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Commentary on: Stubbs B, Koyanagi A, Veronese N, et al. Physical multimorbidity and psychosis: comprehensive cross sectional analysis including 242,952 people across 48 low- and middle-income countries. BMC Med 2016 Nov 22;14:189.
What is already known on this topic?
There is a very strong association between mental and physical illness that challenges the typical focus of healthcare systems on either mental or physical disorders.1 The relationship between psychosis and physical illness, including multiple physical illnesses (multimorbidity), is of considerable interest because people with psychosis have a greatly reduced life expectancy2 and in high-income countries most of those excess early deaths are due to natural causes. The most common of these causes may be inter-related and may therefore form a distinctive pattern of ‘multimorbidity’ associated with psychosis.3 Unravelling that pattern by age and gender, and by exposure to salient risk factors, may provide timely targets for clinical trials and early intervention initiatives to improve health and extend life expectancy. The observed level or pattern of multimorbidity may vary across high-income, middle-income and low-income countries because of variation in exposure to salient risk factors including local psychotropic drug prescribing patterns and tobacco use; both have been implicated in the poor physical health of people with psychosis in high-income countries where cardiovascular disease is the primary cause of excess early deaths. The aim of the study by Stubbs …
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.
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