HNB3224 COMORBIDITY OF PHYSICAL AND MENTAL ILLNESSES

Comorbidity of Physical Illnesses for Persons Living With Mental Illness

The prevalence of comorbidity mental and physical disease has increased and reached epidemic proportions in the past two decades. Most people over the age of sixty experience the simultaneous presence of two or more diseases. As stated by Sartorious (2013) the prevalence of comorbid mental and physical diseases is increasingly affecting people of all ages but the elderly (60 years and above) have the highest number of victims. Comorbidity is a condition that worsens the prognosis of the diseases leading to increased complications and makes treatment impossible. Individuals with chronic diseases such as cancer, diabetes, and hypertension are at a high risk of experiencing severe depression which complicates their condition making it difficult for healthcare practitioners to provide better care.

Patients with mental illness have a high risk of experiencing medical conditions including chronic diseases such as cardiovascular diseases (Scott et al., 2016). Goodell Druss, & Walker (2011) argues that chronic disease is a risk factor or mental illness and vice versa. Medical studies show that medical comorbidity in patients with mental illness has an extensive impact on their life and cost of care (Zolezzi et al., 2017). The co-occurrence of a mental and medical condition is prevalent among patient with mental or chronic illnesses; increasing the burden of symptoms resulting in high mortality among the population and decreased length and quality of life that requires a collaborative care approach to manage and treat since mental disorder is a risk factor for chronic condition and chronic condition is a risk factor for a mental disorder. Comorbidity of mental and physical has a direct impact on the quality of life and care and increases mortality rate (Merikangas et al., 2015). The use of a collaborative care model is effective and efficient in addressing the problem as well as solving the challenges experienced by healthcare workers.

The relationship between mental illness and chronic diseases is evident in patients experiencing chronic diseases such as cancer and diabetes. The comorbidity affects the quality of life and care which lowers the patient’s life expectancy and increases the cost of healthcare. As illustrated by Zolezzi et al. (2017), medical comorbidities among patients with mental illnesses cause premature deaths. Additionally, this population has a high risk of developing chronic diseases such as cancer, respiratory conditions, and heart diseases that cause mortality. Unfortunately, patients with medical comorbidity using the atypical antipsychotic medication are in danger of experiencing poor quality of life due to increased cases of cardiovascular complications (Zolezzi et al., 2017). The quality of life for mentally ill patients suffering from cardiovascular disease is poor given the lack of evidence associating screening or treating depression and anxiety with improved cardiovascular outcomes. Therefore, a patient receiving depression treatment is not prevented from a heart attack. Although managing the modifiable risk factors for cardiovascular diseases for patients with severe mental illness reduces the risk of premature mortality, this population experience discrimination in accessing healthcare services (Cohen, 2017). Consequently, they experience poor quality of life due to external factors beyond their control.

In addition to the poor quality of life characterised by chronic diseases and short life expectancy or premature mortality, this population experiences poor quality of care. As illustrated by Cohen (2017), people with mental illness are less likely to have access to high-quality primary care and seek healthcare services when the disease is at advanced stages. This affects the quality of life and the care they receive. In illustrating how comorbidity affects the quality of care, Cohen (2017) argues that mental disorder patients with cancer seek medical intervention when the cancer is at an advanced stage. Accordingly, this does not only affect the quality of care they receive but also leads to poor survival rate. In most cases, patients might require integrated, person-centred care approach which is unavailable in the health system. Diabetic patients are twice or thrice likely to have depression affecting glycaemic control resulting in a poor quality of life. Comorbidity of mental disorder and physical illness intensifies the burden of symptoms and causes functional impairment.