The risk of a chronic clinical condition following a previous hospitalisation by a psychiatric disorder: a linkage nationwide study in Brazil

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Multimorbidity is the occurrence of more than one chronic condition at a time. This can include conditions like cardiovascular disease, a mental health condition of long duration, such as a mood disorder or dementia or an infectious disease of long duration, such as Tuberculosis.Multimorbidity increases with age and also presents certain distinct patterns related to sex. On the other hand, mental disorders are commonly found together and usually have consequences on other chronic physical condition that the patient may have. Mental health disorders, in particular depression, represent an important risk factor for premature mortality. Multimorbidity can also increase the treatment costs, as subjects with depression will cost 50% more to health systems than those with one chronic condition alone. Cardiovascular diseases are also found to co-occur with depression, this might happen because these patients show difficulties in following their GP 's recommendations. It is of note that women seem to be at higher risk of morbidity from cardiovascular disease, while they are also at a higher risk of depression suggesting gender-specific mechanisms. Analysis of a recent health survey in adult Brazilians observed that the prevalence rate of multimorbidity are higher among women compared to men, among older people and those with lower educational level.We at the Center for Data Integration and Knowledge for Health (CIDACS) have access to very large datasets, which would commonly be known as Big Data. This data comprises information from Brazilian subjects that were listed or benefited by one of the several social programmes or were seen in any of the numerous public hospital of the country's universal health system.This project aims at increasing knowledge over the relationship of mental disorders and other chronic conditions to ameliorate the lives of those affected. More specifically we want to (A) estimate the the risk of hospitalisations or death by diabetes mellitus, cardiovascular diseases or stroke following a hospitalisation due to depressive disorders, alcohol and substance use-related disorders, and schizophrenia; (B) To estimate the risk of the occurrence or death by tuberculosis following a hospitalisation due to depressive disorders, alcohol and substance use-related disorders, and schizophrenia; (C) To investigate how these chronic conditions goes together in clusters and how these patterns evolve over time and ageing.