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J Psychosom Res. 2018 Nov;114:72-80. doi: 10.1016/j.jpsychores.2018.09.011. Epub 2018 Sep 25.

Patterns of chronic physical multimorbidity in psychiatric and general population.

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Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia. Electronic address:
Department of psychological medicine, University Hospital Center Zagreb, Zagreb, Croatia.
Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia.
Croatian Institute of Public Health, Zagreb, Croatia.
Department of Psychiatry, University Hospital Center Split, Split, Croatia.
Association for the Improvement of Mental Health Programmes, Geneva, Switzerland.



A growing body of evidence has demonstrated the high prevalence and complexity of chronic physical multimorbidity defined as ≥2 chronic physical illness in people with psychiatric disorders. The present study aimed to assess differences in the prevalence and patterns of self-reported chronic physical illness and multimorbidity in the general and psychiatric populations.


We performed a latent class analysis of 15 self-reported chronic physical illnesses on a sample of 1060 psychiatric patients and 837 participants from the general population.


Self-reported chronic physical illness and multimorbidity were significantly more prevalent in the population of psychiatric patients than in the general population (P < .001). Psychiatric patients had 27% (CI95% 24% - 30%) higher age-standardized relative risk for chronic physical illness and a 31% (CI95% 28% - 34%) higher for multimorbidity (P < .001). The number of chronic physical illnesses combinations was 52% higher in the psychiatric than in general population (255 vs 161 combinations respectively; P < .001). We identified four distinct latent classes: "Relatively healthy", "Musculoskeletal", "Hypertension and obesity", and "Complex multimorbidity" with no significant differences in the nature of multimorbidity latent classes patterns. The class "Relatively healthy" was significantly less (ARI = -25% (CI95% -30% -21%), and the class "Hypertension and obesity" was significantly more prevalent in the population of psychiatric patients (ARI = 20% (CI95% 17% - 23%).


These findings indicate that mental disorders are associated with an increased risk of a wide range of chronic physical illnesses and multimorbidity. There is an urgent need for the development of the guidelines regarding the physical healthcare of all individuals with mental disorders with multimorbidity in focus.


Chronic medical condition; Comorbidity; Mental disorders; Physical health; Physical illness

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