Physical Comorbidity in Adults Flashcards
What is mental-physical comorbidity?
Co-occurrence of mental disorders and physical disorders at greater than chance level.
What does it mean if a person has a mental disorder in relation to physical diseases?
They are more likely to develop a physical disease than someone without a mental disorder history.
What does it mean if a person has a physical disease in relation to mental disorders?
They are more likely to develop a mental disorder than someone in good health.
What are the two ways mental-physical comorbidity may manifest?
- Concurrent: both conditions evident at the same time
- Over the lifetime: conditions develop at different life stages.
What psychological mechanisms can lead from physical diseases to mental disorders?
- Shock
- Anxiety
- Distress
What factors increase psychological effects of a physical condition?
- If the condition is life threatening
- If the condition causes pain, disability, major lifestyle changes
What are some psychological effects of cancer?
- Fear of death
- Sense of hopelessness
- Stress from treatment and interactions
What is the case study presented about chronic pain?
A 42-year-old artist with chronic back pain became profoundly depressed after unsuccessful surgery.
What treatments were successful for the patient in the chronic pain case study?
Medication and Cognitive Behavioral Therapy (CBT).
What medications can lead from physical diseases to mental disorders?
- Interferon (for some cancers)
- Some anti-retrovirals for HIV
What biological mechanisms can lead to depression from physical diseases?
- Changes in the brain caused by disease
- Examples: vascular depression and Parkinsonian depression.
What is the time frame often associated with mental disorders leading to physical conditions?
Long term, as mental disorders usually start early in life.
What was the purpose of the World Mental Health Surveys study (2012-6)?
To investigate links between earlier mental disorders and subsequent chronic physical conditions.
What was the sample size and scope of the World Mental Health Surveys?
30 countries, 150,000 participants.
What chronic conditions were associated with a history of mental disorder?
- Arthritis
- Chronic pain
- Heart disease
- Stroke
- High blood pressure
- Diabetes
- Asthma
- Chronic lung disease
- Peptic ulcer
- Cancer
How does the number of mental disorders affect the likelihood of physical conditions?
The greater the number of mental disorders, the greater the odds of subsequent physical disease.
What lifestyle behaviors are associated with individuals who have mental disorders?
- Smoking
- Excessive alcohol consumption
- Poor diet
- Lack of exercise
- Poor sleep
What are the clinical implications of mental-physical comorbidity for mental health patients?
Assess lifestyle and physical disease biomarkers early in life.
What is the ‘scandal of premature mortality’ in mental health patients?
Mental health patients die 10-15 years earlier than those without mental disorders.
What should physicians be aware of regarding medical patients with a history of mental health problems?
They may be more vulnerable to psychological distress or mental disorders.
What are some effects of mental disorder comorbidity in medical patients?
- Decreased treatment adherence
- Complicated treatment
- Increased suffering
What is the association between having a mental disorder earlier in life and chronic physical conditions later in life?
Having a mental disorder earlier in life was associated with the subsequent diagnosis of a chronic physical condition sometime later in life.
This highlights a significant link between mental health and physical health outcomes.
What factors were adjusted for in the study of associations of mental disorders with physical conditions?
Age, sex, country, smoking, education, child abuse.
Adjustments help clarify the relationship between mental disorders and physical conditions.
What is the odds ratio of any mood disorder associated with arthritis?
1.6*
Indicates a significant association between mood disorders and the risk of developing arthritis.
What is the odds ratio for any anxiety disorder associated with chronic pain?
1.8*
Suggests a strong link between anxiety disorders and chronic pain conditions.
How does the number of mental disorders correlate with the risk of developing physical conditions?
The greater the number of mental disorders, the greater the odds of subsequent physical disease.
This indicates a cumulative risk effect.
What is the odds ratio for 5+ mental disorders associated with chronic lung disease?
3.4*
This highlights a significant increase in risk for those with multiple mental disorders.
What lifestyle behaviors are more common in people with mental disorders?
Smoking, excessive alcohol consumption, poor diet, lack of exercise, poor sleep.
These behaviors contribute to physical health issues.
What are some biological mechanisms linking mental disorders to physical conditions?
HPA and SNS axes hyperactivity, inflammation, medications like antipsychotics causing obesity and metabolic syndrome.
These mechanisms provide insight into how mental health can impact physical health.
What clinical implications arise from the mental-physical comorbidity?
Assess lifestyle and physical disease biomarkers in mental health patients, start assessment early in life.
Early intervention can prevent the development of chronic physical conditions.
What is the ‘scandal of premature mortality’ in mental health patients?
Mental health patients die 10-15 years earlier than those without mental disorders.
This emphasizes the urgent need for better health management in mental health populations.
What should physicians be aware of when treating medical patients?
Conditions involving pain, disability, threat to life can provoke psychological distress or mental disorders.
Awareness is crucial for comprehensive treatment.
True or False: Mental disorder comorbidity can decrease treatment adherence.
True
This complicates treatment and increases patient suffering.
