Severe mental illness (SMI) encompasses depression, bipolar disorder, and schizophrenia which affect the daily quality of life. While it has a significant impact on their social life, it is also supposedly linked with various comorbidities, of which, cardiovascular disease (CVD) is the most frequently reported. Various biological, behavioral, and genetic mechanisms are thought to play a role: hypothalamic-pituitary-adrenal axis, autonomic nervous system dysregulation, inflammation, and psychotropic medications. Lack of exercise, low-fiber diet, smoking, substance abuse, and failure of medicine compliance also strongly contribute to the increased risk for CVD-related death. The understanding of the complex relationship between CVD and SMI would thus play a significant role in decreasing the incidence of CVD-related morbidity and mortality. This article aims to review and explain the hypothesized increased risk of CVD events in patients with SMI.
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