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01 October 2020

New guidelines to bridge the gap between psychiatric and physical health services

King’s College London researchers are lead authors on the first Maudsley Practice Guidelines on diagnosing physical health conditions in people with severe mental health problems.

Psychiatry illustration of six images showing the brain in various forms

Edited by Dr Toby Pillinger, Dr Fiona Gaughran and Professor David Taylor, the Maudsley Practice Guidelines for Physical Health Conditions in Psychiatry seek to provide a practical guide for psychiatrists and GPs to enable them to recognise and manage common physical health conditions in patients with severe mental health problems.

Assessment and management

Research has shown that people with severe mental illness have a life expectancy that is 15 years shorter than average, the main reasons for death in this group being due to physical health conditions. There are a number of factors contributing to this disparity which include lifestyle, side effects of medication and the level of ability or desire to engage with health services.

An informed physical health assessment of people with severe mental health problems is central to supporting this vulnerable group and ensuring they get the help they need to allow them to lead a better quality of life.

The Maudsley Guidelines for Physical Health likely represents the largest medical collaboration to date that addresses physical health disparities in psychiatric patients.

Co-editor Dr Toby Pillinger from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London

He continued, ‘The book bridges the gap between psychiatric and physical health services for the severely mentally ill by providing evidence-based and practical guidance on assessment, investigation, and management of all major medical, surgical, and emergency presentations seen in psychiatric patients.

Its use will improve the quality of clinical care received by mentally ill patients and, by promoting a holistic approach to treatment that considers both body and mind, will enhance the therapeutic relationship between patient and practitioner.’

Range of expertise

Published by Wiley and with contributions from 125 experts across the UK and abroad in medicine, pharmacy, surgery, dietetics, physiotherapy and psychiatry the book convenes insight on over 100 physical health problems commonly seen in people who are suffering from severe mental health problems.

The physical health of people using mental health services is compromised for many reasons, including the wider determinants of health, lifestyle, smoking, symptoms of mental illness and the adverse effects of medication.

Co-editor Dr Fiona Gaughran, Director of Research and Development at the South London and Maudsley NHS Trust

She added, ‘As a result morbidity and mortality are raised.  The 89 chapters in the Maudsley Practice Guidelines for Physical Health Conditions in Psychiatry have been co-written by specialists and each topic is presented with the mental health patient at its centre. The book aims to provide a comprehensive resource for the medical care of psychiatric patients and ultimately to disseminate best practice and improve health outcomes.’

The Maudsley Guidelines for Physical Health is organised into sections according to medical and surgical sub-specialties, such as cardiology, endocrinology and respiratory medicine. Each chapter takes a similar format which includes a description of the condition and what information to obtain from the patient to help form a diagnosis.

The guidelines cover how best to manage patients in a psychiatric setting - when to refer and what information to include in the referral - and provides evidence-based approaches to the management of side effects of psychiatric medication. The guidelines also provide advice on how to promote healthy lifestyle in those with severe mental health illness.

Maudsley Prescribing Guidelines Series

The Maudsley Prescribing Guidelines (MPG) has been in continuous production since 1993 and is now on its 13th edition, providing an evidence-based publication for prescribing in psychiatry. The MPG is probably the world’s leading clinical reference in Psychiatry for handling prescribing problems as encountered in daily practice and for formulating prescribing policy.

The Maudsley Prescribing Guidelines in Psychiatry deal with conventional treatments for mental health conditions. This new set of guidelines complement the 'original' MPG by concentrating on physical health conditions that might be encountered in a mental health environment.

David Taylor, Professor of Psychopharmacology at the IoPPN, King’s College London and lead author on the Maudsley Prescribing Guidelines since their inception in 1993

He continued, ‘The new guidelines are intended to be used by clinicians who lack specialist knowledge of the physical health conditions included. There is almost no overlap between the two, so clinicians who have possession of both sets of guidelines will have access to over 1400 pages of practical expert advice.’

The Maudsley Practice Guidelines for Physical Health Conditions in Psychiatry will be available later in October and can be pre-ordered here. To hear the editors talk more about the guidelines watch the recent Maudsley Learning Seminar.


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