National Centre for Register-based Research, Aarhus University, Denmark
Harvey A. Whiteford
School of Public Health, The University of Queensland, Australia; and Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Australia
Maria Klitgaard Christensen
National Centre for Register-based Research, Aarhus University, Denmark; and Department of Public Health, Aarhus University, Denmark
Kim Moesgaard Iburg
Department of Public Health, Aarhus University, Denmark
Damian F. Santomauro
School of Public Health, The University of Queensland, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Australia; and Institute for Health Metrics and Evaluation, University of Washington, USA
Esben Agerbo
National Centre for Register-based Research, Aarhus University, Denmark; Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Denmark; and Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
Preben Bo Mortensen
National Centre for Register-based Research, Aarhus University, Denmark; Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark; and Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Denmark
Carsten Bøcker Pedersen
National Centre for Register-based Research, Aarhus University, Denmark; and Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Denmark
National Centre for Register-based Research, Aarhus University, Denmark; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Australia; and Queensland Brain Institute, The University of Queensland, Australia
Oleguer Plana-Ripoll
National Centre for Register-based Research, Aarhus University, Denmark; and Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Denmark
Background General medical conditions (GMCs) often co-occur with mental and substance use disorders (MSDs). Aims To explore the contribution of GMCs to the burden of disease in people with MSDs, and investigate how this varied by age. Method A population-based cohort of 6 988 507 persons living in Denmark during 2000–2015 followed for up to 16 years. Danish health registers were used to identify people with MSDs and GMCs. For each MSD, years lived with disability and health loss proportion (HeLP) were estimated for comorbid MSDs and GMCs, using a multiplicative model for disability weights. Results Those with any MSD lost the equivalent of 43% of healthy life (HeLP = 0.43, 95% CI 0.40–0.44) after including information on GMCs, which was an increase from 25% before including GMCs (HeLP = 0.25, 95% CI 0.23–0.27). Schizophrenia was associated with the highest burden of disease (HeLP = 0.77, 95% CI 0.68–0.85). However, within each disorder, the relative contribution of MSDs and GMCs varied. For example, in those diagnosed with schizophrenia, MSDs and GMCs accounted for 86% and 14% of the total health loss; in contrast, in those with anxiety disorders, the same proportions were 59% and 41%. In general, HeLP increased with age, and was mainly associated with increasing rates of pulmonary, musculoskeletal and circulatory diseases. Conclusions In those with mental disorders, the relative contribution of comorbid GMCs to the non-fatal burden of disease increases with age. GMCs contribute substantially to the non-fatal burden of disease in those with MSDs.
