Pract SP - 436 LP - 437 DO - 10.3399/bjgp17X692621 VL - 67 IS - 663 AU - Mark Ashworth AU - Peter Schofield AU - Jayati Das-Munshi Y1 - 2017/10/01 UR - http://bjgp.org/content/67/663/436.abstract N2 - The indivisible self has become divided. Divided by the structures of medical specialism, which themselves reflect the understanding of a wider society. Divided too by a mind and body philosophy that prefers reductionism to holism. More recently, divided by healthcare management struggling to address the issues of integrated care for patients who place multiple physical and mental healthcare demands upon a system so often seeming to be at breaking point.In spite of forces that divide the self, recent years have seen some convergence in physical and mental health care. In psychiatry, there has been an increasing awareness of the need to address the physical health issues of patients. Primary care too has adopted a more holistic agenda, promoting the concept of ‘medical generalism’, encompassing the medical, psychological, and social agenda of patients.The mortality gap for patients with schizophrenia has been apparent since the 17th century in observations on the mortality of ‘lunacy’.1 A gap of about 20 years for males and 15 years for females is still experienced by patients with psychosis in the developed world.2 Reporting a somewhat smaller mortality gap of 13 years for males and 12 years for females, Chang et al found that schizophrenia, schizoaffective disorder, and bipolar disorder contributed similarly to observed excess mortality values, whereas patients with substance use disorders had a larger mortality gap.3The causes of the mortality gap can broadly be … ER -