Physical multimorbidity and mental health in Italy

Background. Results from the World Health Survey indicate that physical health multimorbidity is significant increased across the depression and the psychosis spectrums worldwide. However, no research evidence is available on physical multimorbidity in patients with mental health problems in Italy. We investigated physical multimorbidity and pharmacological treatments among patients being treated by Italian community mental health services and the associated risk of hospitalization over 18 months. Materials and Methods. This retrospective study is based on linkage of data retrieved from the mental health information system, the hospital discharge records database and the pharmacological prescription databases. Patients living in Emilia-Romagna, Italy and treated by mental health services as of 1/1/2015 were extracted. A total of 17 physical health conditions and 9 pharmacological treatments for the cardiovascular system and thyroid problems were assessed. The association of psychiatric diagnoses and physical multimorbidity with hospitalization was analysed using multivariable Poisson regression models. Results. The study sample includes 8615 patients (59.2% male, mean age 40.3 years). Depression (33.4%), schizophrenia (17.6%) and personality disorder (13.3%) were the most frequent psychiatric diagnoses. Physical comorbidity, i.e. the presence of at least one physical health condition, was found in 19.2% of cases, and multimorbidity (≥2 physical conditions) in 6.5%. Patients treated pharmacologically for physical conditions were 39.6%. Personality disorders, substance use disorders and physical multimorbidity were associated with an increased risk of hospitalization during the follow-up. Conclusions. Physical multimorbidity is found in 6.5% of patients with mental disorders and is associated with an increased risk of hospitalization. Given that physical health multimorbidity can increase the mortality risk, early interventions to reduce it in mental healthcare are warranted.