Physical-mental multimorbidity in children and youth: a scoping review

Romano, Isabella; Buchan, Claire; Baiocco-Romano, Leonardo; Ferro, Mark A.

doi:10.1136/bmjopen-2020-043124

Cited by 26 publications

(11 citation statements)

References 45 publications

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“… 16 Adolescents presenting or admitted to hospital for self-harm are in turn at increased risk of premature death from suicide but also from other causes including natural causes and accidents. 17 18 Mental disorders are indeed frequently comorbid with physical disorders, even at a young age, 19 and are associated with an increased risk of death from so-called ‘natural causes’. 20 Therefore, self-harm, somatic disorders and premature mortality from various causes all contribute to the high burden of mental disorders.…”

Section: Introductionmentioning

confidence: 99%

Self-harm, somatic disorders and mortality in the 3 years following a hospitalisation in psychiatry in adolescents and young adults

Jollant

Goueslard²,

Hawton

et al. 2022

Evid Based Mental Health

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BackgroundThere is limited recent information regarding the risk of self-harm, somatic disorders and premature mortality following discharge from psychiatric hospital in young people.ObjectiveTo measure these risks in young people discharged from a psychiatric hospital as compared with both non-affected controls and non-hospitalised affected controls.MethodsData were extracted from the French national health records. Cases were compared with two control groups. Cases: all individuals aged 12–24 years, hospitalised in psychiatry in France in 2013–2014. Non-affected controls: matched for age and sex with cases, not hospitalised in psychiatry and no identification of a mental disorder in 2008–2014. Affected controls: unmatched youths identified with a mental disorder between 2008 and 2014, never hospitalised in psychiatry. Follow-up of 3 years. Logistic regression analyses were conducted with these confounding variables: age, sex, past hospitalisation for self-harm, past somatic disorder diagnosis.FindingsThe studied population comprised 73 300 hospitalised patients (53.6% males), 219 900 non-affected controls and 9 683 affected controls. All rates and adjusted risks were increased in hospitalised patients versus both non-affected and affected controls regarding a subsequent hospitalisation for self-harm (HR=105.5, 95% CIs (89.5 to 124.4) and HR=1.5, 95% CI (1.4 to 1.6)), a somatic disorder diagnosis (HR=4.1, 95% CI (3.9–4.1) and HR=1.4, 95% CI (1.3–1.5)), all-cause mortality (HR=13.3, 95% CI (10.6–16.7) and HR=2.2, 95% CI (1.5–3.0)) and suicide (HR=9.2, 95% CI (4.3–19.8) and HR=1.7, 95% CI (1.0–2.9)).ConclusionsThe first 3 years following psychiatric hospital admission of young people is a period of high risk for self-harm, somatic disorders and premature mortality.Clinical implicationsAttention to these negative outcomes urgently needs to be incorporated in aftercare policies.

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Section: Introductionmentioning

confidence: 99%

Self-harm, somatic disorders and mortality in the 3 years following a hospitalisation in psychiatry in adolescents and young adults

Jollant

Goueslard²,

Hawton

et al. 2022

Evid Based Mental Health

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“…In Australia, 60–72% of children aged 2–15 years are experiencing an ongoing health condition; commonly obesity, asthma, and eczema [ 3 ] or mental health conditions such as Attention-Deficit/Hyperactivity Disorder (ADHD), anxiety disorders and depression [ 4 ]. These physical and mental health problems frequently co-occur [ 5 , 6 ], defined as physical–mental multimorbidity [ 7 ], however, our understanding of the quality of life of children with physical–mental multimorbidity remains limited in comparison to our understanding in adults [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, others have found no significant association between HRQoL and comorbid physical health problems after accounting for the relationship with existing mental health problems [ 20 ]. Most existing studies focus on multimorbidity within a single physical health disorder (most commonly epilepsy, asthma or allergies); and most estimates were based on small, observational studies from North America and Europe [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

