Mental-Physical Multimorbidity Associates With Decreased Life Expectancy

Mental Disorder
Troubled man suffering mental illness
In this study, mental disorders were determined using data from the Danish Psychiatric Central Research Register and general medical conditions from the Danish National Patient Register.

Patients with comorbid mental and general health disorders were associated with shorter life expectancy than the general population, according to results of a population-based cohort study, published in JAMA Psychiatry.

All individuals (N=5,946,800) living in Denmark between 1900 and 2015 were included in this study. Mental disorders were determined using data from the Danish Psychiatric Central Research Register and general medical conditions (GMCs) from the Danish National Patient Register. Life expectancy was evaluated among mental disorder-GMC pairs.

Between 1969 and 2016, 4.95% of the population were diagnosed with neurotic, stress-related, and somatoform disorders; 3.83% with mood disorders; 2.30% with mental and behavioral disorders due to psychoactive substance use; 2.16% with specific personality disorders; 1.83% with organic mental disorders; 1.47% with schizophrenia and related disorders; and 1.46% with behavioral and emotional disorders.

During the study period, 901,473 persons died and 94,629 emigrated.

The mean mortality rates were higher among individuals with mental disorder and GMC comorbidities than those without either condition (mean mortality rate ratio [MRR], 5.90) or those with only GMCs (mean MRR, 2.40).

The mean MRR for those with a mood disorder was lower (mean, 1.55) than for those with an eating disorder (mean, 3.23) and was generally lower among women (mean, 2.29) than for men (mean, 2.61).

For individuals with mental disorder and GMC comorbidities, mortality was higher than among those with only a mental disorder (mean MRR, 2.07). Stratified by GMC, MRRs were lower for neurological conditions (mean, 1.22) than for cancers (mean, 4.07) and was generally lower among men (mean, 2.14) than women (mean, 2.33).

Compared with the general population, having both a mental disorder and a GMC was associated with an average of 11.35 years of life lost.

This study may have been limited by defining GMCs as 9 broad chronic disorder categories and 31 specific disorders. This study did not include data about accidents, injuries, or acute conditions.

The study authors concluded, “Our findings highlight that individuals with mental disorder–GMC comorbidity have an increased risk of dying; their life expectancy is shorter than that of both the entire population and people with either mental disorders or GMCs only. Mental-physical multimorbidity is increasing and challenging health care systems globally; it is associated with high health care utilization, costs, and social inequality. Logically, it follows that early identification and good management of mental disorders, as well as prevention of GMC comorbidity, could help reduce some of the risk of premature mortality in people with mental disorders.”

Reference

Momen NC, Plana-Ripoll O, Agerbo E, et al. Mortality associated with mental disorders and comorbid general medical conditions. JAMA Psychiatry. Published online March 30, 2022. doi:10.1001/jamapsychiatry.2022.0347