The authors of this paper iterate the strong association
between sickness absences resulting from circulatory,
surgical and psychiatric diseases and increased mortality.
Further, they admit to being surprised by sickness absences
with a psychiatric diagnosis being predictive of cancer-
related mortality also.
Those of us who work in the so-called mental 'health' world
(in fact the mental illness one, in so far as the NHS and
social care interpret the term) are not in the least
surprised. The neurobiological and epigenetic study of
mental illnesses are now rapidly unravelling
strong and associative links between the traditionally
separated areas of mental and physical illness (and
health). For as long as we continue to follow the
Descartian Brick Road, we will continue to be surprised at
such associations and to develop and design education,
training and services that dissect the brainmind from the
rest of the body.
The immunological effects of severe psychiatric illnesses
such as schizophrenia, bipolar disorder and major
depression include effects on various lymphocyte and
cytokine responses. The discombobulating effects of not
having one's brainmind to process life clearly, obfuscate
our purposes even further. We may smoke and drink more and
are, by virtue of the psychiatric illness (and sometimes
its treatment, as with weight gian and diabetes), be
further placed at risk. Perhaps many people with so-called
'brittle' asthma or diabetes are people with 'normal'
diabetes and asthma leading brittle lives (many certainly
have psychiatric and psychological comorbidities).
As someone with a diagnosis of recurrent major depression,
I welcome this paper, since it adds to the weight of
evidence for addressing people's needs and not merely
endlessly assessing them. It is also to be hoped that the
QoF mechanism will continue to be harnessed to address this
vital area and enable at least some GPs to get their teeth
back into these issues (even if their fillings need to be
made of gold?)
Rapid Response:
Current certification - fit to work?
Dear Editor
The authors of this paper iterate the strong association
between sickness absences resulting from circulatory,
surgical and psychiatric diseases and increased mortality.
Further, they admit to being surprised by sickness absences
with a psychiatric diagnosis being predictive of cancer-
related mortality also.
Those of us who work in the so-called mental 'health' world
(in fact the mental illness one, in so far as the NHS and
social care interpret the term) are not in the least
surprised. The neurobiological and epigenetic study of
mental illnesses are now rapidly unravelling
strong and associative links between the traditionally
separated areas of mental and physical illness (and
health). For as long as we continue to follow the
Descartian Brick Road, we will continue to be surprised at
such associations and to develop and design education,
training and services that dissect the brainmind from the
rest of the body.
The immunological effects of severe psychiatric illnesses
such as schizophrenia, bipolar disorder and major
depression include effects on various lymphocyte and
cytokine responses. The discombobulating effects of not
having one's brainmind to process life clearly, obfuscate
our purposes even further. We may smoke and drink more and
are, by virtue of the psychiatric illness (and sometimes
its treatment, as with weight gian and diabetes), be
further placed at risk. Perhaps many people with so-called
'brittle' asthma or diabetes are people with 'normal'
diabetes and asthma leading brittle lives (many certainly
have psychiatric and psychological comorbidities).
As someone with a diagnosis of recurrent major depression,
I welcome this paper, since it adds to the weight of
evidence for addressing people's needs and not merely
endlessly assessing them. It is also to be hoped that the
QoF mechanism will continue to be harnessed to address this
vital area and enable at least some GPs to get their teeth
back into these issues (even if their fillings need to be
made of gold?)
Yours Sincerely
Dr Chris Manning
Competing interests:
None declared
Competing interests: No competing interests