Physical-mental health comorbidity: A population-based cross-sectional study

Abstract

Background Multimorbidity is associated with physical-mental health comorbidity (PMHC). However, the scope of overlap between physical and mental conditions, associated factors, as well as types of mental illness involved are not well described in Eastern Europe. This study aims to assess the PMHC burden in the Estonian population. Methods In this population-based cross-sectional study we obtained health claims data for 55 chronic conditions from the Estonian Health Insurance Fund (EHIF) database, which captures data for all publicly insured individuals (n = 1 240 927 or 94.1% of the total population as of 31 December 2017). We assessed the period-prevalence (3 years) of chronic physical and mental health disorders, as well as associations between them, by age and sex. Results Half of the individuals (49.1% (95% CI 49.0–49.3)) had one or more chronic conditions. Mental health disorders (MHD) were present in 8.1% (8.1–8.2) of individuals, being higher among older age groups, women, and individuals with a higher number of physical conditions. PMHC was present in 6.2% (6.1–6.2) of the study population, and 13.1% (13.0–13.2) of the subjects with any chronic physical disorder also presented with at least one MHD. Dominating MHDs among PMHC patients were anxiety and depression. The prevalence of MHD was positively correlated with the number of physical disorders. We observed variation in the type of MHD as the number of physical comorbidities increased. The prevalence of anxiety, depression, and mental and behavioral disorders due to the misuse of alcohol and other psychoactive substances increased as physical comorbidities increased, but the prevalence of schizophrenia and dementia decreased with each additional physical disease. After adjusting for age and sex, this negative association changed the sign to a positive association in the case of dementia and mental and behavioral disorders due to psychoactive substance misuse. Conclusions The burden of physical-mental comorbidity in the Estonian population is relatively high. Further research is required to identify clusters of overlapping physical and mental disorders as well as the interactions between these conditions. Public health interventions may include structural changes to health care delivery, such as an increased emphasis on integrated care models that reduce barriers to mental health care.

Social determinants of anxiety and mood disorders in a nationally-representative sample – Results from the Saudi National Mental Health Survey (SNMHS)

“…Specifically, participants with a higher number of physical conditions exhibited greater odds of experiencing anxiety and/or mood disorders. Our results agreed with the existing literature that offers insights into various mechanisms through which physical and mental health mutually influence each other, including pain, worry, functional limitations, and lifestyle modifications (Baghdadi et al, 2021; Gabilondo et al, 2012; Jurisson et al, 2021; Scott et al, 2016; Tsang et al, 2008). These findings hold particular significance within the Saudi context for two main reasons.…”

Physical condition and activity of daily living among aging inpatients with mental disorders in Guangzhou, China: a cross‐sectional study

“…The highest prevalence of somatic comorbidities among participants in this study was CVD, predominantly hypertension and coronary heart disease. Notably, the prevalence of comorbidities in this study was substantially higher than in a population‐based cross‐sectional study (13.1%) 27 . Another large sample study reported that the prevalence of multimorbidities substantially increased with age and was present in most people aged 65 years and older 28 .…”

“…Notably, the prevalence of comorbidities in this study was substantially higher than in a populationbased cross-sectional study (13.1%). 27 Another large sample study reported that the prevalence of multimorbidities substantially increased with age and was present in most people aged 65 years and older. 28 Hypertension, chronic lung disease, and the number of comorbidities were associated with hospital readmissions in PMI, according to the results of a systematic review.…”

Initiative to improve handover notes in a tertiary psychiatric hospital

“…Junior doctors have shared dissatisfaction with handover arrangements within mental health hospitals 9. Meanwhile, the complexity of psychiatric disorders has been escalating,10–12 and load of physical and mental health comorbidities has been growing 13 14. There arises a necessity to apply equally robust clinical handover practices within inpatient psychiatric settings.…”