Treatment decisions in major mental illness: weighing the outcomes.

Increased morbidity and mortality in persons with severe mental illness (SMI) are due in large part to preventable medical conditions. An array of factors contributes to the development of obesity and other medical problems, such as diabetes and cardiovascular disease. A holistic approach that integrates both mental and physical health is critical in treating individuals with SMI. The most common causes of disability and death are influenced by behaviors such as smoking, poor nutrition, and lack of exercise. Nonpharmacologic interventions focusing on lifestyle changes can help to prevent and manage psychotropic-associated weight gain. Furthermore, monitoring and treatment guidelines are underutilized in people with SMI; increased use of these guidelines could help to detect and possibly prevent some cardiometabolic problems.