Physical Comorbidity According to Diagnoses and Sex among Psychiatric Inpatients in South Korea

Abstract

People with mental disorders are susceptible to physical comorbidities. Mind–body interventions are important for improving health outcomes. We examined the prevalence of physical comorbidities and their differences by diagnoses and sex among psychiatric inpatients. The dataset, from National Health Insurance claims data, included 48,902 adult inpatients admitted to psychiatric wards for at least 2 days in 2016 treated for schizophrenia, schizotypal and delusional disorders, or mood disorders. We identified 26 physical comorbidities using the Elixhauser comorbidity measure. Among schizophrenia-related disorders, other neurological disorders were most common, then liver disease and chronic pulmonary disease. Among mood disorders, liver disease was most common, then uncomplicated hypertension and chronic pulmonary disease. Most comorbid physical diseases (except other neurological disorders) were more prevalent in mood disorders than schizophrenia-related disorders. Male and female patients with schizophrenia-related disorders showed similar comorbidity prevalence patterns by sex. Among patients with mood disorders, liver disease was most prevalent in males and third-most in females. In both diagnostic groups, liver disease and uncomplicated diabetes mellitus were more prevalent in males, and hypothyroidism in females. Mental health professionals should refer to a specialist to manage physical diseases via early assessments and optimal interventions for physical comorbidities in psychiatric patients.

Adherence of patients with schizophrenia to hypothyroidism treatment

“…Some studies suggest an association between disorders of the thyroid hormone and mental disorders (Bono et al, 2004; Davis and Tremont, 2007; Radhakrishnan et al, 2013; Remaud et al, 2014; Samuels, 2014). A South Korean study has found that the prevalence of hypothyroidism among schizophrenia patients is 4.9% (Park et al, 2021). A large US study has found that schizophrenia is associated with hypothyroidism (OR 1.88, 95% CI 1.51–2.32) as well as other substantial chronic medical burdens (Carney et al, 2006).…”

Nature and Extent of Physical Comorbidities Among Korean Patients With Mental Illnesses: Pairwise and Network Analysis Based on Health Insurance Claims Data

“…So far, studies on physical comorbidity have mainly focused on depression and SMIs. 12 They have emphasized the elevated risk of so-called lifestyle diseases, such as metabolic syndrome, cardiovascular diseases, and cerebrovascular accidents. The common data sources for existing studies were cohort studies, epidemiological catchment area survey or review of admission records.…”

“…2,4,22 Large-scale studies investigating comorbidity patterns are still scarce in Asia. 12 In this study, we sought clues to the following clinically relevant questions by analyzing the health insurance claims dataset in Korea: Is the physical comorbidity in psychiatric patients more extensive than in other disease categories? Which psychiatric diagnoses are associated most closely (or least closely) to physical conditions?…”

Integrating Electronic Health Records and Polygenic Risk to Identify Genetically Unrelated Comorbidities of Schizophrenia That May Be Modifiable

“…Underdiagnosis of comorbid conditions and delays in seeking medical care are important factors contributing to early mortality ( 7 ). Schizophrenia has been associated with a wide variety of comorbidities including cancer and diseases affecting most major organ systems such as endocrine, metabolic, respiratory, cardiovascular, digestive, neurological, musculoskeletal, genitourinary, and immunological ( 2 , 6 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ).…”