BACKGROUND Mental health disorders (MHDs) are associated with physical health disparities, but underlying excess risk and health burden have not yet been comprehensively assessed. OBJECTIVE To assess the burden of comorbid physical health conditions (PHCs) across serious MHDs in Europe. METHODS We estimated the relative prevalence risk of PHCs associated with alcohol use disorders (AUD), bipolar disorder (BD), depressive disorders (DD) and schizophrenia (SZ) across working-age populations of 32 European countries in 2019 based on a targeted literature review. Excess physical health burden was modelled using population-attributable fractions and country-level prevalence data. FINDINGS We screened 10 960 studies, of which 41 were deemed eligible, with a total sample size of over 18 million persons. Relative prevalence of PHCs was reported in 54%, 20%, 15%, 5% and 7% of studies, respectively, for SZ, DD, BD, AUD or mixed. Significant relative risk estimates ranged from 1.44 to 3.66 for BD, from 1.43 to 2.21 for DD, from 0.81 to 1.97 for SZ and 3.31 for AUD. Excess physical health burden ranged between 27% and 67% of the total, corresponding to 84 million (AUD), 67 million (BD), 66 million (DD) and 5 million (SZ) PHC diagnoses in Europe. A 1% reduction in excess risk assuming causal inference could result in two million fewer PHCs across investigated MHDs. CONCLUSIONS This is the first comprehensive study of the physical health burden of serious MHDs in Europe. The methods allow for updates, refinement and extension to other MHDs or geographical areas. CLINICAL IMPLICATIONS The results indicate potential population health benefits achievable through more integrated mental and physical healthcare and prevention approaches.

中文翻译：

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32 个欧洲国家严重精神健康障碍的共病身体健康负担。


背景精神健康障碍（MHD）与身体健康差异相关，但潜在的过度风险和健康负担尚未得到全面评估。目的 评估欧洲严重 MHD 患者的共病身体健康状况 (PHC) 负担。方法 我们根据有针对性的文献估计了 2019 年 32 个欧洲国家工作年龄人口中与酒精使用障碍 (AUD)、双相情感障碍 (BD)、抑郁症 (DD) 和精神分裂症 (SZ) 相关的 PHC 相对患病风险审查。使用人口归因分数和国家级患病率数据对过度的身体健康负担进行建模。结果 我们筛选了 10 960 项研究，其中 41 项被认为符合条件，总样本量超过 1,800 万人。在 SZ、DD、BD、AUD 或混合的研究中，PHC 的相对患病率分别为 54%、20%、15%、5% 和 7%。 BD 的显着相对风险估计范围为 1.44 至 3.66，DD 为 1.43 至 2.21，SZ 为 0.81 至 1.97，AUD 为 3.31。过度身体健康负担占总数的 27% 至 67%，相当于欧洲 8400 万（澳元）、6700 万（BD）、6600 万（DD）和 500 万（深圳）的 PHC 诊断。假设因果推断，超额风险降低 1% 可能会导致所调查的 MHD 中的 PHC 减少 200 万。结论 这是欧洲第一项针对严重 MHD 的身体健康负担的综合研究。这些方法允许更新、细化和扩展到其他 MHD 或地理区域。临床意义 结果表明，通过更加综合的精神和身体保健及预防方法，可以实现潜在的人口健康益处。