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Mental disorders and chronic physical disease may be linked

Embargoed until: Publicly released:
Peer-reviewed: This work was reviewed and scrutinised by relevant independent experts.

Observational study: A study in which the subject is observed to see if there is a relationship between two or more things (eg: the consumption of diet drinks and obesity). Observational studies cannot prove that one thing causes another, only that they are linked.

People: This is a study based on research using people.

An international team of researchers looked at the health records of more than two million New Zealanders, finding that having a mental disorder was linked to later developed chronic physical diseases like cancer, diabetes, and gout at younger ages, and dying at a younger age compared to people without mental disorders. This link was found across different psychiatric disorders, across men and women, and across life span. The study authors say these findings suggest that addressing mental disorders early in people's lives may have an impact on improving the one's length and quality of life, and reduce the healthcare costs linked to physical diseases.

Journal/conference: JAMA Network Open

Link to research (DOI): jamanetworkopen.2020.33448

Organisation/s: University of Auckland, University of Michigan, Ann Arbor, USA

Funder: This research was supported by grants AG032282 and AG049789 from the National Institute on Aging and grant MR/P005918 from the UK Medical Research Council. Additional supportwas provided by grant P30 AG034424 from the National Institute on Aging through the Duke Population Research Institute, grant P2C HD065563 from the National Institute of Child Health and Development through the Duke Population Research Center, grant P30 AG028716 from the National Institute on Aging, and funding from the Jacobs Foundation.

Media release

Poor mental health earlier in life leads to poor physical health in later life, according to a new study.

A collaboration between the University of Auckland, the University of Michigan and Duke University in the US, the study investigated 50 years of births in New Zealand and followed them for 30 years.

It found that people admitted to hospital for a mental health issue had increased risk of mortality within the 30-year period, regardless of whether they had also been in hospital for their physical health. The results were the same for men and women across the age range.

Further, a mental health hospitalisation increased the risk of a later admission for physical health, independent of previous hospital visits for physical health.

Results were again the same for men and women across the age range, associations were similar for all mental disorder types and risks were increased for all chronic physical health conditions.

One of the study’s authors, Associate Professor Barry Milne from University of Auckland social research centre COMPASS, says results suggest that dealing with mental health disorders early may help prevent later disease.

“Even if the association is not causal, mental disorders are salient early warning signs for later physical health problems and early death,” he says.

“This suggests the importance of joined-up healthcare services, for example, embedding physical health screening and prevention into mental health treatment.”

Led by Assistant Professor Leah Richmond-Rakerd from the University of Michigan, the study assessed hospitalisations for mental health conditions, chronic physical health conditions and mortality over a 30-year period from 1988 to 2018.

Mental health conditions diagnosed in inpatient hospitals affected four percent of the population, and included substance use disorder, psychotic disorder, mood disorder, neurotic disorder, self-harm and other disorders.

Chronic physical conditions diagnosed in inpatient hospitals, which affected 20 percent of the population, included gout, diabetes, chronic obstructive pulmonary disease (COPD), traumatic brain injury, stroke, myocardial infarction, coronary heart disease and cancer.

The cohort was 2,349,897 people born in New Zealand between 1928 and 1978 and aged from 10 to 60 at the start of the period.

Published today in JAMA Network Open, the study is distinguished by its long-term follow-up, the use of hospital records rather than a retrospective report, and the ability to establish a chronological sequence.

A further study will investigate the role of mental health in later dementia.

Read the full study: ‘Longitudinal associations of mental disorders with physical diseases and mortality among 2.3 million New Zealand Citizens’ by Richmond-Rakerd, L.S., D’Souza, S., Milne, B.J., Caspi, A, and Moffitt, T.E. JAMA Network Open.

Funding for the research was through grants AG032282 and AG049789 from the National Institute on Aging (NIA) and grant MR/P005918 from the U.K. Medical Research Council. Additional support was provided by NIA grant P30 AG034424 through the Duke Population Research Institute, National Institute of Child Health and Development grant P2C HD065563 through the Duke Population Research Center, NIA grant P30 AG028716, and the Jacobs Foundation.

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