Physical health in affective disorders: a narrative review of the literature

Abstract

This article reviews the most common non-psychiatric comorbidities associated with affective disorders, examining the implications of their possible bidirectional link. A narrative review was conducted on the association among the three most common non-psychiatric diseases in major depressive disorder and bipolar disorder (obesity, metabolic syndrome, and cardiovascular diseases) in articles published from January 1994 to April 2020. The evidence suggests that obesity, metabolic syndrome, and cardiovascular diseases are highly prevalent in patients diagnosed with affective disorders. The presence of non-psychiatric comorbidities significantly worsens the therapeutic management and prognosis of affective disorders and vice versa. In many cases, these comorbidities may precede the onset of affective disorders, although in most cases they appear after it. The presence of these concurrent non-psychiatric diseases in an individual diagnosed with an affective disorder is associated with a more complex disease presentation and management. For professionals, the evidence unequivocally supports routine surveillance of comorbidities from a multidisciplinary approach.

Physical Health and Transition to Psychosis in People at Clinical High Risk

“…There are several reasons to promote good physical health and lifestyles during the CHR-P phase. As discussed above, a large proportion of CHR-P subjects develop comorbid disorders (e.g., mood, anxiety) at various stages [ 9 ], which are also correlated with physical health deterioration [ 28 ]. Second, in CHR-P individuals who will transition to psychosis, adopting a preventative approach in the earliest stage is associated with better long-term outcomes [ 29 ], as psychosis is frequently associated with a wide range of comorbid and multiple physical health illnesses [ 30 ] and often progresses to chronic, severe conditions [ 31 ].…”

Efficacy of Psychosocial and Psychological Interventions in Addition to Drug Therapy to Improve Global Functioning of Inpatients with Schizophrenia Spectrum and Mood Disorders: A Real-World Observational Study

“…In addition, patients with major depressive disorder and bipolar disorder show increased risk of developing obesity, metabolic syndrome, and cardiovascular disease, and in general higher morbidity and mortality, significantly worsening the therapeutic management and prognosis of affective disorders, due to greater treatment resistance, lower recovery rates, and worse course of illness. 15 Assessing prevalence and burden estimates from the Global Burden of Disease study 2019, mental disorders accounted for 654.8 million estimated cases (95% UI 603.6-708.1) in 1990 and 970.1 million cases (900.9-1044.4) in 2019, corresponding to an increase of 48.1% between 1990 and 2019. 16 The term "rehabilitation" has been used in mental health to describe a range of different approaches and interventions aimed at providing a recovery-orientated approach helping patients to progress from more intensive support to greater independence, to improve in functioning and quality of life through rehabilitation.…”

Metabolic Syndrome in Affective Disorders: Associations with Dark Triad Personality Traits

“…Compared to mentally healthy individuals, individuals with AD tend to have a lower life expectancy [ 1 , 2 ], which is reattracted to increased suicidality and low socioeconomic status [ 3 , 4 ] but also to a higher prevalence of somatic comorbidities. Along with cardiovascular diseases, metabolic syndrome (MetS) is one of the most common somatic problems in AD [ 5 ].…”