Mental disorders and chronic physical disease may be linked

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 hospitalization 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 center 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.

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