The contribution of general medical conditions to the non-fatal burden of mental disorders: register-based cohort study in Denmark.
Comorbidity
burden of disease
disability
epidemiology
health metrics
Journal
BJPsych open
ISSN: 2056-4724
Titre abrégé: BJPsych Open
Pays: England
ID NLM: 101667931
Informations de publication
Date de publication:
07 Oct 2022
07 Oct 2022
Historique:
entrez:
7
10
2022
pubmed:
8
10
2022
medline:
8
10
2022
Statut:
epublish
Résumé
General medical conditions (GMCs) often co-occur with mental and substance use disorders (MSDs). To explore the contribution of GMCs to the burden of disease in people with MSDs, and investigate how this varied by age. A population-based cohort of 6 988 507 persons living in Denmark during 2000-2015 followed for up to 16 years. Danish health registers were used to identify people with MSDs and GMCs. For each MSD, years lived with disability and health loss proportion (HeLP) were estimated for comorbid MSDs and GMCs, using a multiplicative model for disability weights. Those with any MSD lost the equivalent of 43% of healthy life (HeLP = 0.43, 95% CI 0.40-0.44) after including information on GMCs, which was an increase from 25% before including GMCs (HeLP = 0.25, 95% CI 0.23-0.27). Schizophrenia was associated with the highest burden of disease (HeLP = 0.77, 95% CI 0.68-0.85). However, within each disorder, the relative contribution of MSDs and GMCs varied. For example, in those diagnosed with schizophrenia, MSDs and GMCs accounted for 86% and 14% of the total health loss; in contrast, in those with anxiety disorders, the same proportions were 59% and 41%. In general, HeLP increased with age, and was mainly associated with increasing rates of pulmonary, musculoskeletal and circulatory diseases. In those with mental disorders, the relative contribution of comorbid GMCs to the non-fatal burden of disease increases with age. GMCs contribute substantially to the non-fatal burden of disease in those with MSDs.
Sections du résumé
BACKGROUND
BACKGROUND
General medical conditions (GMCs) often co-occur with mental and substance use disorders (MSDs).
AIMS
OBJECTIVE
To explore the contribution of GMCs to the burden of disease in people with MSDs, and investigate how this varied by age.
METHOD
METHODS
A population-based cohort of 6 988 507 persons living in Denmark during 2000-2015 followed for up to 16 years. Danish health registers were used to identify people with MSDs and GMCs. For each MSD, years lived with disability and health loss proportion (HeLP) were estimated for comorbid MSDs and GMCs, using a multiplicative model for disability weights.
RESULTS
RESULTS
Those with any MSD lost the equivalent of 43% of healthy life (HeLP = 0.43, 95% CI 0.40-0.44) after including information on GMCs, which was an increase from 25% before including GMCs (HeLP = 0.25, 95% CI 0.23-0.27). Schizophrenia was associated with the highest burden of disease (HeLP = 0.77, 95% CI 0.68-0.85). However, within each disorder, the relative contribution of MSDs and GMCs varied. For example, in those diagnosed with schizophrenia, MSDs and GMCs accounted for 86% and 14% of the total health loss; in contrast, in those with anxiety disorders, the same proportions were 59% and 41%. In general, HeLP increased with age, and was mainly associated with increasing rates of pulmonary, musculoskeletal and circulatory diseases.
CONCLUSIONS
CONCLUSIONS
In those with mental disorders, the relative contribution of comorbid GMCs to the non-fatal burden of disease increases with age. GMCs contribute substantially to the non-fatal burden of disease in those with MSDs.
Identifiants
pubmed: 36205020
doi: 10.1192/bjo.2022.583
pii: S205647242200583X
pmc: PMC9634585
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e180Subventions
Organisme : Danmarks Grundforskningsfond
ID : Niels Bohr Professorship to JMcG
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