People with physical diseases are reported to be at elevated risk of subsequent mental disorders. However, previous studies have considered only a few pairs of conditions, or have reported only relative risks. This study aimed to systematically explore the associations between physical diseases and subsequent mental disorders. It examined a population-based cohort of 7,673,978 people living in Denmark between 2000 and 2021, and followed them for a total of 119.3 million person-years. The study assessed nine broad categories of physical diseases (cardiovascular, endocrine, respiratory, gastrointestinal, urogenital, musculoskeletal, hematological and neurological diseases, and cancers), encompassing 31 specific diseases, and the subsequent risk of mental disorder diagnoses, encompassing the ten ICD-10 groupings (organic, including symptomatic, mental disorders; mental disorders due to psychoactive substance use; schizophrenia and related disorders; mood disorders; neurotic, stress-related and somatoform disorders; eating disorders; personality disorders; intellectual disabilities; pervasive developmental disorders; and behavioral and emotional disorders with onset usually occurring in childhood and adolescence). Using Poisson regression, the overall and time-dependent incidence rate ratios (IRRs) for pairs of physical diseases and mental disorders were calculated, adjusting for age, sex and calendar time. Absolute risks were estimated with the Aalen-Johansen estimator. In total, 646,171 people (8.4%) were identified as having any mental disorder during follow-up. All physical diseases except cancers were associated with an elevated risk of any mental disorder. For the nine broad pairs of physical diseases and mental disorders, the median point estimate of IRR was 1.51 (range: 0.99-1.84; interquartile range: 1.29-1.59). The IRRs ranged from 0.99 (95% CI: 0.98-1.01) after cancers to 1.84 (95% CI: 1.83-1.85) after musculoskeletal diseases. Risks varied over time after the diagnosis of physical diseases. The cumulative mental disorder incidence within 15 years after diagnosis of a physical disease varied from 3.73% (95% CI: 3.67-3.80) for cancers to 10.19% (95% CI: 10.13-10.25) for respiratory diseases. These data document that most physical diseases are associated with an elevated risk of subsequent mental disorders. Clinicians treating physical diseases should constantly be alert to the possible development of secondary mental disorders.

中文翻译：

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身体疾病与随后的精神障碍之间的关联：基于人群的队列纵向研究


据报道，患有身体疾病的人随后患精神疾病的风险较高。然而，之前的研究只考虑了几对条件，或者只报告了相对风险。本研究旨在系统地探讨身体疾病与随后的精神障碍之间的关联。它研究了 2000 年至 2021 年间居住在丹麦的 7,673,978 人的人口队列，并对他们进行了总计 1.193 亿人年的跟踪。该研究评估了九大类身体疾病（心血管、内分泌、呼吸、胃肠道、泌尿生殖、肌肉骨骼、血液和神经系统疾病以及癌症），涵盖 31 种特定疾病，以及随后诊断为精神障碍的风险，涵盖十种 ICD- 10组（器质性，包括症状性精神障碍；精神活性物质使用引起的精神障碍；精神分裂症及相关障碍；情绪障碍；神经质、压力相关和躯体形式障碍；饮食障碍；人格障碍；智力障碍；广泛性发育障碍；和行为和情绪障碍通常发生在儿童期和青春期）。使用泊松回归，计算了成对的身体疾病和精神疾病的总体和时间依赖性发病率比（IRR），并根据年龄、性别和日历时间进行了调整。绝对风险使用 Aalen-Johansen 估计器进行估计。随访期间总共有 646,171 人（8.4%）被确定患有精神障碍。除癌症外，所有身体疾病都与任何精神障碍的风险升高有关。对于九大对身体疾病和精神障碍，IRR 的中位点估计为 1。51（范围：0.99-1.84；四分位距：1.29-1.59）。癌症后的 IRR 为 0.99 (95% CI: 0.98-1.01)，肌肉骨骼疾病后的 IRR 为 1.84 (95% CI: 1.83-1.85)。在诊断出身体疾病后，风险随着时间的推移而变化。诊断出躯体疾病后 15 年内精神障碍的累积发病率从癌症的 3.73%（95% CI：3.67-3.80）到呼吸系统疾病的 10.19%（95% CI：10.13-10.25）不等。这些数据证明，大多数身体疾病都与随后发生精神障碍的风险升高有关。治疗躯体疾病的临床医生应时刻警惕继发性精神障碍的可能发展。