Modelling associations between neurocognition and functional course in young people with emerging mental disorders: a longitudinal cohort study.
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ABSTRACT:
SUBMITTER: Crouse JJ
PROVIDER: S-EPMC7026055 | biostudies-literature | 2020 Jan
REPOSITORIES: biostudies-literature
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Modelling associations between neurocognition and functional course in young people with emerging mental disorders: a longitudinal cohort study.
Crouse Jacob J JJ Chitty Kate M KM Iorfino Frank F Carpenter Joanne S JS White Django D Nichles Alissa A Zmicerevska Natalia N Guastella Adam J AJ Scott Elizabeth M EM Lee Rico S C RSC Naismith Sharon L SL Scott Jan J Hermens Daniel F DF Hickie Ian B IB
Translational psychiatry 20200121 1
Neurocognitive impairment is commonly associated with functional disability in established depressive, bipolar and psychotic disorders. However, little is known about the longer-term functional implications of these impairments in early phase transdiagnostic cohorts. We aimed to examine associations between neurocognition and functioning at baseline and over time. We used mixed effects models to investigate associations between neurocognitive test scores and longitudinal social and occupational ...[more]
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Project description:ImportanceExcess risk of physical disease and mortality has been observed among individuals with psychiatric conditions, suggesting that ameliorating mental disorders might also be associated with ameliorating the later onset of physical disability and early mortality. However, the temporal association between mental disorders and physical diseases remains unclear, as many studies have relied on retrospective recall, used cross-sectional designs or prospective designs with limited follow-up periods, or given inadequate consideration to preexisting physical illnesses.ObjectiveTo examine whether mental disorders are associated with subsequent physical diseases and mortality across 3 decades of observation.Design, setting, and participantsThis population-based cohort study used data from the New Zealand Integrated Data Infrastructure, a collection of nationwide administrative data sources linked at the individual level, to identify mental disorders, physical diseases, and deaths recorded between July 1, 1988, and June 30, 2018, in the population of New Zealand. All individuals born in New Zealand between January 1, 1928, and December 31, 1978, who resided in the country at any time during the 30-year observation period were included in the analysis. Data were analyzed from July 2019 to November 2020.ExposuresNationwide administrative records of mental disorder diagnoses made in public hospitals.Main outcomes and measuresChronic physical disease diagnoses made in public hospitals, deaths, and health care use.ResultsThe study population comprised 2 349 897 individuals (1 191 981 men [50.7%]; age range at baseline, 10-60 years). Individuals with a mental disorder developed subsequent physical diseases at younger ages (hazard ratio [HR], 2.33; 95% CI, 2.30-2.36) and died at younger ages (HR, 3.80; 95% CI, 3.72-3.89) than those without a mental disorder. These associations remained across sex and age and after accounting for preexisting physical diseases. Associations were observed across different types of mental disorders and self-harm behavior (relative risks, 1.78-2.43; P < .001 for all comparisons). Mental disorders were associated with the onset of physical diseases and the accumulation of physical disease diagnoses (incidence rate ratio [IRR], 2.00; 95% CI, 1.98-2.03), a higher number of hospitalizations (IRR, 2.43; 95% CI, 2.39-2.48), longer hospital stays for treatment (IRR, 2.70; 95% CI, 2.62-2.79), and higher associated health care costs (b = 0.115; 95% CI, 0.112-0.118).Conclusions and relevanceIn this study, mental disorders were likely to begin and peak in young adulthood, and they antedated physical diseases and early mortality in the population. These findings suggest that ameliorating mental disorders may have implications for improving the length and quality of life and for reducing the health care costs associated with physical diseases.
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