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Severe Mental Illness Linked with Higher Odds of Multiple Chronic Conditions
People with severe mental illness have elevated odds for a range of chronic physical health problems 5 years before through 5 years after their diagnosis of schizophrenia, bipolar disorder, or other psychotic illness, according to a study published in The Lancet Psychiatry.
“Chronic physical health problems should not be viewed as the inevitable result of psychotropic medication’s adverse effects and long-term health risk factors such as poor diet, smoking, or drug or alcohol misuse, because many of these conditions are present at the point of severe mental illness diagnosis first being recorded,” wrote researchers from University College London in England. “Potentially, interventions targeted at improving the physical health of people with severe mental illness have been initiated too late relative to disease progression.”
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The study matched 68,789 patients diagnosed with severe mental illness between 2000 and 2018 with 274,827 patients without a severe mental illness diagnosis. Researchers looked at the prevalence of 24 chronic physical conditions from 5 years before to 5 years after the diagnosis date of schizophrenia, bipolar disorder, and other psychotic illness, or an equivalent date in matched cohort.
At the time of diagnosis, the most prevalent chronic physical conditions in people with severe mental illness were asthma, hypertension, diabetes, neurological disease, and hypothyroidism, researchers reported.
For people with schizophrenia, the study found elevated odds for 3 chronic health conditions 5 years before diagnosis, 5 conditions at the point of diagnosis, and 13 conditions 5 years after diagnosis compared with the matched cohort. For people with bipolar disorder, odds were elevated for 12 conditions 5 years before diagnosis, for 15 conditions at diagnosis, and for 19 conditions 5 years afterward. People with other psychotic illness had increased odds for 10 conditions before diagnosis, 15 conditions at diagnosis, and 16 conditions after diagnosis.
Patients with schizophrenia often had lower odds for several chronic conditions compared with matched controls, according to the study.
“Therefore,” researchers wrote, “it is likely that these conditions—namely, cardiac arrhythmias, myocardial infarction, cancer, renal disease, peptic ulcer, rheumatic disease, hypertension, peripheral vascular disease, and valvular disease—are under-diagnosed at the point of schizophrenia diagnosis. This is despite evidence that health care use in the 5 years before a diagnosis of schizophrenia is increased and that people with schizophrenia have more lifestyle-related risk factors.”
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