How physical illness adds to disability in people with severe mental illness
In nearly 14,000 people with severe mental illness, over 60% had several physical conditions, and each type of comorbidity was linked to higher disability.
The question
People with severe mental illness, such as schizophrenia or bipolar disorder, have more physical health problems, and disability is a major part of the burden of mental illness. Might physical multimorbidity help drive the disability?
What we did
In work led by Rebecca Bendayan at King’s College London, we used the clinical record search system at the South London and Maudsley hospital. Our sample was 13,933 people diagnosed with severe mental illness between 2007 and 2018 who had a disability score (HoNOS). Physical conditions were defined using ICD-10 chapters.
What we found
More than 60% of the sample had complex multimorbidity; the commonest affected systems were neurological (34.7%), dermatological (15.4%) and circulatory (14.8%). Every comorbidity group was linked to higher disability, and people with musculoskeletal, skin, respiratory, endocrine, neurological, haematological or circulatory conditions had difficulties in more than five domains. They were at greater risk of problems with daily living, hallucinations and cognition.
Why it matters
These people should be a target for prevention and intervention programmes, rather than their physical and mental health being treated separately.