2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T80f,Adults with severe mental illness (SMI) face a 10- to 20-year reduction in life expectancy, largely due to heightened cardiometabolic diseases. Low levels of physical activity (PA) and prolonged sedentary behavior (SB) are modifiable risk factors that contribute to this mortality gap. Although strong evidence demonstrates that PA is safe and effective in improving psychiatric and physical outcomes, systematic integration into clinical practice remains limited. Individuals with SMI are among the most physically inactive groups in society, often spending more than 10 hours per day sedentary and rarely meeting recommended PA recommendations. Low PA and high SB exacerbate neuroinflammatory, neuroendocrine, and cardiometabolic pathways implicated in psychiatric morbidity. Recent meta-analyses show that structured PA, that is, exercise, produces moderate to large reductions in depressive and psychotic symptoms, as well as benefits for cognition, quality of life, and cardiometabolic health. Evidence also suggests that mentally passive SB, such as prolonged television viewing, are associated with poorer mental health outcomes. Physical activity should be individualized to each person's capabilities and preferences, emphasizing forms they find enjoyable. Two sessions of strength training weekly are advised, and greater mental health benefits typically arise from leisure or active travel PA. To guide translation into care, the 5A framework (Ask, Assess, Advise, Assist, Arrange) provides a structured, pragmatic approach: clinicians can screen for PA and SB, assess readiness and safety, provide tailored advice, support motivation and goal setting, and arrange follow-up, referral, and community support. PA should be considered a core component of psychiatric care. By systematically promoting PA and reducing prolonged SB through structured clinical frameworks, psychiatrists and other mental health professionals can improve symptoms, enhance physical and cognitive health, and help narrow the life expectancy gap experienced by people with SMI.31:Ta14, Importance Adults with severe mental illness (SMI) face a 10- to 20-year reduction in life expectancy, largely due to heightened cardiometabolic diseases. Low levels of physical activity (PA) and prolonged sedentary behavior (SB) are modifiable risk factors that contribute to this mortality gap. Although strong evidence demonstrates that PA is safe and effective in improving psychiatric and physical outcomes, systematic integration into clinical practice remains limited. Observations Individuals with SMI are among the most physically inactive groups in society, often spending more than 10 hours per day sedentary and rarely meeting recommended PA recommendations. Low PA and high SB exacerbate neuroinflammatory, neuroendocrine, and cardiometabolic pathways implicated in psychiatric morbidity. Recent meta-analyses show that structured PA, that is, exercise, produces moderate to large reductions in depressive and psychotic symptoms, as well as benefits for cognition, quality of life, and cardiometabolic health. Evidence also suggests that mentally passive SB, such as prolonged television viewing, are associated with poorer mental health outcomes. Physical activity should be individualized to each person’s capabilities and preferences, emphasizing forms they find enjoyable. Two sessions of strength training weekly are advised, and greater mental health benefits typically arise from leisure or active travel PA. To guide translation into care, the 5A framework (Ask, Assess, Advise, Assist, Arrange) provides a structured, pragmatic approach: clinicians can screen for PA and SB, assess readiness and safety, provide tailored advice, support motivation and goal setting, and arrange follow-up, referral, and community support. Conclusions and Relevance PA should be considered a core component of psychiatric care. By systematically promoting PA and reducing prolonged SB through structured clinical frameworks, psychiatrists and other mental health professionals can improve symptoms, enhance physical and cognitive health, and help narrow the life expectancy gap experienced by people with SMI. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Severe Mental Illness: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Severe Mental Illness (condition). Clinician-written summaries and actionable practice insights. 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sex-based generalizability is uncertain.","value_numeric":null},{"paper_doi":"10.1111/bdi.70176","tag_type":"warning","value":"Extremely small sample (n=2); all themes are hypothesis-generating only and should not be used to draw clinical conclusions about BD patients broadly.","value_numeric":null},{"paper_doi":"10.1111/bdi.70176","tag_type":"warning","value":"Study does not fall under Dutch medical ethics review requirements—no formal ethics committee approval was obtained, though informed consent was collected per Declaration of Helsinki.","value_numeric":null}],"summaries":{"what_studied":"Semi-structured interviews with two adults diagnosed with bipolar disorder (BD) who independently used ChatGPT (GPT-4o) for self-reflection, symptom management, and emotional support; thematic analysis explored perceived utility and risks.","key_result":"Both participants shifted trust away from mental health professionals toward ChatGPT, perceiving it as more understanding and nonjudgmental; attachment patterns differed by clinical stability—the more vulnerable individual (Person B) developed emotionally intimate, anthropomorphized interactions and explicitly deprioritized clinician input when it conflicted with AI responses, while the more stable individual (Person A) maintained reflective distance.","limitations":"- Only 2 participants; 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meta-analyses, with additional benefits for cognition, quality of life, and cardiometabolic health; adults with SMI often spend >10 hours/day sedentary and rarely meet PA recommendations.","limitations":"This is a narrative review/viewpoint without a systematic search protocol or primary data; effect sizes cited are drawn from external meta-analyses rather than original trial data; implementation barriers (e.g., staffing, resources) are discussed qualitatively without formal evaluation.","practice_takeaway":"Use the 5A framework to screen, advise, and arrange PA support for every patient with SMI — two weekly strength-training sessions and leisure or active-travel PA are practical starting targets. 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