The onset and accumulation of physical multimorbidity in severe and common mental disorders

Abstract

Purpose of review Despite of the heightened risks and burdens of physical comorbidities across the entire spectrum of mental disorders, relatively little is known about physical multimorbidity in this population. The aim of this narrative review is to present recent data regarding the onset and accumulation of physical multimorbidity and to assess its impact on the onset, course, treatment, and outcomes of mental disorders. Recent findings A substantial body of literature shows increased risk of physical multimorbidity among people with mental disorders. The disparity in physical multimorbidity occurs even before the diagnosis of mental disorder, and the younger age group appears to be at particular risk. Numerous patterns of association between mental disorders and medical disorders involving multiple organ systems have been identified. Physical multimorbidity affects people with mental disorders across their life spans, is associated with a wide range of unfavorable outcomes and presents significant clinical and public health concerns. Summary To address physical health inequalities among people with mental disorders compared with the general population, we must focus on the physical health from the very first point of contact with a mental health service. Treatment of mental disorders must be customized to meet the needs of patients with different physical multimorbidity patterns. Future work is needed to clarify how physical multimorbidity influences mental disorder treatment outcomes.

Metabolic Syndrome in Patients of a Psychosocial Care Center in Brazil: A Cross-Sectional Study

“…The high prevalence of MS and obesity, as previously described, should serve as an alert for better clinical monitoring of individuals with mental illness, so this study demonstrates its relevance to promote a local diagnosis of these individuals' metabolic illness, which is reinforced by the literature [18]. Thus, the occurrence of MS is a marker of multimorbidity, which despite being a recent concept, has been described as more prevalent among individuals with mental illness when compared to the general population [32] and is associated with polypharmacy and worse outcomes in the population with mental illness [33].…”

Sex Differences in Comorbidity Combinations in the Swedish Population

“…Research into shared and modifiable risk factors of frequent (sex-specific) comorbidity patterns is important for prevention and improving clinical care. Based on the high observed mental–physical comorbidity, the need for better integration of mental and physical health care services is apparent, as discussed by others [ 28 , 29 , 33 ]. Interacting effects between comorbid conditions on the respective treatment and prognosis can render the clinical management of patients with co-/multimorbidity more complex [ 2 , 33 , 124 ].…”

“…Another increasingly recognized problem is the high comorbidity between psychiatric conditions and physical diseases [ 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. The diagnosis of comorbid psychiatric disorders in chronic physical illness can be difficult [ 25 , 26 , 27 ], and interactions between mental-physical comorbidity can negatively affect the respective treatment outcomes [ 24 , 28 , 29 , 30 ]. Excess mortality in people with mental illness across different diagnostic groups [ 31 ] is largely related to comorbid medical diseases [ 32 ], for which they are less likely to receive standard treatment [ 19 , 33 ].…”

Pandemics and Mental Health: an Unfortunate Alliance

“…Mental illness remains one of the leading causes of disability in the USA, reinforcing the need for early detection, timely behavioral and psychopharmacological therapy, and consistent follow-up [1]. According to the National Institute of Mental Health (NIMH), 57.7 million people over the age of 18 (26.2% of the population) suffer from a diagnosable mental health disorder in any given year.…”