Psychiatry Research EG

Medical comorbidity in individuals with established mental illnesses is an area of great concern [1]. The combined diagnosis of medical and psychiatric illnesses has been linked to increased functional and occupational disabilities [2], poorer quality of life [3], and accelerated mortality [4] compared with the diagnosis either one alone. Medical illnesses affect more than half of those with mental illnesses, particularly among older people [5]. Mental illness has been a strong barrier to effective medical care. Most mental illnesses are associated with medical morbidity and mortality, leading to lower quality of life, decreased functioning, and increased risk of early death [6]. It represents a major health problem, with a 15–30 year shorter lifetime compared with the general population [7]. Individuals with severe mental illness die earlier than those in the general population because of poor health, side effects of medication, and insufficient medical care [8]. There are important reasons for mental health clinicians to be interested in the physical health of their patients. Physical illness is prevalent among more than 45% of psychiatric outpatients and often remains undiscovered [9]. A number of reviews have shown that people with severe mental illness have an increased mortality, about two or three times as high as that in the general population [10]. This mortality gap, which translates to a 13–30-year shortened life expectancy in patients [11], has widened in recent decades [12], even in countries where the quality of healthcare programs is generally good [13]. About 60% of this increase in mortality is due to physical illness [14]. Disability can be defined as limitations in carrying out activities of daily living, such as self-care, mobility, and activities inside or outside the home [15]. Mental disorders often result in significant burden of illness and disability. The WHO has reported that mental illness is one of the largest contributors to disability worldwide [16]. The measure ‘disability-adjusted life years’ combines burden from premature mortality with that from living with disability and provides a comprehensive assessment of the burden of illness. The overall disability-adjusted life years burden for mental disorders is projected to increase to 15% by the year 2020, and this increase is proportionately larger than that for cardiovascular diseases (CVDs) [17]. Assessment of disability in social and occupational functioning is necessary in epidemiological studies [18]. Generally, poor levels of knowledge and skill on physical health monitoring in the workforce may contribute to the poor physical health of people with serious mental illnesses [19]. Recently, there has been a renewed interest in better managing the complex relationships that exist between mental and physical illnesses [20]. Thus, the aim of this study was to assess the prevalence of physical illness and disabilities associated with it in psychiatric patients attending the psychiatric outpatient clinic of Zagazig University Hospital