The relationship between physical and mental health multimorbidity and children’s health-related quality of life

et al. 2022

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Purpose To examine the relationships between physical health problems, and borderline or clinical levels of mental health symptoms and children’s health-related quality of life (HRQoL). Methods Data were from the Longitudinal Study of Australian Children (2004–2018). Parents reported on their child’s HRQoL (PedsQL), physical health problems and mental health symptoms (Strengths and Difficulties Questionnaire, SDQ). A pooled cross-sectional analysis using linear regressions examined the relationships between physical health and clinical/borderline mental health symptoms, individually and when multi-morbid, and children’s HRQoL, and whether these relationships vary by a range of child, family and social factors. Results The sample comprised 47,567 observations of children aged 4–17 years. Borderline and clinical levels of mental health symptoms were associated with significantly lower HRQoL, equal to more than two-times (10.5 points) and more than three-times (16.8 points) the clinically meaningful difference, respectively. This was a larger difference than that associated with physical health problems (4.4 points). We found a significant interaction effect between physical health problems and clinical mental health symptoms which was associated with even poorer HRQoL after accounting for the individual relationships of both problems. Mental health problems were associated with poorer HRQoL for older versus younger children; and the interaction effect was significant for boys but not girls. Conclusion Findings highlight the importance of identifying and addressing mental health symptoms in children of all ages, even if these problems do not meet formal clinical criteria. Particular attention should be paid to the mental health and HRQoL of children with physical–mental multimorbidity, who are at risk of disproportionately poorer HRQoL.

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“…The review also found that older adults and those with multiple conditions had a significantly higher prevalence of multimorbidity. Although it is more prevalent among older adults, it can affect people of all age groups, including children and young people [ 1 , 2 ]. Evidence also shows that multimorbidity is common among people with mental health disorders and those from lower socioeconomic positions [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

The economic burden of multimorbidity: Protocol for a systematic review

Banstola,

Anokye,

Pokhrel

2024

PLoS ONE

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Multimorbidity, also known as multiple long-term conditions, leads to higher healthcare utilisation, including hospitalisation, readmission, and polypharmacy, as well as a financial burden to families, society, and nations. Despite some progress, the economic burden of multimorbidity remains poorly understood. This paper outlines a protocol for a systematic review that aims to identify and synthesise comprehensive evidence on the economic burden of multimorbidity, considering various definitions and measurements of multimorbidity, including their implications for future cost-of-illness analyses. The review will include studies involving people of all ages with multimorbidity without any restriction on location and setting. Cost-of-illness studies or studies that examined economic burden including model-based studies will be included, and economic evaluation studies will be excluded. Databases including Scopus (that includes PubMed/MEDLINE), Web of Science, CINAHL Plus, PsycINFO, NHS EED (including the HTA database), and the Cost-Effectiveness Analysis Registry, will be searched until March 2024. The risk of bias within included studies will be independently assessed by two authors using appropriate checklists. A narrative synthesis of the main characteristics and results, by definitions and measurements of multimorbidity, will be conducted. The total economic burden of multimorbidity will be reported as mean annual costs per patient and disaggregated based on counts of diseases, disease clusters, and weighted indices. The results of this review will provide valuable insights for researchers into the key cost components and areas that require further investigation in order to improve the rigour of future studies on the economic burden of multimorbidity. Additionally, these findings will broaden our understanding of the economic impact of multimorbidity, inform us about the costs of inaction, and guide decision-making regarding resource allocation and cost-effective interventions. The systematic review’s results will be submitted to a peer-reviewed journal, presented at conferences, and shared via an online webinar for discussion.

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Physical-mental multimorbidity in children and youth: a scoping review

Cited by 26 publications

References 45 publications

Self-harm, somatic disorders and mortality in the 3 years following a hospitalisation in psychiatry in adolescents and young adults

Self-harm, somatic disorders and mortality in the 3 years following a hospitalisation in psychiatry in adolescents and young adults

The relationship between physical and mental health multimorbidity and children’s health-related quality of life

The economic burden of multimorbidity: Protocol for a systematic review

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