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RESEARCH WEEKLY: Exploring the Elevated Risk of Chronic Physical Conditions
By Hope Parker
(December 7, 2022) People with severe mental illness suffer from chronic health conditions at a higher rate than the general population. While these health conditions can decrease both the quality of life and the lifespan of people with severe mental illness, reasons for this disparity have remained unclear.
One way of exploring the relationship between severe mental illness and chronic health conditions is through examining the timing of a person’s chronic health condition diagnosis. A new article from The Lancet Psychiatry explores this temporal relationship and found that people with severe mental illness have an elevated risk for several chronic health problems even before they receive their first diagnoses of a severe mental illness.
Study Details
This study was conducted on data from over 65,000 adults in the United Kingdom who had been diagnosed with a severe mental illness between 2000 and 2018. Researchers examined the diagnosis of chronic physical health conditions five years before and after the diagnosis of a severe mental illness. The prevalence of these chronic health conditions was also compared to the prevalence of chronic health conditions in the general population.
Key Findings
At the time of their first severe mental illness diagnosis, 43% of individuals already had at least one chronic health condition. Specifically, people with severe mental illness were more likely than the general population to have:
- A neurological disease,
- Asthma,
- Diabetes,
- Hypertension and
- Hypothyroidism.
Even five years prior to being first diagnosed with a severe mental illness, people with severe mental illness were more likely than the general population to be suffering from a chronic health condition. This was especially true for people with bipolar disorder, who experienced elevated levels of 13 of the 24 health conditions included in this study. These individuals were more likely than the general population to be suffering from:
- A fluid or electrolyte disorder,
- A neurological condition,
- A pulmonary circulation disorder,
- Asthma,
- Diabetes,
- HIV,
- Hypothyroidism,
- Paralysis,
- Peptic ulcers and
- Liver disease.
Five years after being diagnosed, people with severe mental illness continued to be at an elevated risk for all health conditions listed above, as well as:
- Chronic obstructive pulmonary disease,
- Congestive heart failure,
- Deficiency anemia and
- Renal disease.
Implications
There are a number of reasons why people with severe mental illness may be more at risk for developing chronic health conditions than the general population. Many people with severe mental illness face additional risk factors for both developing and exacerbating chronic health conditions, such as decreased self-care, low socio-economic status, poor diet, smoking, and substance misuse. The authors of this article suggest that the side-effects of some psychotropic medications may also contribute to chronic conditions such as diabetes, hypothyroidism, renal disease and hypertension.
Additionally, the authors suggest people with a diagnosis of a severe mental illness may experience ‘diagnostic overshadowing’ once they are diagnosed with a mental illness. The term ‘diagnostic overshadowing’ describes when care providers mistakenly attribute symptoms of a physical health condition to a psychiatric condition and may contribute to worse treatment outcomes for people with diagnosed severe mental illness. More research is needed to know exactly how this may impact people with severe mental illness.
Increased awareness of the elevated physical health risks for people with severe mental illness, such as the ones found in this study, may help alleviate the health-disparities faced by people with severe mental illness. Encouraging those who may be struggling with a mental health condition to seek treatment for their mental illness may additionally decrease an individual’s risk for deterioration of functional skills, such as self-care. Finally, consistent monitoring and early intervention may help people with severe mental illness to manage their chronic conditions and improve their quality of life.
References
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