Patterns of chronic physical multimorbidity in psychiatric and general population
Patterns of chronic physical multimorbidity in psychiatric and general population
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DOI：
10.1016/j.jpsychores.2018.09.011
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发表时间：
2018-11-01
影响因子：
4.7
通讯作者：
Sartorius, Norman
中科院分区：
文献类型：
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作者：
Filipcic, Igor;Filipcic, Ivona Simunovic;Sartorius, Norman
目的：越来越多的证据表明，慢性躯体多病（定义为精神障碍患者中≥ 2种慢性躯体疾病）的患病率和复杂性很高。本研究旨在评估一般人群和精神病人群中自报慢性躯体疾病和多发病率的患病率和模式的差异。方法：我们对1060名精神病患者和837名来自一般人群的参与者进行了15种自报慢性躯体疾病的潜在类别分析。自报慢性躯体疾病和多重精神病在精神病患者人群中的患病率明显高于一般人群（P <0.001）。精神病患者患慢性躯体疾病的年龄标准化相对危险度高27%（CI 95% 24%- 30%），患多种疾病的年龄标准化相对危险度高31%（CI 95% 28% - 34%）（P <0.001）。精神病患者的慢性躯体疾病组合数量比普通人群高52%（分别为255对161; P <0.001）。我们确定了四个不同的潜在类别：“相对健康”，“肌肉骨骼”，“高血压和肥胖”，和“复杂的multimorphins”，在multimorphins潜在类别模式的性质没有显着差异。“相对健康”类显著低于（ARI = 25%（CI 95%-30%-21%），精神病患者中“高血压和肥胖”类别的患病率显著高于其他类别（ARI = 20%（CI 95% 17% - 23%）。这些研究结果表明，精神障碍与各种慢性身体疾病和多发性硬化症的风险增加有关。迫切需要制定关于所有精神障碍患者身体保健的准则，重点是多重精神障碍。
Objective: A growing body of evidence has demonstrated the high prevalence and complexity of chronic physical multimorbidity defined as >= 2 chronic physical illness in people with psychiatric disorders. The present study aimed to assess differences in the prevalence and patterns of self-reported chronic physical illness and multi morbidity in the general and psychiatric populations.Methods: We performed a latent class analysis of 15 self-reported chronic physical illnesses on a sample of 1060 psychiatric patients and 837 participants from the general population.Results: Self-reported chronic physical illness and multimorbidity were significantly more prevalent in the population of psychiatric patients than in the general population (P < .001). Psychiatric patients had 27% (CI95% 24%- 30%) higher age-standardized relative risk for chronic physical illness and a 31% (CI95% 28% - 34%) higher for multimorbidity (P < .001). The number of chronic physical illnesses combinations was 52% higher in the psychiatric than in general population (255 vs 161 combinations respectively; P < .001). We identified four distinct latent classes: "Relatively healthy", "Musculoskeletal", "Hypertension and obesity", and "Complex multimorbidity" with no significant differences in the nature of multimorbidity latent classes patterns. The class "Relatively healthy" was significantly less (ARI = 25% (CI95%-30%-21%), and the class "Hypertension and obesity" was significantly more prevalent in the population of psychiatric patients (ARI = 20% (CI95% 17% - 23%).Conclusions: These findings indicate that mental disorders are associated with an increased risk of a wide range of chronic physical illnesses and multimorbidity. There is an urgent need for the development of the guidelines regarding the physical healthcare of all individuals with mental disorders with multimorbidity in focus.