Key result
Serious mental health disorders linked to up to ~266% greater risk of physical health conditions.
Why the study?
Mental health disorders are associated with physical health disparities, but underlying excess risk and health burden have not yet been comprehensively assessed.
What is the relative prevalence risk and excess burden of comorbid physical health conditions across serious mental health disorders in Europe?
Systematic Review (n=18,000,000)
Yes
What is the relative prevalence risk and excess burden of comorbid physical health conditions across serious mental health disorders in Europe?
Effect estimate: RR 0.81-3.66
Serious mental health disorders are associated with a significantly increased risk of comorbid physical health conditions, accounting for 27% to 67% of the total physical health burden in this population.
Requires integrated physical health screening in mental health care; confirms substantial excess comorbidity burden across disorders.
BACKGROUND: Mental health disorders (MHDs) are associated with physical health disparities, but underlying excess risk and health burden have not yet been comprehensively assessed. OBJECTIVE: To assess the burden of comorbid physical health conditions (PHCs) across serious MHDs in Europe. METHODS: We estimated the relative prevalence risk of PHCs associated with alcohol use disorders (AUD), bipolar disorder (BD), depressive disorders (DD) and schizophrenia (SZ) across working-age populations of 32 European countries in 2019 based on a targeted literature review. Excess physical health burden was modelled using population-attributable fractions and country-level prevalence data. FINDINGS: We screened 10 960 studies, of which 41 were deemed eligible, with a total sample size of over 18 million persons. Relative prevalence of PHCs was reported in 54%, 20%, 15%, 5% and 7% of studies, respectively, for SZ, DD, BD, AUD or mixed. Significant relative risk estimates ranged from 1.44 to 3.66 for BD, from 1.43 to 2.21 for DD, from 0.81 to 1.97 for SZ and 3.31 for AUD. Excess physical health burden ranged between 27% and 67% of the total, corresponding to 84 million (AUD), 67 million (BD), 66 million (DD) and 5 million (SZ) PHC diagnoses in Europe. A 1% reduction in excess risk assuming causal inference could result in two million fewer PHCs across investigated MHDs. CONCLUSIONS: This is the first comprehensive study of the physical health burden of serious MHDs in Europe. The methods allow for updates, refinement and extension to other MHDs or geographical areas. CLINICAL IMPLICATIONS: The results indicate potential population health benefits achievable through more integrated mental and physical healthcare and prevention approaches.
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Wienand et al. (2024) conducted a systematic review in Serious mental health disorders (n=18,000,000). Serious mental health disorders was evaluated on Relative prevalence risk of physical health conditions (RR 0.81-3.66). Serious mental health disorders were associated with significant relative risks for physical health conditions (0.81 to 3.66), accounting for 27% to 67% of the total physical health burden.
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