Effect of contributing factors on the incidence of non-communicable diseases among adults with common mental health disorders: a systematic review

Abstract

Background Individual, social and environmental factors play a dynamic role in determining mental health outcomes. The linkage between mental health and non-communicable disease is widely noted, but the mechanisms are poorly understood. The current systematic review aims to identify common contributing factors linking mental health to non-communicable disease incidence among adults to inform planned preventive interventions for high-risk non-communicable disease and mental ill-health populations. Methods MEDLINE, PsycINFO, EMBASE and CINAHL were searched from February to August 2019 for case-control and longitudinal studies of adults with common mental health disorders (depression and anxiety) assessing the causal effect of individual, environmental and social factors on the incidence of common non-communicable diseases (cancers, cardiovascular diseases, chronic obstructive pulmonary disease and diabetes mellitus). There were no geographical restrictions for the selected studies and the results were generated utilising a narrative synthesis. Results Of 15,266 unique documents identified by search terms, 419 met criteria for full-text review and 11 studies met inclusion criteria for data extraction. None of the identified studies had the onset of chronic obstructive pulmonary disease as an outcome. The majority of the studies showed a significant effect of depression and/or post-traumatic stress disorder on non-communicable disease incidence. The chronicity of mental health disorders appears to exacerbate their effect on non-communicable disease onset. Older age, higher body mass index, female sex, smoking status and number of cigarettes smoked, low educational attainment and ethnicity were found to exert a significant effect on the association between mental health disorders and non-communicable disease onset. Conclusion Findings from this review provide evidence to guide health practice and policy to reduce the burden of non-communicable diseases and mental health disorders. Interventions targeted towards identifying and treating mental health illnesses and the factors linking mental and physical health lower the burden of mental disorders and prevent the subsequent development of non-communicable diseases. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Global Health Research programme (NIHR award ref: 16/136/100). A plain language summary of this research article is available on the NIHR Journals Library Website https://doi.org/10.3310/CTDH4677.