Comorbidity of mental and physical disorders: a key problem for medicine in the 21st century

Sartorius, Norman

doi:10.1111/acps.12888

Cited by 41 publications

(30 citation statements)

References 6 publications

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“…Alternatively, they may use pain medications to alleviate their mental health symptoms, or indeed have a physiological dependence on pain medications. Pain is a commonly reported reason for self-harm, and there is emerging evidence for the links between mental illness and physical conditions including pain and inflammation generally (Rizvi et al, 2017, Sartorius, 2018. Whilst further research is required to extrapolate the associations between suicidal behaviour and pain, the current findings indicate a need for health care providers to exercise vigilance and ask people with pain related conditions, or who use medication for pain, about suicidal thoughts.…”

Section: Discussionmentioning

confidence: 80%

“…In the current study we considered pain medications specifically, as pain (physical and psychological) has been linked to increased risk of suicidal thoughts and behaviours via many routes (Calati et al, 2015, Elman et al, 2013, Rizvi et al, 2017, Verrocchi et al, 2016. Firstly, epidemiological studies suggest that mental disorders and physical disorders (including chronic pain conditions) are highly comorbid (Sartorius, 2018). Patients with common mental disorders, such as depression and anxiety often first present to primary care with physical symptoms characterised by pain (Escobar et al, 2006).…”

Section: Control Studymentioning

confidence: 99%

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Prescribed pain and mental health medication prior to suicide: A population based case control study

O’Neill

Graham

Ennis

2019

Journal of Affective Disorders

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Background; Information about prescription medications prior to death by suicide may help us understand the role of medications, illness and service contact in suicide. Aims; Through the use of a novel dataset, this study aims to provide an improved understanding of the relationships between pain medication and mental health medication, suicide and area level deprivation. Methods; Data was included on all deaths by suicide in NI (Northern Ireland) between 1/1/2012 and 31/12/2015. Each death was matched to 5 live controls, based on age (the closest match within two years) and gender, resulting in a dataset consisting of 6630 individuals. Four data sources were linked to obtain the final dataset. Results; Suicide linked with and deprivation, with a heightened risk of suicide for 9 months after last prescription of pain medication and for up to two years after last prescription of mental health medication. Odds ratios for death by suicide were strongest among those with the most recent prescriptions (within 0-3 months) (OR for death by suicide=12.20 amongst those with mental health prescription medication; OR for death by suicide=3.69 amongst those with pain medication). These figures support the associations between suicide and pain related conditions, and physical health difficulties. Recent prescriptions are particularly important. Limitations; Received medication prescriptions may not have been taken as recommended. Conclusions; Contact with a clinician to obtain a prescription may present opportunities for intervention. Suicide assessment (and evidence-based suicide specific treatments) may be important for people who are receiving prescribed medication, particularly for a mental illness. Highlights  Odds ratios for death by suicide linked to recency of prescription  Links were for both mental health medications and pain medications  Suicide is more likely in areas that are more deprived  Clinician contact to obtain prescription may allow intervention

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Section: Discussionmentioning

confidence: 80%

Section: Control Studymentioning

confidence: 99%

Prescribed pain and mental health medication prior to suicide: A population based case control study

O’Neill

Graham

Ennis

2019

Journal of Affective Disorders

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“…Moreover, psychiatric patients infected with COVID-19 can be exposed to greater barriers in obtaining timely health services. 12 People with psychiatric conditions usually have an increased risk to develop medical comorbidities than the general population such as cardiovascular disease, diabetes mellitus, hypertension, chronic lung disease. 13 Such conditions have been associated with more severe evolution and higher mortality risk in COVID-19 patients.…”

Section: Outbreak and Patients With Psychiatric Diseasementioning

confidence: 99%

COVID-19 outbreak and impact on mental health and psychiatric services

Fraticelli¹,

Alamia²,

Guanella³

2020

Emerg Care J

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“…Comorbidity is one of the most important challenges to modern-day psychiatry and medicine. 22 There is growing interest among researchers and practitioners in the influence of comorbidity on health-care utilization. 23 Whereas, the relationship between somatic comorbidity and psychiatric rehospitalization is still poorly understood phenomenon.…”

Section: Introductionmentioning

confidence: 99%

<p>Physical Comorbidities are Independently Associated with Higher Rates of Psychiatric Readmission in a Chinese Han Population</p>

Yang¹,

Zhong²,

Zhou³

et al. 2020

NDT

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Background In people with psychosis, physical comorbidities are highly widespread and leading contributors to the untimely death encountered. Readmission rates in psychiatric patients are very high. Somatic comorbidities could be one of the considerable risk factors for psychiatric rehospitalization. Nevertheless, much less is known about the relation between physical comorbidities and psychiatric readmission. We aimed to investigate the association between physical comorbidities and psychiatric readmission in Han Chinese patients with psychiatric disorders. Methods We used administrative data for January 1, 2009 to December 31, 2018 from the headquarters of the Affiliated Brain Hospital of Guangzhou Medical University to identify adults with schizophrenia, unipolar depression or bipolar disorder discharged from hospital. Data were extracted on sociodemographic and clinical characteristics. The Charlson comorbidity index (CCI) was used to assess the existence of significant physical comorbidity. Cox proportional hazards regression estimated rehospitalization risk after discharge. Results A total of 15,620 individuals were included in this study, with the mean age of 35.1 years (SD = 12.8), and readmission occurred for 23.6% of participants. Survival analysis showed that physical comorbidities were statistically and significantly associated with psychiatric readmission, even after the adjustment for the number of psychiatric comorbidities, other sociodemographic and clinical variables. Conclusion Our results suggest that somatic comorbidities are related with higher rates of psychiatric readmission. Hence, to treat psychosis more effectively and to reduce rehospitalization, it is crucial to treat physical comorbidities promptly and adequately. It is absolutely necessary to bring somatic comorbidities to the forefront of psychiatric treatment and research.

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Comorbidity of mental and physical disorders: a key problem for medicine in the 21st century

Cited by 41 publications

References 6 publications

Prescribed pain and mental health medication prior to suicide: A population based case control study

Prescribed pain and mental health medication prior to suicide: A population based case control study

COVID-19 outbreak and impact on mental health and psychiatric services

<p>Physical Comorbidities are Independently Associated with Higher Rates of Psychiatric Readmission in a Chinese Han Population</p>

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