severe mental illness

Although the prevalence of infectious diseases is higher in people with severe mental illness, further research is lacking. A recent population-based study in Sweden found an increased prevalence of HIV, hepatitis B, and hepatitis C in people with severe mental illness, and that substance misuse contributed most to this increase.

Severe mental illness is a broad term to describe psychiatric disorders that are persistent and disabling. Examples of severe mental illness are schizophrenia and bipolar disorder. Individuals with severe mental illness have mortality rates 2-3 times those of the general population and a reduction in life expectancy of up to 20 years. Evidence suggests that the prevalence of blood-borne viruses (BBVs) is higher in individuals with severe mental illness. BBVs include diseases like HIV and hepatitis B and C. However, studies regarding infectious disease prevalence in mental health research are lacking. Therefore, Bauer-Staeb and colleagues performed a study to examine the prevalence of HIV and hepatitis B and C in individuals with severe mental illness

The population-based, nationwide study used longitudinal data from 6,815,931 Swedish adults. Severe mental illness was defined as a clinical diagnosis of schizophrenia, schizoaffective disorder, bipolar disorder, or other psychotic illnesses. BBV status was defined as having a diagnosis of HIV or hepatitis B or C.

The authors published their results in a recent issue of the Lancet Psychiatry.Of the total population used in the study, 1.43% had a diagnosis of a severe mental illness. The prevalence of BBVs was higher in people with severe mental illness than those without. For example, of the general population, 0.09% had HIV, but there was a prevalence of 0.24% for HIV in those with severe mental illness. In other words, the odds of having HIV were 2.57 times higher in those with severe mental illness than in the general population. Similarly, the odds of hepatitis B were 2.29 times higher, and the odds of hepatitis C were a staggering 6.18 times higher.

The study also found that substance misuse contributed most to the increased risk of BBVs. “Prevention strategies should be adopted to reduce the risk of BBV infection among people with severe mental illness,” the authors noted in the article. “Given the substantial risk substance misuse poses for the acquisition of BBVs, helping individuals with severe mental illness reduce harms associated with their substance use might be the most beneficial avenue to reduce infection rates,” they added.

Written by Liana Merrill, PhD

Reference: Bauer-Staeb, C. et al. (2017). Prevalence and risk factors for HIV, hepatitis B, and hepatitis C in people with severe mental illness: a total population study of Sweden. Lancet Psychiatry.

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