Physical and mental health multimorbidity across the lifespan (LIfespaN multimorbidity research Collaborative (LINC)).

当个体同时出现两种或两种以上不同的疾病时，就会出现多病（MM）。这在身体疾病和精神疾病之间很常见，几乎一半患有精神疾病的人也患有身体疾病。大约三分之一患有身体疾病的人同时也患有精神疾病。这些患者的生活质量比那些患有单一疾病的人更差，他们往往很难得到最好的护理，而且有可能活得更短。一种常见且严重的MM类型介于内化疾病（抑郁和焦虑）和心血管疾病（ICV-MM）之间。然而，对于ICV-MM是如何发展的以及为什么会发生，人们知之甚少。然而，我们确实知道，内化疾病和心血管风险（如肥胖、胆固醇）往往在成年前就开始了。为了真正了解内源性病毒的风险是如何发展的，我们需要对所有年龄段的人进行大规模的研究，这些人的健康状况已经被长期跟踪。对儿童的研究是至关重要的，因为它们可以告诉我们在以后的生活中发生ICV-MM的早期风险。这对于制定更好的计划以预防高危儿童罹患ICV-MM非常重要。我们知道基因会影响内化和心血管疾病的风险，有些人的遗传风险很高。我们也知道，在生命早期开始的某些情况（神经发育状况），如智力残疾、自闭症和多动症，会增加以后发展为ICV MM的风险。儿童所处的环境也会增加这种风险，例如，贫困、身体虐待或性虐待等压力经历。但基因、神经发育条件和早期环境风险究竟如何影响ICV-MM在整个生命周期中的发展，目前仍不清楚。众所周知，某些人群患ICV-MM的风险更高，比如南亚血统的人和女性，但我们不知道为什么会这样。更好地了解ICV-MM如何在社会不同群体中发展，将有助于医生为患者提供符合其特定需求的护理。它还将帮助医生，政府和学校以最适合他们的方式预防高危儿童的ICV-MM。要真正了解ICV-MM发展的复杂性，需要一个具有广泛专业知识的研究团队，他们共同了解身体和精神疾病，以及遗传、神经发育条件和人们生活的环境如何影响他们的一生。我们的寿命多病研究协作（LINC）结合了身体和精神疾病的广泛医学和研究专业知识。我们汇集了五项大型研究，对许多人的健康状况进行了长期跟踪。可以获得丰富的医疗数据，包括来自医疗记录的数据。这些人的遗传信息也是可用的。其他重要的信息也被收集，比如人们的生活环境、生活事件和生活方式。这些研究跟踪了儿童、青少年和成年人的长期健康状况。因此，我们可以研究内化和心血管疾病如何在成年期同时发生。重要的是，我们还可以在儿童出现这些疾病之前研究他们的早期风险因素。由于我们的儿童和成人样本在种族和经济状况上存在差异，我们也可以研究ICV-MM在社会不同群体中的发展差异。最后，因为我们有基因数据，我们可以研究基因如何影响高危人群的ICV-MM发展。我们的研究将帮助我们了解ICV-MM是如何发展的，以及哪些环境影响了这一点。我们的研究成果对于预防因遗传、性别、种族或经济原因而面临风险的儿童罹患ICV-MM具有重要意义。我们将与患者、医生和慈善机构合作，制定具体的健康建议，以便在未来减少高危人群的ICV-MM。

Multimorbidity (MM) happens when two or more different diseases are present at the same time in an individual. This is common between physical and psychiatric diseases with almost half of people with a psychiatric disease also having a physical disease. As well as about a third of people with a physical disease also having a psychiatric disease. These patients have worse quality of life than those with a single disease, they often struggle to get the best care and are at risk of living less long. A common and serious type of MM is between internalizing diseases (depression and anxiety) and cardiovascular disease (ICV-MM). Still, very little is understood as to how ICV-MM develops and why it happens. We do know however that both internalizing disease and cardiovascular risk (e.g., obesity, cholesterol) tend to begin before adulthood.To really understand how ICV risk develops, we need large studies of people of all ages whose health has been followed over time. Studies of children are crucial because they can tell us about early risks for development of ICV-MM later in life. This is important for developing better plans to prevent at-risk children developing ICV-MM.We know that genes influence risk of both internalizing and cardiovascular disease and that some people are at high genetic risk. We also know that certain conditions that start early in life (neurodevelopmental conditions) such as intellectual disability, autism and ADHD increase risk of developing ICV MM later. Children's environments can also increase this risk, for example, stressful experiences such as poverty and physical or sexual abuse. But how exactly genes, neurodevelopmental conditions and early environmental risks influence the development of ICV-MM over the lifespan is still not understood.Certain groups are known to be at increased risk of ICV-MM, such as people of South Asian heritage and women, but we don't know why this is. Better understanding of how ICV-MM develops in different groups in society will help doctors give patients care that is matched to their specific needs. It will also help doctors, governments and schools prevent ICV-MM in at-risk children in ways that work best for them. To really understand the complexities of ICV-MM development, a team of researchers with a wide range of expertise is needed who together understand physical and psychiatric diseases as well as how genetics, neurodevelopmental conditions and the environments people live in influence them throughout their lives.Our LIfespaN multimorbidity research Collaborative (LINC) combines wide-ranging medical and research expertise in physical and psychiatric diseases. We have brought together five very large studies in which the health of many people has been followed over time. Rich medical data is available, including from medical records. Genetic information is also available for these people. Other important information has also been collected such as on people's living environments, life events and lifestyles. These studies follow the health over time of children, adolescents and adults. We can therefore study how internalizing and cardiovascular disease happen together in adulthood. Importantly we can then also study early risk factors in the children before they develop these conditions. Because our child and adult samples differ in ethnicity and economic situation, we can also study how the development of ICV-MM differs for different groups in society. Finally, because we have genetic data, we can study how genes influence ICV-MM development in people at risk.Our study will help us understand how ICV-MM develops and which circumstances influence this. What we learn will be important for the prevention of ICV-MM in children who are at risk because of genetics, their sex, or ethnic or economic reasons. We will work with patients, doctors and charities to develop specific health advice in order to reduce ICV-MM in at risk groups in the future.