Mental disorders increase the risk of mortality from other diseases

Both physical diseases and mental disorders contribute significantly to the growing burden on healthcare systems across the globe. The prevention or early detection of mental disorders could improve both mental and physical health.

The study, led by King’s College London, involved Dr. Joaquim Raduà, head of the IDIBAPSImaging of mood- and anxiety-related disorders (IMARD) research group, CIBERSAM researcher and associate professor at University of Barcelona.

Cardiovascular diseases, cancer, chronic respiratory diseases and diabetes are responsible for over 50% of deaths worldwide. Moreover, globally mental disorders are a significant cause of disability and of years of life lost.

Up to now, although there is evidence of a bidirectional association between mental disorders and physical diseases, no detailed information had been provided on the impact these disorders have on the prognosis and clinical outcome of physical diseases.

For the study in World Psychiatry, for the first time all the reviews and meta-analyses of this subject were examined in order to quantify the evidence for this relationship and to estimate how many physical diseases or deaths could be avoided if mental disorders were reduced or detected early.

A systematic search of different databases identified over 20,000 potentially relevant articles. Finally, for the study, 251 prospective studies from 47 systematic reviews were assessed.

The analysis of different studies showed that mood disorders, especially depression, are an important risk factor for adverse events including cardiovascular diseases. So, depression increases the risk of mortality in patients with diabetes mellitus by 184%, by 44% in patients with myocardial infarction, and 41% in patients with kidney failure. It also increases the risk of major cardiac events by 52% in patients with myocardial infarction, and increases the risk of dementia by 111% in patients with diabetes.

“A reduction in the cases of depression could avoid 27% of all deaths in patients with diabetes, 14% of major cardiac events in patients with myocardial infarction, and 12% of deaths in patients with kidney failure", says Joaquim Raduà.

Moreover, the study also highlights the fact that schizophrenia increases the risk of mortality in the context of different diseases. It increases mortality from cancer by 74% in patients with some kind of tumour and mortality in patients with cardiovascular diseases by 54%. By reducing cases of schizophrenia, 12% of the deaths in patients with cardiovascular diseases could be avoided.

“Although the mechanisms are not described in detail, the poorer clinical outcome of certain physical diseases in people with a mental disorder is due to a combination of factors, which range from common biological mechanisms to behavioural aspects related to the mental disorder”, points out Raduà.

The results of the analysis show that mental disorders increase the risk of a poorer clinical outcome in several physical diseases. “Prevention aimed at the early detection of various mental disorders, such as alcohol abuse, depression and schizophrenia, could reduce the incidence of different adverse events in people with other types of disease, such as cardiovascular disease, cancer or diabetes”, concludes Joaquim Raduà.

Study reference:

Impact of mental disorders on clinical outcomes of physical diseases: an umbrella review assessing population attributable fraction and generalized impact fraction.
Dragioti E, Raduà J, Solmi M, Gosling CJ, Oliver D, Lascialfari F, Ahmed M, Cortese S, Estradé A, Arrondo G, Gouva M, Fornaro M, Batiridou A, Dimou K, Tsartsalis D, Carvalho AF, Shin JI, Berk M, Stringhini S, Correll CU, Fusar-Poli P.
World Psychiatry. 2023 Feb;22(1):86-104. doi: 10.1002/wps.21068. PMID: 36640414.