A study in Lancet Psychiatry reports that adults with schizophrenia or bipolar disorder are more than twice as likely as those without these disorders to have multiple physical health problems like heart disease or diabetes. Further, the presence of multiple physical problems was more common in adults with schizophrenia or bipolar disorder than the presence of multiple psychiatric disorders.
“While health services and treatment guidelines often operate on the assumption that individuals have a single principal diagnosis, these results attest to the clinical complexity many people with severe mental illness face in relation to burden of chronic disease,” wrote Sean Halstead, M.D., of the University of Queensland in Brisbane, Australia, and colleagues.
Halstead and colleagues collected data from 82 observational studies of adults with schizophrenia spectrum disorder or bipolar disorder that assessed the prevalence of co-occurring physical or psychiatric conditions (though only a few studies examined both). The combined data included more than 1.6 million adults with one of these disorders and over 13 million adults with neither disorder (controls).
Overall, 25% of adults with schizophrenia or bipolar disorder had two or more physical health problems, while 13% had three or more physical health problems. In comparison, 14% of these adults had two or more psychiatric problems (on top of their index diagnosis). The prevalence of multiple physical health problems was roughly the same for schizophrenia and bipolar.
After analyzing data from 11 studies of physical problems that included controls, the researchers calculated that compared with controls, adults with schizophrenia or bipolar disorder had 2.4 times the odds of having two or more physical health problems. The burden was even higher in adults 40 or younger, who had 4 times the odds of multiple physical health problems.
Halstead and colleagues suggested that “a nuanced combination” of multiple factors likely contributes to the poor physical health of young adults with schizophrenia or bipolar disorder, including genetics, prenatal exposures, lifestyle choices, and psychotropic medication side effects. This greater lifetime exposure to poor physical health may explain the high rates of premature mortality seen in people with these two disorders.
For related information, see the Psychiatric News article, “Award Winner Describes Efforts to Improve Cognition in People With Bipolar Disorder.”
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