Martin Lambert1, Friederike Ruppelt2, Anna-Katharina Siem3, Anja Christine Rohenkohl4, Vivien Kraft5, Daniel Luedecke6, Mary Sengutta7, Romy Schröter8, Anne Daubmann9, Christoph U Correll10, Jürgen Gallinat11, Anne Karow12, Klaus Wiedemann13, Daniel Schöttle14. 1. Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistreet 52, 20246 Hamburg, Germany. Electronic address: lambert@uke.de. 2. Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistreet 52, 20246 Hamburg, Germany. Electronic address: f.ruppelt@uke.de. 3. Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistreet 52, 20246 Hamburg, Germany. Electronic address: a.siem@uke.de. 4. Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistreet 52, 20246 Hamburg, Germany. Electronic address: a.rohenkohl@uke.de. 5. Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistreet 52, 20246 Hamburg, Germany. Electronic address: v.kraft@uke.de. 6. Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistreet 52, 20246 Hamburg, Germany. Electronic address: da.luedecke@uke.de. 7. Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistreet 52, 20246 Hamburg, Germany. Electronic address: m.sengutta@uke.de. 8. Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistreet 52, 20246 Hamburg, Germany. Electronic address: r.schroeter@uke.de. 9. Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf (UKE), Germany. Electronic address: a.daubmann@uke.de. 10. The Zucker Hillside Hospital, Psychiatry Research, 75-59 263rd Street, Glen Oaks, NY 11004, USA. Electronic address: ccorrell@lij.edu. 11. Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistreet 52, 20246 Hamburg, Germany. Electronic address: j.gallinat@uke.de. 12. Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistreet 52, 20246 Hamburg, Germany. Electronic address: karow@uke.de. 13. Center for Acute and Affective Disorders, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistreet 52, 20246 Hamburg, Germany. Electronic address: wiedemann@uke.de. 14. Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistreet 52, 20246 Hamburg, Germany; Center for Acute and Affective Disorders, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistreet 52, 20246 Hamburg, Germany. Electronic address: d.schoettle@uke.de.
Abstract
BACKGROUND: People with psychotic disorders fulfilling criteria of a severe and persistent mental illness (SPMI) display a high risk of somatic comorbidity (SC). METHODS: ACCESS II is a prospective, long-term study examining the effectiveness of Integrated Care for people with psychotic disorders fulfilling SPMI criteria. Chronic comorbid somatic disorders were systematically assessed according to ICD-10-GM criteria. Patients treated for ≥4years in ACCESS were categorized as early psychosis (treatment: ≤2years) or non-early psychosis (treatment: >2years) patients. RESULTS: Of 187 patients treated in ACCESS for ≥4years (mean age=41.8years, males=44.4%), 145 (77.5%) had SC, (mean=2.1±2.1). Overall, 55 different diseases from 15 different ICD-10-GM disease areas were identified. Prevalence of ≥1 SC (p=0.09) and specific types of SC (p=0.08-1.00) did not differ between early and non-early psychosis patients, but non-early psychosis patients had a higher mean number of SC (2.3±2.2 vs. 1.3±1.3, p=0.002). SC patients had higher rates of comorbid mental disorders (93% vs. 81%, p=0.002), specifically posttraumatic stress disorder (23% vs. 7%, p=0.002), and suicide attempts (43% vs. 19%, p<0.001). At the 4-year endpoint, both patients with and without comorbidity displayed major improvements in psychopathology, severity of illness, functioning, quality of life and satisfaction with care. CONCLUSIONS: SC is frequent in patients with severe psychotic disorders, even in the early psychosis phase. The magnitude of the problem underlines the need for regular screening, comprehensive assessment, preventive pharmacotherapy, and targeted SC management.
BACKGROUND:People with psychotic disorders fulfilling criteria of a severe and persistent mental illness (SPMI) display a high risk of somatic comorbidity (SC). METHODS: ACCESS II is a prospective, long-term study examining the effectiveness of Integrated Care for people with psychotic disorders fulfilling SPMI criteria. Chronic comorbid somatic disorders were systematically assessed according to ICD-10-GM criteria. Patients treated for ≥4years in ACCESS were categorized as early psychosis (treatment: ≤2years) or non-early psychosis (treatment: >2years) patients. RESULTS: Of 187 patients treated in ACCESS for ≥4years (mean age=41.8years, males=44.4%), 145 (77.5%) had SC, (mean=2.1±2.1). Overall, 55 different diseases from 15 different ICD-10-GM disease areas were identified. Prevalence of ≥1 SC (p=0.09) and specific types of SC (p=0.08-1.00) did not differ between early and non-early psychosispatients, but non-early psychosispatients had a higher mean number of SC (2.3±2.2 vs. 1.3±1.3, p=0.002). SC patients had higher rates of comorbid mental disorders (93% vs. 81%, p=0.002), specifically posttraumatic stress disorder (23% vs. 7%, p=0.002), and suicide attempts (43% vs. 19%, p<0.001). At the 4-year endpoint, both patients with and without comorbidity displayed major improvements in psychopathology, severity of illness, functioning, quality of life and satisfaction with care. CONCLUSIONS: SC is frequent in patients with severe psychotic disorders, even in the early psychosis phase. The magnitude of the problem underlines the need for regular screening, comprehensive assessment, preventive pharmacotherapy, and targeted SC management.
Authors: Daniel Schöttle; Friederike Ruppelt; Benno G Schimmelmann; Anne Karow; Alexandra Bussopulos; Jürgen Gallinat; Klaus Wiedemann; Daniel Luedecke; Anja Christine Rohenkohl; Christian G Huber; Thomas Bock; Martin Lambert Journal: Front Psychiatry Date: 2019-10-24 Impact factor: 4.157
Authors: Salla Karjula; Riikka K Arffman; Laure Morin-Papunen; Stephen Franks; Marjo-Riitta Järvelin; Juha S Tapanainen; Jouko Miettunen; Terhi T Piltonen Journal: Arch Womens Ment Health Date: 2021-11-29 Impact factor: 3.633
Authors: Martin Lambert; Anne Karow; Jürgen Gallinat; Daniel Lüdecke; Vivien Kraft; Anja Rohenkohl; Romy Schröter; Constanze Finter; Anna-Katharina Siem; Lisa Tlach; Nathalie Werkle; Susann Bargel; Gunda Ohm; Martin Hoff; Helmut Peter; Martin Scherer; Claudia Mews; Susanne Pruskil; Johannes Lüke; Martin Härter; Jörg Dirmaier; Michael Schulte-Markwort; Bernd Löwe; Peer Briken; Heike Peper; Michael Schweiger; Mike Mösko; Thomas Bock; Martin Wittzack; Hans-Jochim Meyer; Arno Deister; Rolf Michels; Stephanie Herr; Alexander Konnopka; Hannah König; Karl Wegscheider; Anne Daubmann; Antonia Zapf; Judith Peth; Hans-Helmut König; Holger Schulz Journal: BMJ Open Date: 2020-05-04 Impact factor: 2.692