Many individuals with mental health problems have comorbid physical conditions, or may present with substance/alcohol misuse or abuse issues. This results in complex treatment challenges that may not be adequately addressed by a model of care that is solely delivered by an individual clinician using a sole intervention. Mainstream pharmacotherapeutic treatment of mental health problems often have limited effectiveness in completely resolving symptoms, and may cause adverse side effects. Adjunctive treatment approaches, including nutraceuticals, lifestyle and behaviour change interventions, are widely used to assist with treatment of mental health problems. However, whilst these can be generally safer with fewer side effects, they have varying levels of evidentiary support. These circumstances warrant reframing the current treatment approach towards a more evidence-based integrative model which may better address the real-world challenges of psychiatric disorders and comorbid physical conditions. In essence, this means developing an integrative model of care which embodies an evidence-informed, personalized stepwise approach using both conventional pharmacological treatments alongside novel adjunctive treatments (where applicable) via the application of a collaborative care approach. In order to inform this position, a brief review of findings on common patterns of comorbidity in mental illness is presented, followed by identification of limitations of conventional treatments, and potential applications of integrative medicine interventions. Advantages and challenges of integrative mental health care, collaborative models of care, review of research highlights of select integrative approaches, and comment on potential cost advantages are then discussed. We propose that a collaborative care model incorporating evidence-based integrative medicine interventions may more adequately address mental health problems with comorbid medical conditions. Robust research is now required of such a model, potentially within an integrative clinical practice.

中文翻译：

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精神疾病和身体合并症患者的综合协作护理模型

许多有精神健康问题的人患有合并疾病，或者可能出现物质/酒精滥用或滥用问题。这导致了复杂的治疗挑战，而仅由单个临床医生仅通过单独干预提供的护理模型可能无法充分解决这些挑战。精神健康问题的主流药物治疗通常不能完全缓解症状，效果有限，并且可能引起不良副作用。辅助治疗方法，包括营养保健品，生活方式和行为改变干预措施，被广泛用于协助治疗心理健康问题。然而，尽管这些药物通常更安全，副作用更少，但它们具有不同水平的证据支持。这些情况需要将当前的治疗方法改组为基于证据的整合模型，该模型可以更好地应对精神疾病和合并症的现实世界挑战。从本质上讲，这意味着要开发一种综合的护理模型，该模型通过协作护理方法的应用，将常规药理学疗法与新型辅助疗法（如适用）结合起来，体现出循证告知，个性化的逐步治疗方法。为了阐明这一立场，我们简要回顾了有关精神疾病合并症常见模式的发现，然后确定了常规治疗的局限性以及中西医结合的潜在应用。综合精神卫生保健的优势和挑战，然后讨论了护理的协作模型，对某些综合方法的研究重点的回顾以及对潜在成本优势的评论。我们建议，结合基于证据的中医干预措施的合作医疗模式可以更充分地解决合并病情况下的精神健康问题。现在需要在集成临床实践中对这种模型进行强大的研究。