Individuals with severe mental illnesses are almost twice as likely to suffer from multiple physical health problems compared to those without such mental conditions, according to new research published in BMJ Mental Health. This finding sheds new light on the intricate relationship between mental and physical health.
Prior research has long suggested a complex link between mental health and physical well-being. However, understanding this relationship in depth, especially for those with severe mental health conditions, remained a challenge. Physical multimorbidity, which refers to the presence of two or more chronic health conditions in an individual, is a growing concern globally, particularly as it can significantly impact a person’s quality of life, healthcare needs, and overall well-being.
“Worldwide, mental health complications are among the top ten leading causes of health burdens,” study author Lee Smith, a professor of public health at Anglia Ruskin University, told PsyPost. “These complications are associated with an increased risk of physical illness, including, for example, diabetes mellitus, and gastrointestinal, cardiovascular, and respiratory diseases. Moreover, the prevalence of physical multimorbidity is expected to rise. Indeed, those with mental health complications may be at greatest risk.”
The researchers conducted a meta-analysis, a statistical method that combines the results of multiple studies to provide a more comprehensive understanding of a particular issue. Meta-analyses are particularly useful in healthcare research, as they help in drawing broader conclusions from various smaller studies, which might not be apparent when these studies are viewed in isolation.
In this case, the research team delved into a pool of over 1,200 studies, ultimately focusing on 19 articles that met their stringent criteria. These articles, which included a total of nearly 8 million participants (194,123 psychiatric patients and 7,660,590 control participants), ranged from cohort and case-control to cross-sectional studies.
People with severe mental illnesses, such as schizophrenia, bipolar disorder, and severe depression, were found to have a 1.84 times higher risk of experiencing physical multimorbidity compared to those without such mental health conditions.
This elevated risk translates to a significant burden on these individuals, often complicating their healthcare needs and affecting their life expectancy. The physical health problems identified ranged widely, including metabolic diseases like diabetes and obesity, hypertension, epilepsy, and serious conditions like cancer and heart disease.
What’s more, these associations were consistent across different regions, with studies from Europe, Asia, North America, and the Middle East all indicating a similar trend.
“Mental health underpins our individual and collective abilities to make decisions, build relationships, and shape the world we live in,” Lee said in a news release. “It is evident from our research that individuals with severe mental illness are at a significantly higher risk of experiencing physical multimorbidity.”
“This complex relationship between severe mental illness and physical multimorbidity has far-reaching implications, including decreased treatment compliance, increased risk of treatment failure, increased treatment costs, relapsing disease, worsening prognosis, and reduced life expectancy.”
“Poor clinical management of physical comorbidities in people with mental disorders exacerbates the issue, leading to an increased burden on individuals, their communities, and healthcare systems. A holistic approach is urgently needed to improve the physical, mental, and social outcomes of individuals dealing with severe mental illness and physical multimorbidity.”
However, it is essential for readers to understand the complexities and limitations of this research. One significant challenge was the diversity in the types of physical conditions considered across the studies, which introduced a degree of variability in the results. Moreover, due to the observational nature of the included studies, the research couldn’t definitively establish a cause-and-effect relationship between severe mental illness and physical multimorbidity.
Future research, therefore, needs to focus on more homogeneous studies and delve deeper into understanding the mechanisms that drive this association. This could include exploring genetic factors, the impact of long-term medication use, and lifestyle factors associated with mental illness.
“We believe it would be desirable to adopt a sectorial approach, focusing on common groups of diagnoses in order to facilitate thematic working groups, to consider specific service needs and to design the best approach for mental health patients,” Lee said.
Despite these limitations, the study is a crucial step forward in understanding the intertwined nature of mental and physical health. It highlights an urgent need for an integrated approach to healthcare, where the treatment of severe mental illnesses is not isolated from the management of physical health conditions. Such an approach can lead to more effective and holistic care, improving the life quality and outcomes for patients.
“The present research highlights the link between severe mental illness and physical multimorbidity,” Lee told PsyPost. “Thus, a multidisciplinary approach for those with severe mental illness and physical multimorbidity is now urgent to improve physical, mental and social outcomes.”
The study, “Relationship between severe mental illness and physical multimorbidity: a meta-analysis and call for action“, was authored by Damiano Pizzol, Mike Trott, Laurie Butler, Yvonne Barnett, Tamsin Ford, Sharon A.S. Neufeld, Anya Ragnhildstveit, Christopher N. Parris, Benjamin R. Underwood, Guillermo Felipe López Sánchez, Matt Fossey, Carol Brayne, Emilio Fernandez-Egea, Guillaume Fond, Laurent Boyer, Jae Il Shin, Shahina Pardhan, and Lee Smith.