Estimating the prevalence of chronic medical co-morbidities in the seriously mentally ill in primary care: a modelling framework

An increasing body of evidence suggests that, in comparison to the general population, patients with severe mental illnesses such as schizophrenia or bipolar disorder have worse physical health and a far shorter life expectancy, due primarily to co-morbid chronic diseases. The standardised mortality ratio for all forms of mental disorder is at least 1.5 and varies with the type and severity of the disorder. Whilst data on the prevalence of chronic diseases in primary care is available nationally, there is a lack of health intelligence on medical co-morbidities associated with chronic mental illnesses. The aim of this PhD was to develop and validate epidemiological models for predicting expected prevalence of two major chronic medical conditions namely, coronary heart disease (CHD) and chronic obstructive pulmonary disease (COPD), on general practice data for people with concurrent serious mental illness (SMI) group. The study probed the national epidemiological synthetic estimation of the two physical disorders to determine their prevalence within a local primary care setting and their co-existence within the serious mentally ill (SMI) group identified through the Quality Framework dataset (QOF) within GP practices and their localities. The expected prevalence was compared with recorded cases