Somatic multicomorbidity and disability in patients with psychiatric disorders in comparison to the general population: a quasi-epidemiological investigation in 54,826 subjects from 40 countries (COMET-G study)

Fountoulakis KN 1 , Karakatsoulis GN 1 , Abraham S 2 , Adorjan K 3 , Ahmed HU 4 , Alarcón RD 5 Show all authors , Arai K 6 , Auwal SS 7 , Berk M 8 , Bjedov S 9 , Bobes J 10 , Bobes-Bascaran T 11 , Bourgin-Duchesnay J 12 , Bredicean CA 13 , Bukelskis L 14 , Burkadze A 15 , Cabrera Abud II 16 , Castilla-Puentes R 17 , Cetkovich M 18 , Colon-Rivera H 19 , Corral R 20 , Cortez-Vergara C 21 , Crepin P 22 , De Berardis D 23 , Zamora Delgado S 24 , Lucena D 25 , Sousa A 26 , Stefano RD 27 , Dodd S 8 , Priyanka Elek L 28 , Elissa A 29 , Erdelyi-Hamza B 28 , Erzin G 30 , Etchevers MJ 31 , Falkai P 3 , Farcas A 32 , Fedotov I 33 , Filatova V 34 , Fountoulakis NK 35 , Frankova I 36 , Franza F 37 , Frias P 38 , Galako T 39 , Garay CJ 31 , Garcia-Álvarez L 11 , García-Portilla MP 10 , Gonda X 28 , Gondek TM 40 , Morera González D 41 , Gould H 42 , Grandinetti P 23 , Grau A 24 , Groudeva V 43 , Hagin M 44 , Harada T 45 , Hasan TM 46 , Azreen Hashim N 47 , Hilbig J 14 , Hossain S 48 , Iakimova R 49 , Ibrahim M 50 , Iftene F 51 , Ignatenko Y 52 , Irarrazaval M 53 , Ismail Z 54 , Ismayilova J 55 , Jakobs A 56 , Jakovljević M 57 , Jakšić N 9 , Javed A 58 , Kafali HY 59 , Karia S 26 , Kazakova O 60 , Khalifa D 50 , Khaustova O 36 , Koh S 42 , Kopishinskaia S 61 , Kosenko K 62 , Koupidis SA 63 , Kovacs I 28 , Kulig B 28 , Lalljee A 64 , Liewig J 12 , Majid A 65 , Malashonkova E 12 , Malik K 29 , Malik NI 66 , Mammadzada G 67 , Mandalia B 64 , Marazziti D 68 , Marčinko D 9 , Martinez S 42 , Matiekus E 14 , Mejia G 42 , Memon RS 69 , Meza Martínez XE 70 , Mickevičiūtė D 71 , Milev R 51 , Mohammed M 72 , Molina-López A 73 , Morozov P 74 , Muhammad NS 75 , Mustač F 9 , Naor MS 76 , Nassieb A 50 , Navickas A 14 , Okasha T 50 , Pandova M 49 , Panfil AL 77 , Panteleeva L 78 , Papava I 13 , Patsali ME 79 , Pavlichenko A 52 , Pejuskovic B 80 , Pinto Da Costa M 81 , Popkov M 82 , Popovic D 83 , Raduan NJN 47 , Vargas Ramírez F 24 , Rancans E 84 , Razali S 47 , Rebok F 85 , Rewekant A 86 , Ninoska Reyes Flores E 87 , Rivera-Encinas MT 88 , Saiz P 10 , Sánchez de Carmona M 89 , Saucedo Martínez D 90 , Saw JA 47 , Saygili G 91 , Schneidereit P 92 , Shah B 93 , Shirasaka T 94 , Silagadze K 15 , Sitanggang S 95 , Skugarevsky O 96 , Spikina A 97 , Mahalingappa SS 98 , Stoyanova M 49 , Szczegielniak A 99 , Tamasan SC 77 , Tavormina G 100 , Tavormina MGM 100 , Theodorakis PN 101 , Tohen M 102 , Tsapakis EM 103 , Tukhvatullina D 104 , Ullah I 105 , Vaidya R 106 , Vega-Dienstmaier JM 107 , Vrublevska J 84 , Vukovic O 80 , Vysotska O 108 , Widiasih N 29 , Yashikhina A 61 , Prezerakos PE 109 , Smirnova D 61

