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Systematic Review Meta-Analysis Journal Article Ppublish 26 citations

PubMed: 37907331 DOI: 10.1136/bmjment-2023-300870

Relationship between severe mental illness and physical multimorbidity: a meta-analysis and call for action.

BMJ Ment Health 26(1)

Authors: Damiano Pizzol, Mike Trott, Laurie Butler, Yvonne Barnett, Tamsin Ford, Sharon As 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, Lee Smith

Affiliations

  • ENI, San Donato Milanese, Italy.
  • Queensland Centre for Mental Health Research, The University of Queensland, Brisbane, Queensland, Australia.
  • Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
  • Department of Psychiatry, University of Cambridge, Cambridge, UK.
  • Cambridgeshire and Peterborough NHS Foundation trust, Cambridge, UK.
  • School of Life Sciences, Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, UK.
  • Department of Public Health Sciences, University of Murcia, Murcia, Spain.
  • Veterans and Families Institute for Military Social Research, Anglia Ruskin University, Cambridge, UK.
  • Cambridge Public Health, University of Cambridge, Cambridge, UK.
  • CEReSS-Health Services Research and Quality of Life Center, Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille, Marseille, France.
  • Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea.
  • Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK.
  • Centre for Inclusive Community Eye Health, Anglia Ruskin University, Caambridge, UK.
  • Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.

Abstract

BACKGROUND

People with severe mental illness (SMI) have a higher prevalence of several chronic physical health conditions, and the prevalence of physical multimorbidity is expected to rise. The aim of this study was to assess the strength of the association between SMI and physical multimorbidity.

STUDY SELECTION AND ANALYSIS

We systematically searched PubMed/Medline, Scopus, Embase, Web of Science, PsycINFO and the behavioural sciences collection databases, from inception to 31 January 2023, for studies that investigated the association between SMI and physical multimorbidity. Humans of any age either clinically diagnosed and/or currently receiving treatment for SMI, specified as schizophrenia (and related psychotic disorders), bipolar disorder and psychotic depression, were eligible. Data from studies selected for inclusion were converted into ORs, with a subsequent meta-analysis conducted.

FINDINGS

We included 19 studies with a total of 194 123 patients with SMI with different diagnoses and drawn from the general population. The pooled OR for physical multimorbidity in people with versus without SMI was 1.84 (95% CI 1.33 to 2.54), with the analysis indicating a high level of heterogeneity (98.38%). The other 15 studies included in the systematic review for which it was not possible to conduct a meta-analysis showed strong associations between SMI and physical multimorbidity.

CONCLUSIONS

The current evidence highlights the link between SMI and physical multimorbidity. A multidisciplinary approach is now urgent to develop the best models of services tailored to patients with SMI with physical multimorbidities to improve physical, mental and social outcomes. CRD42023395165.

MeSH

Mental Health, Mental Disorders, Prevalence, Multimorbidity

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