Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria.
BMJ Ment Health. 2024 Apr 5;27(1):e301021. doi: 10.1136/bmjment-2024-301021.
Mental health disorders (MHDs) are associated with physical health disparities, but underlying excess risk and health burden have not yet been comprehensively assessed.
To assess the burden of comorbid physical health conditions (PHCs) across serious MHDs in Europe.
We estimated the relative prevalence risk of PHCs associated with alcohol use disorders (AUD), bipolar disorder (BD), depressive disorders (DD) and schizophrenia (SZ) across working-age populations of 32 European countries in 2019 based on a targeted literature review. Excess physical health burden was modelled using population-attributable fractions and country-level prevalence data.
We screened 10 960 studies, of which 41 were deemed eligible, with a total sample size of over 18 million persons. Relative prevalence of PHCs was reported in 54%, 20%, 15%, 5% and 7% of studies, respectively, for SZ, DD, BD, AUD or mixed. Significant relative risk estimates ranged from 1.44 to 3.66 for BD, from 1.43 to 2.21 for DD, from 0.81 to 1.97 for SZ and 3.31 for AUD. Excess physical health burden ranged between 27% and 67% of the total, corresponding to 84 million (AUD), 67 million (BD), 66 million (DD) and 5 million (SZ) PHC diagnoses in Europe. A 1% reduction in excess risk assuming causal inference could result in two million fewer PHCs across investigated MHDs.
This is the first comprehensive study of the physical health burden of serious MHDs in Europe. The methods allow for updates, refinement and extension to other MHDs or geographical areas.
The results indicate potential population health benefits achievable through more integrated mental and physical healthcare and prevention approaches.
精神健康障碍（MHDs）与身体健康差异有关，但尚未全面评估潜在的超额风险和健康负担。
评估欧洲严重 MHD 合并身体健康状况（PHC）的负担。
我们根据一项针对性文献综述，估计了 2019 年欧洲 32 个国家工作年龄人群中与酒精使用障碍（AUD）、双相情感障碍（BD）、抑郁障碍（DD）和精神分裂症（SZ）相关的 PHC 的相对流行风险。使用人群归因分数和国家层面的流行率数据来建模超额身体健康负担。
我们筛选了 10960 项研究，其中 41 项被认为符合条件，总样本量超过 1800 万人。分别有 5%、20%、15%、5%和 7%的研究报告了 SZ、DD、BD、AUD 或混合的 PHC 相对流行率。BD 的显著相对风险估计值范围为 1.44 至 3.66，DD 为 1.43 至 2.21，SZ 为 0.81 至 1.97，AUD 为 3.31。身体健康负担的超额范围在 27%至 67%之间，相当于欧洲有 8400 万（AUD）、6700 万（BD）、6600 万（DD）和 500 万（SZ）PHC 诊断。假设因果推断，降低 1%的超额风险可使调查的 MHD 减少 200 万例 PHC。
这是欧洲严重 MHD 身体健康负担的首次综合研究。该方法允许对其他 MHD 或地理区域进行更新、改进和扩展。
研究结果表明，通过更综合的心理健康和身体健康护理以及预防方法，可能会带来潜在的人群健康获益。