Affiliations 

  • 1 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki Greece, Thessaloniki, Greece
  • 2 Pennine Care NHS Foundation Trust, Heywood, UK
  • 3 Department of Psychiatry, Ludiwig-Maximilians-University, Munich, Germany
  • 4 Child Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh
  • 5 Section of Psychiatry and Mental Health, Universidad Peruana Cayetano Heredia, Facultad de Medicina Alberto Hurtado, Lima, Peru
  • 6 School of Medicine and Health Science, Institute of Health Science Shinshu University, Matsumoto, Japan
  • 7 Department of Psychiatry, Bayero University, Kano, Nigeria
  • 8 IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Deakin University, School of Medicine, Barwon Health, Geelong, Australia
  • 9 Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
  • 10 Psychiatry Area, Department of Medicine, University of Oviedo, Oviedo, Spain
  • 11 ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
  • 12 Division of Child and Adolescent Psychiatry, Department of Psychiatry, Groupe Hospitalier Nord Essonne, Orsay, France
  • 13 Department of Neuroscience, Discipline of Psychiatry, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
  • 14 Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
  • 15 Mental Hub, Tbilisi, Georgia
  • 16 Hospital San Juan de Dios Hospital, Guadalajara, Mexico
  • 17 Janssen Research and Development, Johnson & Johnson, American Society of Hispanic Psychiatry and WARMI Women Mental Health, Cincinnati, OH, USA
  • 18 Institute of Translational and Cognitive Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
  • 19 APM Board Certified in General Psychiatry and Neurology, Addiction Psychiatry, & Addiction Medicine, UPMC, DDAP, Philadelphia, PA, USA
  • 20 Department of Teaching and Research, Hospital Borda, Buenos Aires, Argentina
  • 21 Universidad Peruana Cayetano Heredia, Clínica AngloAmericana, Lima, Peru
  • 22 Sanitaire and Social Union for Accompaniment and Prevention, Center of Ambulatory Psychiatry of Narbonne and Lezigan, Narbonne, France
  • 23 Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL Teramo, Teramo, Italy
  • 24 Child and Adolescent Psychiatry Department, Hospital Luis Calvo Mackenna, Santiago, Chile
  • 25 Departamento de Fisiología e Farmacología, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
  • 26 Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
  • 27 Department of Biotechnological and Applied Clinical Sciences, Section of Psychiatry, University of L'Aquila, L'Aquila, Italy
  • 28 Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
  • 29 Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
  • 30 Department of Psychiatry, Ankara Dışkapı Training and Research Hospital, Ankara, Turkey
  • 31 Faculty of Psychology, University of Buenos Aires (UBA), Buenos Aires, Argentina
  • 32 Centre of Neuroscience, Queen's University, Kingston, Ontario, Canada
  • 33 Department of Psychiatry and Narcology, Ryazan State Medical University n.a. Academician I.P. Pavlov, Ryazan, Russia
  • 34 State Budgetary Institution of the Rostov Region "Psychoneurological Dispensary", Rostov-on-Don, Russia
  • 35 Faculty of Medicine, Medical University of Sofia, Sofia, Bulgaria
  • 36 Medical Psychology, Psychosomatic Medicine and Psychotherapy Department, Bogomolets National Medical University, Kyiv, Ukraine
  • 37 "Villa dei Pini" Psychiatric Rehabilitation Center, Avellino, Italy
  • 38 Hospital Magalhães Lemos, Porto, Portugal
  • 39 Department of Psychiatry, Medical Psychology and Drug Abuse, Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic
  • 40 Specialty Training Section, Polish Psychiatric Association, Wroclaw, Poland
  • 41 Instituto Nacional de Psiquiatría Ramón De la Fuente Muñiz, Mexico City, Mexico
  • 42 Department of Psychiatry, University of California San Diego, San Diego, USA
  • 43 Department of Diagnostic Imaging, University Hospital Saint Ekaterina, Sofia, Bulgaria
  • 44 Forensic Psychiatry Unit, Abarbanel Mental Health Center, Bat Yam, Israel
  • 45 Faculty of Human Sciences, Education Bureau of the Laboratory Schools, University of Tsukuba, Tokyo, Japan
  • 46 Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
  • 47 Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
  • 48 Department of Public Health and Informatics, Jahangirnagar University, Dhaka, Bangladesh
  • 49 Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry "Saint Naum", Sofia, Bulgaria
  • 50 Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
  • 51 Department of Psychiatry, Queens University, Kingston, ON, Canada
  • 52 Education Center, Mental Health Clinic No. 1 named after N.A. Alexeev of Moscow Healthcare Department, Moscow, Russia
  • 53 Ministry of Health, Millenium Institute for Research in Depression and Personality, Santiago, Chile
  • 54 Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
  • 55 National Mental Health Center of the Ministry of Health of the Republic of Azerbaijan, Baku, Azerbaijan
  • 56 Department of Psychiatry, Westchester Medical Center Health System, Valhalla, NY, USA
  • 57 School of Medicine, University of Zagreb, Zagreb, Croatia
  • 58 Institute of Applied Health Research, University of Birmingham, Birmingham, UK
  • 59 Department of Child Psychiatry, Ankara City Hospital, Ankara, Turkey
