School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Sci Rep. 2021 Mar 11;11(1):5731. doi: 10.1038/s41598-021-85126-4.
Physical non-communicable diseases (NCDs) and mental health disorders are a rapidly increasing health burden in low-and middle-income countries. This study aims to examine the relationships between mental health disorders and cascade of care in managing four common physical NCDs (hypertension, diabetes, dyslipidemia, chronic kidney disease) in China. We utilized two waves of nationally-representative China Health and Retirement Longitudinal Study (CHARLS 2011, 2015) of older adult population aged 45 and above. A series of unadjusted and adjusted mixed-effect logistic regression was applied to evaluate the association between presence of mental health disorder and physical chronic disease awareness, treatment, and control. We found that the odds of dyslipidemia (AOR 1.81, 95% CI 1.36-2.39) and kidney disease awareness (AOR 2.88, 95% CI 2.12-3.92) were higher for individuals with mental chronic conditions, compared to those without mental chronic conditions. The odds of having hypertension treatment was higher for subjects with mental health disorder, compared to those without (AOR 1.32, 95% CI 1.02-1.70). The odds of having physical chronic conditions controlled was not significantly associated with having mental chronic conditions (P > 0.05). These results indicated that adults with mental health disorder have a greater likelihood of awareness of having dyslipidemia and kidney disease, and receiving treatment for hypertension. Strategies to address the growing burden of physical-mental NCDs in China should include efforts to improve management of patients with comorbid health condition and improve access to continual high-quality treatment after the first diagnosis.
身体非传染性疾病（NCDs）和精神健康障碍是中低收入国家日益严重的健康负担。本研究旨在探讨精神健康障碍与管理四种常见身体 NCD（高血压、糖尿病、血脂异常、慢性肾脏病）的护理连续体之间的关系。我们使用了中国具有代表性的两次全国性老年人健康与退休纵向研究（CHARLS 2011 年和 2015 年）的数据，研究对象为 45 岁及以上的成年人。我们采用一系列未经调整和调整后的混合效应逻辑回归来评估存在精神健康障碍与身体慢性疾病认知、治疗和控制之间的关联。我们发现，与没有精神慢性疾病的人相比，有精神慢性疾病的人血脂异常（OR 1.81，95%CI 1.36-2.39）和肾脏病认知（OR 2.88，95%CI 2.12-3.92）的几率更高。与没有精神健康障碍的人相比，有精神健康障碍的人接受高血压治疗的几率更高（OR 1.32，95%CI 1.02-1.70）。而身体慢性疾病得到控制的几率与是否患有精神慢性疾病没有显著关联（P＞0.05）。这些结果表明，有精神健康障碍的成年人更有可能认知到患有血脂异常和肾脏病，并接受高血压的治疗。为了应对中国身体-精神 NCD 日益增长的负担，应该包括努力改善合并健康状况患者的管理，并改善首次诊断后获得持续高质量治疗的机会。
