Maurizio Pompili

Andrea Fiorillo

Suicide is a complex phenomenon that is now considered understood as a neurodevelopmental condition encompassing childhood experiences as well as proximal conditions such as mental disorders and adverse life events. Individuals in crisis may face overwhelming psychological pain, which in some cases may overcome the threshold of each unique individual for whom suicide is considered the best option to deal with such pain. However, many socio-demographic, personal, or temperamental variables have been investigated for their causal association with suicide risk, but to date no single factor has clearly demonstrated an association with suicide. The mental disorders most frequently associated with suicide risk include bipolar disorders and major unipolar depression, substance use disorders and schizophrenia. However, anxiety, personality, eating, and trauma-related disorders, as well as organic mental disorders, also contribute to suicidal risk. Moreover, in modern society, the presence of social uncertainty, the changes in family models, the development of social media, and the loss of face-to-face interaction can have an impact on suicide risk, particularly in the younger generation.

Preventing Suicide in Patients with Mental Disorders

Dinesh Bhugra

Umberto Volpe

Psychiatry in Practice: Education, Experience, and Expertise provides detailed advice and useful tips for early career psychiatrists, and all others who wish to enhance their practical psychiatry skills. Each chapter is written by prominent early career psychiatrists from around the world, offering relevant and timely advice to those who are newly qualified, as well as a global perspective on the practical issues faced today. Covering a variety of topics from 'Psychiatric Emergencies' to 'Ethics and clinical practice in psychiatry', chapters include vignettes of scenarios that may be encountered, making this book pertinent and easily applicable to many early career situations. Skills related to personal management and managing resources are often not taught during training but are key to establishing a career in psychiatry - this book will help the new clinician to develop professionally. The emphasis on practicality ensures psychiatrists are prepared for the needs of the modern health service and society at large, and ensures patients across the world experience the best treatment available.

Education, Experience, and Expertise

Psychiatry in Practice

Norman Sartorius

Mario Luciano

Patients with severe mental disorders (SMD), including major depression, bipolar disorder, schizophrenia and related spectrum disorders, have a reduced life expectancy of 10-25 year compared with the general population. This life expectancy gap is 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. Factors contributing to the reduced life expectancy can be grouped into three main categories: a) factors related to the patient; b) factors related to clinicians; and c) factors related to the health system. As regards the first group, patients with SMD often adopt unhealthy lifestyle behaviors, including heavy smoking, reduced physical activity, sedentary behaviors, poor diet and alcohol or drug abuse, and are reluctant to seek for physical care with GPs and other medical specialists. Increasing the levels of physical activity, improving the dietary patterns, and reducing the smoking habits of people with severe mental disorders represent a global health challenge and a public health priority. Until now, attempts made to reduce this mortality gap have acted at three different levels: health system level, physician level, and patient level. The third-level interventions include electronic alerts through smartphones and web-based platforms, intensive case management, promotion of healthy habits, complex psychosocial interventions. Several population-based studies have showed that lifestyle behaviors are amenable to change through the adoption of specific psychosocial interventions. However, most clinical guidelines, although emphasizing the importance of health monitoring and regular check-ups for patients with severe mental illnesses, do not make specific recommendations on the provision of lifestyle interventions. These lifestyle-oriented interventions, consisting of behavioral, educational, and psychological components, have been conducted mainly in research settings, and have shown a good impact on patients’ physical health. Despite this, their feasibility in routine settings has not been tested yet. It seems to be clinically and ethically relevant to develop, validate and carry out interventions to improve the 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 will summarize the available knowledge of the efficacy and effectiveness of psychosocial interventions aimed at improving healthy lifestyle behaviors and promoting the physical health of patients with severe mental disorders. Total number of articles: 19

Andrea Fiorillo

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