Abstract
Background
People with a mental illness have higher risks of somatic diseases and higher mortality, but this has been poorly documented in France. We studied the associations between mental illnesses and acute cardiovascular events (ACEs) and cancers in the French national health data system (SNDS).
Methods
We included all health insurance general scheme beneficiaries ≥18 years-of-age in 2016. Mental illnesses (psychotic disorder, neurotic or mood disorder, mental retardation and addictive disorder), ACEs (acute coronary syndrome (ACS), stroke, acute heart failure and pulmonary embolism) and cancers (breast, colorectal, lung and prostate) were identified using algorithms based on long-term disease registry, hospitalization diagnoses and specific drug deliveries. The associations were measured using morbidity ratios standardized by age and gender when appropriate (SMRs).
Results
ACEs were more frequent in the subjects with a mental illness than in the general population: ACS (SMR: 1.6), stroke (2.3), acute heart failure (1.9), pulmonary embolism (2.4). Similar results were found for each mental illness, except for ACS, which were less frequent in those with a mental retardation (SMR: 0.5) and were not associated with psychotic disorder (SMR: 1.0). Mental illness was also associated with more frequent breast (SMR: 1.3), colorectal (1.3), lung (2.0) and prostate (1.2) cancers, in particular for those with a neurotic or mood disorder (SMRs: 1.3, 1.5, 2.3, 1.2, respectively) and, for lung cancer, those with an addictive disorder (SMR: 2.6).
Conclusions
Globally, ACEs and cancers were more frequent in patients with a mental illness relative to the general population after standardization by age and gender, which could be related to adverse effects of certain psychotropic drugs or behaviours or risk factors related to the mental illness. Healthcare professionals should be aware of this to more adequately account for the specificities of the patients with a mental illness.
Key messages
ACEs and cancers were more frequent in patients with a mental illness relative to the general population after standardization by age and gender. Healthcare professionals should be aware of this to more adequately account for the specificities of the patients with a mental illness.
Young and computer-literate healthcare professionals have the greatest expectations for heart failure telemonitoring
