Department of Research, Innovation & Medical Education, East London NHS Foundation Trust, London, United Kingdom.
Division of Psychiatry, University College London, London, United Kingdom.
Eur Psychiatry. 2020 Feb 20;63(1):e19. doi: 10.1192/j.eurpsy.2020.22.
Policies addressing the physical health of people with mental disorders have historically focused on those with severe mental illness (SMI), giving less prominence to the more prevalent common mental disorders (CMDs). Little is known about the comparative physical health outcomes of these patient groups. We aimed to first compare the: (a) number of past-year chronic physical conditions and (b) recent physical health service utilization between CMDs vs. SMI, and secondly compare these outcomes between people with CMDs vs. people without mental disorders.
We analyzed cross-sectional data from the third Adult Psychiatric Morbidity Survey, a representative sample of the English population. We determined the presence of physical conditions and health service utilization by self-report and performed logistic regression models to examine associations of these outcomes between participant groups.
Past-year physical conditions were reported by the majority of participants (CMDs, n = 815, 62.1%; SMI = 27, 63.1%) with no variation in the adjusted odds of at least one physical condition between diagnoses (odds ratio [OR] = 0.96, 95% confidence intervals [CI] 0.42-1.98, p = 0.784). People with CMDs were significantly more likely to be recently hospitalized relative to with those with SMI (OR = 6.33, 95% CI 5.50-9.01, p < 0.05). Having a CMD was associated with significantly higher odds of past-year physical conditions and recent health service utilization (all p < 0.001) compared with the general population.
People with CMDs experience excess physical health morbidities in a similar pattern to those found among people with SMI, while their somatic hospitalization rates are even more elevated. Findings highlight the importance of recalibrating existing public health strategies to bring equity to the physical health needs of this patient group.
历史上，针对精神障碍患者身体健康的政策主要集中在严重精神疾病（SMI）患者身上，对更为普遍的常见精神障碍（CMD）关注较少。对于这些患者群体的比较身体健康结果知之甚少。我们的目的首先比较：（a）过去一年中慢性身体疾病的数量和（b）CMD 与 SMI 之间近期的身体健康服务利用情况，其次比较 CMD 患者与无精神障碍患者之间的这些结果。
我们分析了第三次成人精神疾病发病率调查的横断面数据，这是英国人口的代表性样本。我们通过自我报告确定了身体状况和健康服务的利用情况，并进行了逻辑回归模型分析，以检查这些结果在参与者群体之间的关联。
大多数参与者（CMD，n=815，62.1%；SMI=27，63.1%）报告了过去一年中有身体疾病，但在调整后的诊断之间至少有一种身体疾病的可能性没有差异（优势比[OR] = 0.96，95%置信区间[CI] 0.42-1.98，p=0.784）。与 SMI 患者相比，CMD 患者最近住院的可能性显著更高（OR=6.33，95%CI 5.50-9.01，p<0.05）。与一般人群相比，患有 CMD 与过去一年身体疾病和近期健康服务利用的可能性显著更高（均 p<0.001）。
CMD 患者的身体健康疾病负担与 SMI 患者相似，但他们的躯体住院率更高。研究结果强调了重新调整现有公共卫生策略的重要性，以使该患者群体的身体健康需求得到公平对待。
