Women have a key role in managing their own and their family's health. This chapter outlines some of the factors that affect women's health and recommends ways to improve it.

Women's health

In the UK, life expectancy has risen over the past 100 years. In part, this is due to better disease prevention and improved detection and treatment of diseases. In 2016, the average life expectancy of a 65-year-old woman rose to 86 years (Public Health England, 2016). Life expectancy tends to be greater in more affluent areas than in poorer areas. Causes of death in the UK vary with age group. In women aged 20–34 years the leading cause of death is suicide (12% of deaths); in ages 35–49 years it is breast cancer (14% of deaths) and in women over 80 years it is dementia (17% of deaths) (ONS, 2015).

Compared with men, women tend to be shorter, have less muscle mass and blood, and have smaller lung, liver and kidney capacities. This means that women are more sensitive to the harmful effects of smoking and alcohol, and side-effects of medicine. Reproductive health plays a part, too. Young women are more at risk of sexually transmitted diseases. On the positive side, rates of teenage pregnancy have recently fallen to their lowest recorded levels (ONS, 2017).

Linking physical and mental health

Physical conditions can cause mental health problems

It is essential to discover whether a physical condition is causing a mental problem or illness, because the treatment will be different. For example, is some medicine taken to treat severe acne causing a young person's depression? Is an overactive thyroid gland causing anxiety and weight loss? Is depression and psychosis due to an underactive thyroid gland? Is delirium causing a confused state or does the person have dementia, or both conditions? Simple blood tests can be used to screen for many of the physical causes of mental health conditions.

Mental health conditions can worsen physical health

In the UK, 30% of those with long-term physical conditions also have mental health conditions (4.6 million people) (Naylor et al, 2012). For instance, depression can complicate illnesses such as diabetes mellitus. Depression increases the risk threefold that a patient will not take their medical treatment (Di Matteo et al, 2000) which would compromise their recovery.

Physicians and psychiatrists have written this book, to cover the essential physical health topics that are most relevant to people with mental disorders and intellectual disabilities.

Of course, it is not possible to cover every eventuality, physical condition or disability in this book, but Essentials of Physical Health in Psychiatry will help you to increase your knowledge, and confidence, in managing at least some of the more common physical conditions that your patients may develop. In addition, we hope that Essentials of Physical Health in Psychiatry will stimulate you to read in more depth.

Finally, our authors, experts in their respective fields, have provided guidance on when to seek help from medical specialist colleagues; with their advice, this will enable psychiatrists and psychiatric nurses to care for the physical as well as mental health of their patients, whether in an institution or in the community.