Where are patients who have co-occurring mental and physical diseases located?

Kristian L Toftegaard, Lea Nørgreen Gustafsson, Richard Uwakwe, Ulla A Andersen, Thomas Becker, Graziella Giacometti Bickel, Bernhard Bork, Joachim Cordes, Karel Frasch, Bent Ascanius Jacobsen, Reinhold Kilian, Jens Ivar Larsen, Christoph Lauber, Birthe Mogensen, Wulf Rössler, Kenji J Tsuchiya, Povl Munk-Jørgensen

Research output: Contribution to journalJournal articleResearchpeer-review


BACKGROUND: Patients with a psychiatric illness have a higher prevalence of physical diseases and thus a higher morbidity and mortality.

AIM: The main aim was to investigate where patients with co-occurring physical diseases and mental disorders (psychotic spectrum or mood) in the health and social service system are identified most frequently before admission into psychiatry. The second aim was to compare the differences in the treatment routes taken by the patients before entry into psychiatric services in all the participating countries (Denmark, Germany, Japan, Nigeria and Switzerland).

METHODOLOGY: On admission to a psychiatric service, patients diagnosed with schizophrenia, schizotypal or delusional disorders (International Classification of Diseases-10 (ICD-10) group F2) or mood (affective) disorders (ICD-10 group F3) and a co-morbid physical condition (cardiovascular disease, diabetes mellitus and overweight) were asked with which institutions or persons they had been in contact with in the previous 6 months.

RESULTS: Patients from Denmark, Germany and Switzerland with mental disorders had almost the same contact pattern. Their primary contact was to public or private psychiatry, with a contact percentage of 46%-91%; in addition, general practice was a common contact, with a margin of 41%-93%. Similar tendencies are seen in Japan despite the small sample size. With regard to general practice, this is also the case with Nigerian patients. However, religious guidance or healing was rarely sought by patients in Europe and Japan, while in Nigeria about 80% of patients with mental disorders had contacted this type of service.

CONCLUSION: Promoting prophylactic work between psychiatry and the general practice sector may be beneficial in diminishing physical conditions such as cardiovascular disease, diabetes mellitus and overweight in patients with mental disorders in European countries and Japan. In Nigeria (a low-to-middle-income country), religious guides or healers, along with general practitioners, are the most frequently contacted, and they therefore seem to be the most obvious partner to collaborate with.

Original languageEnglish
JournalInternational Journal of Social Psychiatry
Issue number5
Pages (from-to)456-464
Publication statusPublished - 28. Aug 2015


  • Cardiovascular Diseases
  • Comorbidity
  • Cooperative Behavior
  • Denmark
  • Diabetes Mellitus
  • General Practice
  • Germany
  • Health Services
  • Humans
  • Japan
  • Logistic Models
  • Mood Disorders
  • Nigeria
  • Overweight
  • Psychiatry
  • Schizophrenia
  • Social Work
  • Switzerland
  • Journal Article
  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • physical disease
  • Pathway to care
  • psychiatric illness
  • collaboration


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