Mens sana in corpore sano

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The Roman poet Juvenal coined the famous phrase when he wrote ‘Orandum est ut sit mens sana in corpore sano’ — You should pray for a healthy mind in a healthy body toàn thân — around the over of the first century AD. Nearly 2000 years later, we are still wrestling with dualism, struggling lớn understand the components of the biopsychosocial model of illness, và striving for parity of esteem between the sciences of the mind & biomedicine, slowly uncovering the immensely complicated relationships between mental & physical health và illness. In this issue of the BJGP, a number of articles approach this complex topic. The value of physical exercise in relieving the symptoms of arthritis & in reducing perinatal distress và postnatal depression seem clear, yet a survey of GPs suggests that the assessment of levels of activity, encouragement khổng lồ exercise, và the recording and management of overweight, all need to lớn be re-framed as bộ vi xử lý core components of many consultations.

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The editorial by Mark Ashworth & colleagues elegantly dissects the continuing challenge of maintaining và monitoring physical health in patients with severe mental illness (SMI), whose life expectancy is still shockingly inferior khổng lồ comparable people without mental health problems. They see a clear role here for primary care, commenting that:

‘The divided self may be a little less divided if patients with SMI can access more holistic care.’

Olga Kozlowska and her colleagues emphasise the need khổng lồ ‘close the gap’ between physical và mental health in people with another serious long-term medical problem — diabetes — & debate approaches khổng lồ doing so. Yerrakalva and Griffin, also in the Debate and Analysis section, begin a much overdue conversation about the health risks of sitting — the new smoking? — and consider how a brief intervention in primary care might work to lớn reduce sedentary behaviour. In Life &Times, Sir Muir Gray and Kenny Butler makes a robust case for more physical exercise for everyone and strongly recommends that practices, as well as patients, include an exercise programme in their daily schedules, using the Active 10 App.

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There is another, important related theme in this issue of the BJGP — the wellbeing of doctors. Two recent papers giảm giá with this. One is about the problems GPs face in seeking help when they run into trouble with mental health problems. The findings of the study would have surprised no-one 20 years ago but today are a real indictment of prevailing professional attitudes to lớn mental illness. The other is about resilience training; fashionable, sometimes poorly understood, và sometimes dismissed, which emphasises the need to tailor this essential tư vấn to the needs of the individual doctor, in the context of his or her practice, while at the same time trying to vì chưng something about a system which has created the need for it in the first place.

We also publish an abbreviated version of Clare Gerada’s 2017 William Pickles Lecture, A new kind of doctor, which reflects her long-standing & passionate concern for the wellbeing of the medical workforce, and the conditions in which they are sometimes forced khổng lồ work. It is essential reading, & concludes as follows:

‘The new kind of doctor must think about their own needs if they are going to lớn be able to do their best for patients. This is not about denying the needs of the patient. But self-sacrifice is no longer an option. It’s bad for doctors. & what’s bad for doctors is bad for patients too. When the system demands too much, the doctors of the future must be encouraged to lớn say “ No more!”.’

Also essential are some liên hệ details. If you or someone you know might need help with a mental health concern, including găng tay or depression, or an addiction problem, the GP Health Service (http://gphealth.nhs.uk/) & DocHealth, (dochealth.org.uk) supported by the BMA và the Royal Medical Benevolent Fund (RMBF, http://www.rmbf.org), are both entirely confidential và readily accessible. The RMBF provides packages of support in addition to lớn significant funding, & is mở cửa to all doctors, including refugee doctors & also lớn medical students in their final two clinical years.