Summary: Researchers have identified that some physical diseases tend to occur more frequently in young people who have previously suffered from certain mental disorders.

Source: University of Basel.

Mental disorders and physical diseases frequently go hand in hand. For the first time, psychologists at the University of Basel and Ruhr University Bochum have identified temporal patterns in young people: arthritis and diseases of the digestive system are more common after depression, while anxiety disorders tend to be followed by skin diseases.

Physical diseases and mental disorders affect a person’s quality of life and present a huge challenge for the healthcare system. If physical and mental disorders systematically co-occur from an early age, there is a risk that the sick child or adolescent will suffer from untoward developments.

Data from 6,500 teenagers

In a project financed by the Swiss National Science Foundation, a research group led by PD Dr. Marion Tegethoff in collaboration with Professor Gunther Meinlschmidt from the University of Basel’s Faculty of Psychology has now examined the temporal pattern and relationship between physical diseases and mental disorders in children and young people. In the journal PLOS ONE, they analyzed data from a representative sample of 6,483 teenagers from the US aged between 13 and 18.

The researchers noted that some physical diseases tend to occur more frequently in children and adolescents if they have previously suffered from certain mental disorders. Likewise, certain mental disorders tend to occur more frequently after the onset of particular physical diseases. Affective disorders such as depression were frequently followed by arthritis and diseases of the digestive system, while the same relationship existed between anxiety disorders and skin diseases. Anxiety disorders were more common if the person had already suffered from heart disease. A close association was also established for the first time between epileptic disorders and subsequent eating disorders.

Epilepsy and eating disorders

The results offer important insights into the causal relationship between mental disorders and physical diseases. The newly identified temporal associations draw attention to processes that could be relevant both to the origins of physical diseases and mental disorders and to their treatment. In an earlier study, the same authors had already provided evidence for the relationship between mental disorders and physical diseases in young people.

“For the first time, we have established that epilepsy is followed by an increased risk of eating disorders – a phenomenon, that had previously been described only in single case reports. This suggests that approaches to epilepsy treatment could also have potential in the context of eating disorders,” explains Marion Tegethoff, the study’s lead author. From a health policy perspective, the findings underscore that the treatment of mental disorders and physical diseases should be closely interlinked from an early age on.

Source: Marion Tegethoff – University of Basel
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Original Research: Full open access research for “Chronology of Onset of Mental Disorders and Physical Diseases in Mental-Physical Comorbidity – A National Representative Survey of Adolescents” by Marion Tegethoff, Esther Stalujanis, Angelo Belardi, and Gunther Meinlschmidt in PLOS ONE. Published online October 21 2016 doi:10.1371/journal.pone.0165196

Abstract

Chronology of Onset of Mental Disorders and Physical Diseases in Mental-Physical Comorbidity – A National Representative Survey of Adolescents

Background

The objective was to estimate temporal associations between mental disorders and physical diseases in adolescents with mental-physical comorbidities.

Methods

This article bases upon weighted data (N = 6483) from the National Comorbidity Survey Adolescent Supplement (participant age: 13–18 years), a nationally representative United States cohort. Onset of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition lifetime mental disorders was assessed with the fully structured World Health Organization Composite International Diagnostic Interview, complemented by parent report. Onset of lifetime medical conditions and doctor-diagnosed diseases was assessed by self-report.

Results

The most substantial temporal associations with onset of mental disorders preceding onset of physical diseases included those between affective disorders and arthritis (hazard ratio (HR) = 3.36, 95%-confidence interval (CI) = 1.95 to 5.77) and diseases of the digestive system (HR = 3.39, CI = 2.30 to 5.00), between anxiety disorders and skin diseases (HR = 1.53, CI = 1.21 to 1.94), and between substance use disorders and seasonal allergies (HR = 0.33, CI = 0.17 to 0.63). The most substantial temporal associations with physical diseases preceding mental disorders included those between heart diseases and anxiety disorders (HR = 1.89, CI = 1.41 to 2.52), epilepsy and eating disorders (HR = 6.27, CI = 1.58 to 24.96), and heart diseases and any mental disorder (HR = 1.39, CI = 1.11 to 1.74).

Conclusions

Findings suggest that mental disorders are antecedent risk factors of certain physical diseases in early life, but also vice versa. Our results expand the relevance of mental disorders beyond mental to physical health care, and vice versa, supporting the concept of a more integrated mental-physical health care approach, and open new starting points for early disease prevention and better treatments, with relevance for various medical disciplines.

“Chronology of Onset of Mental Disorders and Physical Diseases in Mental-Physical Comorbidity – A National Representative Survey of Adolescents” by Marion Tegethoff, Esther Stalujanis, Angelo Belardi, and Gunther Meinlschmidt in PLOS ONE. Published online October 21 2016 doi:10.1371/journal.pone.0165196