• Natalie C Momen, Oleguer Plana-Ripoll, Esben Agerbo, Michael E Benros, Anders D Børglum, Maria K Christensen, Søren Dalsgaard, Louisa Degenhardt, Peter de Jonge, Jean-Christophe P G Debost, Morten Fenger-Grøn, Jane M Gunn, Kim M Iburg, Lars V Kessing, Ronald C Kessler, Thomas M Laursen, Lim Carmen C W CCW 0000-0003-1595-6307 From the National Center for Register-based Research (N.C.M., O.P.-R., E.A., M.K.C., S.D., J.-C.P.G.D., T.M.L.,, Ole Mors, Preben B Mortensen, Katherine L Musliner, Merete Nordentoft, Carsten B Pedersen, Liselotte V Petersen, Anette R Ribe, Annelieke M Roest, Sukanta Saha, Andrew J Schork, Kate M Scott, Carson Sievert, Holger J Sørensen, Terry J Stedman, Mogens Vestergaard, Bjarni Vilhjalmsson, Thomas Werge, Nanna Weye, Harvey A Whiteford, Anders Prior, and John J McGrath.
• From the National Center for Register-based Research (N.C.M., O.P.-R., E.A., M.K.C., S.D., J.-C.P.G.D., T.M.L., P.B.M., K.L.M., C.B.P., L.V.P., B.V., N.W., J.J.M.), Center for Integrated Register-based Research (E.A., P.B.M., C.B.P.), the Departments of Biomedicine-Human Genetics (A.D.B.) and Public Health (M.K.C., M.F.-G., K.M.I., M.V., A.P.), the Center for Integrative Sequencing (A.D.B.), and the Big Data Center for Environment and Health (C.B.P.), Aarhus University, the Lundbeck Foundation Initiative for Integrative Psychiatric Research (E.A., A.D.B., S.D., O.M., P.B.M., K.L.M., M.N., C.B.P., L.V.P., A.J.S., B.V., T.W.), the Center for Genomics and Personalized Medicine (A.D.B.), the Department of Neurology (J.-C.P.G.D.), and the Research Unit, Department of Psychosis (O.M.), Aarhus University Hospital, and the Research Unit for General Practice (M.F.-G., A.R.R., M.V., A.P.), Aarhus, the Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital (M.E.B., M.N., H.J.S.), Psychiatric Center Copenhagen (L.V.K.), Faculty of Health and Medical Sciences (L.V.K.), the Department of Clinical Medicine (T.W.), and the Lundbeck Foundation GeoGenetics Center, GLOBE Institute (T.W.), University of Copenhagen, Copenhagen, and the Institute of Biological Psychiatry, Mental Health Center Sankt Hans, Mental Health Services Capital Region, Roskilde (A.J.S., T.W.) - all in Denmark; the National Drug and Alcohol Research Centre, University of New South Wales, Sydney (L.D.), the Department of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, VIC (J.M.G.), and the Queensland Brain Institute (C.C.W.L., S.S., J.J.M.), Queensland Centre for Mental Health Research, the Park Centre for Mental Health (C.C.W.L., S.S., T.J.S., H.A.W., J.J.M.), and the School of Public Health, Faculty of Medicine (H.A.W.), University of Queensland, Brisbane - all in Australia; the Departments of Psychology (P.J.) and Developmental Psychology (A.M.R.), Heymans Institute, and the Interdisciplinary Center, Psychopathology and Emotion Regulation (P.J., A.M.R.), University of Groningen, Groningen, the Netherlands; the Department of Health Care Policy, Harvard Medical School, Boston (R.C.K.); the Neurogenomics Division, Translational Genomics Research Institute, Phoenix, AZ (A.J.S.); the Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand (K.M.S.); Sievert Consulting, Minneapolis (C.S.); and the Institute for Health Metrics and Evaluation, University of Washington, Seattle (H.A.W.).
• N. Engl. J. Med. 2020 Apr 30; 382 (18): 1721-1731.

BackgroundPersons with mental disorders are at a higher risk than the general population for the subsequent development of certain medical conditions.MethodsWe used a population-based cohort from Danish national registries that included data on more than 5.9 million persons born in Denmark from 1900 through 2015 and followed them from 2000 through 2016, for a total of 83.9 million person-years. We assessed 10 broad types of mental disorders and 9 broad categories of medical conditions (which encompassed 31 specific conditions). We used Cox regression models to calculate overall hazard ratios and time-dependent hazard ratios for pairs of mental disorders and medical conditions, after adjustment for age, sex, calendar time, and previous mental disorders. Absolute risks were estimated with the use of competing-risks survival analyses.ResultsA total of 698,874 of 5,940,299 persons (11.8%) were identified as having a mental disorder. The median age of the total population was 32.1 years at entry into the cohort and 48.7 years at the time of the last follow-up. Persons with a mental disorder had a higher risk than those without such disorders with respect to 76 of 90 pairs of mental disorders and medical conditions. The median hazard ratio for an association between a mental disorder and a medical condition was 1.37. The lowest hazard ratio was 0.82 for organic mental disorders and the broad category of cancer (95% confidence interval [CI], 0.80 to 0.84), and the highest was 3.62 for eating disorders and urogenital conditions (95% CI, 3.11 to 4.22). Several specific pairs showed a reduced risk (e.g., schizophrenia and musculoskeletal conditions). Risks varied according to the time since the diagnosis of a mental disorder. The absolute risk of a medical condition within 15 years after a mental disorder was diagnosed varied from 0.6% for a urogenital condition among persons with a developmental disorder to 54.1% for a circulatory disorder among those with an organic mental disorder.ConclusionsMost mental disorders were associated with an increased risk of a subsequent medical condition; hazard ratios ranged from 0.82 to 3.62 and varied according to the time since the diagnosis of the mental disorder. (Funded by the Danish National Research Foundation and others; COMO-GMC ClinicalTrials.gov number, NCT03847753.).Copyright © 2020 Massachusetts Medical Society.

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