LAUSR

Abstract Background Patients with psychotic disorders have a reduced life expectancy compared to those without psychosis, and this is primarily due to differences in physical illnesses. We aimed to assess the risk of developing multimorbidity or multiple chronic physical health conditions, and quantify its prevalence among this clinical population. Methods We identified studies through MEDLINE, EMBASE and PsycINFO from 1990 to September 2019, and reference scanning of included studies. Quantitative studies were included if proportions of 2+ and/or 3+ chronic physical health conditions were evaluated for patients with psychosis. Findings from all studies were descriptively summarized, and estimates for risk and prevalence of multimorbidity were meta-analyzed using random effects models. Results Fourteen studies were included, eight of which were meta-analyzed to determine the risk of developing 2+ chronic conditions for patients with psychosis. The pooled meta-analytic estimate suggests that persons with psychosis have an increased risk of developing multimorbidity than those without psychotic disorders (Risk ratio, RR=1.69, 95% CI 1.37, 2.08). All studies employed different operational definitions of multimorbidity, with respect to both the number and types of included chronic conditions. Evidence from included studies suggests gender and age as potential risk factors for developing multiple chronic conditions. Discussion Patients with psychosis are 69% more likely to develop multimorbidity than those without psychotic disorders. Clinicians responsible for the management of patients with psychosis should assess their risk for somatic illnesses. Future research examining multimorbidity should employ consistent definitions to better enable cross-study comparisons.