Chronic Medical Problems in the Chronic Mentally Ill

The findings of our study support previous reports documenting a high rate of chronic medical illness among the chronic mentally ill. More than 42 percent of CSP clients were reported to have at least one chronic medical problem severe enough to limit functioning. This finding was not attributable to age.

The data indicate that different psychiatric groups have different needs that must be considered when planning possible interventions. The medical problems associated with OBS and retardation are so much a part of these syndromes that prevention efforts would have to focus on the psychiatric disorder itself. However, the high rate of illness from medication side effects might be prevented by more careful treatment regimens (8).

The clients categorized as having other nonpsychotic disorders are the most puzzling. Research needs to be done on the link between limiting medical conditions and a "career" as a chronic mental patient (7). Longitudinal data are required to understand the complex interaction between limiting medical conditions and less severe psychiatnic disorders that result in outcomes as disabling as those associated with psychoses.

Other studies have offered recommendations to help assure that the chronic mentally ill receive adequate medical care (1-4). Psychiatrists need to become adept at caring for physical illness, and primary care physicians need to acquire skill in caring for the mentally ill. Service systems like the community support program that link medical and mental health care are essential in moving toward those goals. To increase efforts toward primary prevention, we need a betten understanding of the interrelationship between physical and psychiatnic illnesses. However, efforts geared toward primary prevention will probably require a far better understanding of the part physical illness plays in persons' becoming or remaining mentally ill.