The Maudsley Prescribing and Practice Guidelines for Physical Health Conditions in Psychiatry (MGPH) aims to bridge the gap between psychiatric and physical health services for people with Severe Mental Illness (SMI), services which are usually geographically and organizationally separate. This will be achieved by providing psychiatric healthcare practitioners with an evidence-based practical guide to investigation and management of common physical health conditions in SMI, as well as guidance regarding appropriate referrals to medical subspecialties.

David M. Taylor, Ph.D., is Director of Pharmacy and Pathology at the Maudsley Hospital and Professor of Psychopharmacology at King’s College, London.  

Fiona Gaughran, M.D., is Director of Research at the South London and Maudsley NHS Foundation Trust, where she is Lead Consultant for the National Psychosis Service.    

Toby Pillinger, M.D. Ph.D., is an Academic Clinical fellow at the Institute of Psychiatry, Psychology and Neuroscience, King’s College London and South London and Maudsley NHS Foundation Trust. 

Cardiology

1. Chest pain

2. Tachycardia (elevated heart rate)

3. Hypertension (raised blood pressure)

4. Postural hypotension (fall in blood pressure on standing)

5. Peripheral edema (lower limb swelling)

6. Myocarditis and cardiomyopathy

7. QTc prolongation

8. Weight gain

9. Hypercholesterolemia (raised cholesterol)

Endocrinology

1. Diabetes Mellitus

2. Thyroid disease

3. Hyperprolactinemia and bone health

4. Diabetes Insipidus

Hematology

1. Anemia (low hemoglobin)

2. Neutropenia (low neutrophils)

3. Eosinophilia (raised eosinophils)

4. Thrombocytopenia (low platelets) and platelet dysfunction

5. Venous thromboembolic disease (deep vein thrombosis (DVT) and pulmonary embolus (PE)) and anticoagulation

Gastroenterology

1. Gastro-esophageal reflux disease

2. Dry mouth and hypersalivation

3. Gastrointestinal bleeding

4. Inflammatory bowel disease (IBD)

5. Irritable bowel syndrome (IBS)

6. Coeliac disease

7. Constipation

8. Diarrhea

9. Nausea and vomiting

10. Dysphagia (difficulty swallowing)

11. Deranged liver function tests & hepatitis

12. Alcohol

13. Weight loss

Renal/Genitourinary

1. Nocturnal enuresis (bedwetting)

2. Polyuria (excess urination)

3. Urinary retention

4. Derangements in sodium levels

5. Derangements in potassium levels

6. Chronic Kidney Disease (CKD)

7. Urinary Tract Infection (UTI)

8. Sexual Dysfunction

Dermatology

1. Rashes

2. Hair loss/gain

Infectious diseases

1. HIV and antiretroviral medications

2. Hepatitis B and C

3. Tuberculosis

4. Sexual health

5. Influenza

6. Gastroenteritis

Respiratory

1. Smoking

2. Chronic Obstructive Pulmonary Disease (COPD) (emphysema and chronic bronchitis)

3. Asthma

4. Pneumonia

5. Obstructive Sleep Apnea (OSA)

Neurology

1. Headache

2. Syncope (transient loss of consciousness)

3. Hearing loss and tinnitus

4. Delirium

5. Parkinsonism

6. Tremor

7. Seizures

8. Sleep disturbance

Rheumatology and Musculoskeletal

1. Elevated creatine kinase

2. Back pain

3. Arthritis

4. Systemic Lupus Erythematosus (SLE)

5. Sarcoid

6. Fibromyalgia

Ophthalmology

1. Common vision problems

2. Blurred vision

3. Glaucoma

4. Dry eyes

Emergencies

1. Acute Coronary Syndrome (ACS)

2. Tachycardia

3. Hypertensive crisis

4. Shortness of breath

5. Asthma

6. Sepsis

7. Acute Kidney Injury

8. Diabetic ketoacidosis (DKA) and Hyperglycemic Hyperosmolar State

9. Hypoglycemia

10. Gastrointestinal bleeding

11. Status epilepticus

12. Anaphylaxis

13. Coma

14. Thyroid emergencies

15. Addisonian crisis

16. Head injury

17. Meningitis

18. Stroke and Transient Ischemic Attack (TIA)

19. Overdose