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Addressing comorbidity between mental disorders and major noncommunicable diseases

Background technical report to support implementation of the WHO European Mental Health Action Plan 2013?2020 and the WHO European Action Plan for the Prevention and Control of Noncommunicable Diseases 2016?2025

Addressing comorbidity between mental disorders and major noncommunicable diseases

Background technical report to support implementation of the WHO European Mental Health Action Plan 2013?2020 and the WHO European Action Plan for the Prevention and Control of Noncommunicable Diseases 2016?2025

Alan Cohen

Abstract

Reduced healthy life expectancy due to the high burden of both mental ill health and noncommunicable diseases (NCDs) is a major public health concern in the European Region. The links between mental disorders and major NCDs are well established. In clinical practice, however, mental disorders in patients with NCDs as well as NCDs in patients with mental disorders are often overlooked. Premature mortality and disability could be reduced if there were a greater focus on comorbidity. This report addresses the needs of adults of working age with mental health problems ? those with common mental disorders such as depression and anxiety and those with more severe conditions such as schizophrenia and bi-polar affective disorder. It also addresses the needs of those with NCDs, specifically cardiovascular diseases, cancers, chronic respiratory diseases and diabetes mellitus. The report was prepared as a technical background paper to the WHO European Mental Health Action Plan 2013?2020 and the WHO European Action Plan for the Prevention and Control of Noncommunicable diseases 2016?2025. It is envisaged that the report will contribute to a better understanding of comorbidity by public health specialists and health care providers alike, which in turn will help to promote a more integrated approach for patients with comorbidity.

Keywords MENTAL HEALTH CHRONIC DISEASE HEALTH-CARE SYSTEMS HEALTH COMORBIDITY NONCOMMUNICABLE DISEASES

ISBN: 9789289052535

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? World Health Organization 2017

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Contents

Acknowledgements

iv

Glossary

v

Abbreviations and acronyms

v

Executive summary

vi

1. Introduction

1

1.1 The burden of mental disorders and major noncommunicable diseases

1

1.2 Political commitment to addressing the burden of mental disorders and major noncommunicable diseases 1

1.3 Rationale and scope of the report

2

2. Relations between mental disorder and major noncommunicable diseases

3

2.1 Diabetes

3

2.2 Cardiovascular disease

8

2.3 Chronic respiratory diseases

14

2.4 Cancer

19

3. Implications for health services

23

3.1 Health service delivery

23

3.2 Strengthened knowledge and skills in the health workforce

24

4. Conclusions

25

5. References

26

iii

Acknowledgements

This report was written by Dr Alan Cohen, Director of Primary Care at the West London Mental Health Trust (rtd.). Essential advice and support were provided to the main author by Dr Dan Chisholm, Dr Jill Farrington, Dr Matt Muijen and Dr Elena Shevkun, WHO Regional Office for Europe. Dr Marilys Corbex and Dr Juan Tello, WHO Regional Office for Europe, provided valuable peer review comments. The report was produced under the overall guidance of Dr Gauden Galea, Director of the Division of Noncommunicable Diseases and Promoting Health through the Life-course in the WHO Regional Office for Europe. This publication was partially funded by the Government of the Russian Federation within the context of the WHO European Office for the Prevention and Control of Noncommunicable Diseases (NCD Office).

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