Comorbidity associated with Severe Mental illness (The APNA study)
Abstract People with severe mental illness (SMI) that includes bipolar disorder or schizophrenia die on average 10-20 years sooner than the general population. Poor mental health can negatively affect quality of life and life expectancy more so than having multiple physical illnesses. The division between health services treating mental and physical health often means that patients suffering from both physical and mental conditions are at particular risk of poor care. Although more than 50 million people in the EU suffer multiple from more than one chronic disease, it is not well know the comorbidity associated with severe mental illness. Methods The study is a cross-sectional study within the APNA Study (Navarre primary health care prospective cohort) that included 470942 people over 18 years old in Navarre (Spain). Age, sex, chronic diseases diagnosis and SMI) that includes (bipolar disorder or schizophrenia were extracted. Lineal regression models for the number of chronic disease were computed. Logistic regression adjusted by sex and age, was computed for each chronic disease. Results Adjusting by age and sex, people with SMI have 1.47 (95% CI 1.44-1.50) more chronic diseases than people without SMI. Adjusting by age and sex, persons with SMI have a higher prevalence of comorbidity: OR = 13.29 (95% CI = 12.27-14.36). Patients with SMI have a higher prevalence of asthma OR = 1.41 (95% CI 1.21-1.64), COPD OR = 2.30 (95% CI 2.51-3.35), Type 2 DM OR = 1.50 (95% CI 1.31-1.70) hyperthyroidism OR = 1.63 (95% CI 1.26-2.10), Chronic kidney disease OR = 1.,43 (95% IC 1.10-1.88), Obesity OR = 1.68 (95% CI 1.47-1,92) and Hypothyroidism OR 1.63 (95% IC 1.43-1,85). Conclusions Patients with severe mental illness have a higher prevalence of comorbidity than the general population with an OR of 13.29. Health service should screen patient with severe mental illness for chronic diseases due to their high prevalence and mortality. Key messages Patients with severe mental illness die on average 10-20 years sooner than the general population this could be to a higher prevalence of comorbidity. Health services should screen patients with severe mental illness for chronic diseases due to their higher prevalence.