  • 60 Faculty of Medicine, Lund University, Malmö, Sweden
  • 61 International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia
  • 62 Department of Psychiatry, Drug Abuse and Psychology, Odessa National Medical University, Odessa, Ukraine
  • 63 Occupational and Environmental Health Sector, Public Health Policy Department, School of Public Health, University of West Attica, Athens, Greece
  • 64 Desousa Foundation, Mumbai, Maharashtra, India
  • 65 Department of Psychiatry, SKIMS Medical College, Srinagar, India
  • 66 Department of Psychology, University of Sargodha, Sargodha, Pakistan
  • 67 Department of Psychiatry, Azerbaijan Medical University, Baku, Azerbaijan
  • 68 Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
  • 69 Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
  • 70 Postgraduate Program in Psychiatry, National Autonomous University of Honduras, Tegucigalpa, Honduras
  • 71 Private outpatient clinics "JSC InMedica Klinika", Vilnius, Lithuania
  • 72 Department of Clinical Services, Federal Neuropsychiatric Hospital, Kaduna, Nigeria
  • 73 General Office for the Psychiatric Services of the Ministry of Health, Mexico City, Mexico
  • 74 Department of Postgraduate Education, Russian National Research Medical University n.a. N.I. Pirogov, Moscow, Russia
  • 75 Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
  • 76 Sackler School of Medicine New York State American Program, Tel Aviv University, Tel Aviv-Yafo, Israel
  • 77 Compartment of Liaison Psychiatry, "Pius Brinzeu" County Emergency Clinical Hospital, Timisoara, Romania
  • 78 Department of Medical Psychology, Psychiatry and Psychotherapy, Kyrgyz-Russian Slavic University, Bishkek, Kyrgyz Republic
  • 79 School of Social Sciences, Hellenic Open University, Patras, Greece
  • 80 Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • 81 South London and Maudsley NHS Foundation Trust, London, UK
  • 82 Department of the Introduction to Internal Medicine and Family Medicine, International Higher School of Medicine, Bishkek, Kyrgyz Republic
  • 83 Abarbanel Mental Health Center, Bat-Yam, Israel
  • 84 Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia
  • 85 Servicio de Emergencia, Acute inpatient Unit, Hospital Moyano, Buenos Aires, Argentina
  • 86 General Psychiatry Unit I, Greater Poland Neuropsychiatric Center, Kościan, Poland
  • 87 Department of Psychiatry, National Autonomous University of Honduras, Tegucigalpa, Honduras
  • 88 Centro de Investigación en Salud Pública, Facultad de Medicina, Universidad de San Martín de Porres, Instituto Nacional de Salud Mental "Honorio Delgado - Hideyo Noguchi", Lima, Perú
  • 89 Faculty of Health Sciences, Anahuac University, Mexico City, Mexico
  • 90 Department of Psychiatry, Escuela Nacional de Medicina, TEC de Monterrey, Servicio de geriatría. Hospital Universitario "José Eleuterio González" UANL, Monterrey, Nuevo León, Mexico
  • 91 Department of Cognitive Science and Artificial Intelligence, Tilburg University, Tilburg, The Netherlands
  • 92 Klinik für Allgemeine Psychiatrie und Psychotherapie Ost, Psychiatrische Institutsambulanz, Klinikum am Weissenhof, Weissenhof, Germany
  • 93 DY Patil Medical College, Navi Mumbai, Maharashtra, India
  • 94 Department of Psychiatry, Teine Keijinkai Medical Center, Sapporo, Japan
  • 95 Psychiatric Unit, Pambalah Batung General Hospital, South Kalimantan, Amuntai, Indonesia
  • 96 Department of Psychiatry and Medical Psychology, Belarusian State Medical University, Minsk, Belarus
  • 97 Saint Petersburg Psychoneurological Dispensary No. 2, Saint Petersburg, Russia
  • 98 Derbyshire Healthcare NHS Foundation Trust, The Liasion Team, Royal Derby Hospital, Derby, Derbyshire, UK
  • 99 Department of Psychiatric Rehabilitation, Department of Psychiatry and Psychotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Poland
  • 100 Psychiatric Studies Centre, Provaglio d'Iseo, Italy
  • 101 Health Policy, WHO Regional Office for Europe, Copenhagen, Denmark
  • 102 Department of Psychiatry and Behavioral Sciences, School of Medicine, University of New Mexico, Albuquerque, Nm, USA
  • 103 "Agios Charalambos" Mental Health Clinic, Heraklion, Crete, Greece
  • 104 Centre for Global Public Health, Institute of Population Health Sciences, Queen Mary University of London, London, UK
  • 105 Kabir Medical College, Gandhara University, Peshawar, Pakistan
  • 106 Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
  • 107 Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú
  • 108 Educational and Research Center - Ukrainian Family Medicine Training Center, Bogomolets National Medical University, Kyiv, Ukraine
  • 109 Department of Nursing, University of Peloponnese, Laboratory of Integrated Health Care, Tripoli, Greece
CNS Spectr, 2024 Apr;29(2):126-149.
PMID: 38269574 DOI: 10.1017/S1092852924000026

Abstract

BACKGROUND: The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders.

METHODS: The sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions.

RESULTS: About 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15-20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome.

CONCLUSIONS: The finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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