Mental health and physical illnessWhen the Roman poet Juvenal wrote that mankind should wish only for “mens sana in corpore sano” (a healthy mind in a healthy body) rather than fame and fortune, he linked mental and physical wellbeing in a way which has become increasingly difficult to understand in our modern world.

After all, we might see a relationship between chronic back pain and depression, but is there really a way in which anxiety, obsessive compulsive-disorder or eating disorders can contribute to heart disease, strokes or asthma?

Now a comprehensive 10-year compilation of 18 studies of more than 47,500 people across 17 countries (including more than 7000 in New Zealand) has revealed a strong relationship between a number of mental disorders and physical illnesses.

The research was carried out using information gathered between 2001 and 2011 (including the New Zealand Mental Health Survey 2003-04) and analysed by a number of authors led by Dr Kate Scott from the Department of Psychological Medicine at the University of Otago. And the results have led the authors to question how people seeking help for mental health issues should be treated.

The findings included “statistically significant” associations between 16 mental disorders (including mood disorders, anxiety disorders, impulse control disorders such as bulimia nervosa, and substance abuse) and 10 physical conditions (including arthritis, chronic pain, heart disease, stroke, hypertension, diabetes, asthma, chronic lung disease, peptic ulcers and cancer).

And for people who experienced an increasing number of mental disorders over their lifetime, the odds of the onset or diagnosis of all 10 types of physical conditions greatly increased too.

“Specific mental disorders were associated with between 1.5{7e66f01e68c52d858b59d425bd8f3886b02d30322136bee7d8e459b39be00af4} and 13.3{7e66f01e68c52d858b59d425bd8f3886b02d30322136bee7d8e459b39be00af4} of chronic physical condition onsets. To put [this] in context, high body mass index, which has similarities to mental disorders in being a prevalent risk factor associated with multiple outcomes, is associated with 13{7e66f01e68c52d858b59d425bd8f3886b02d30322136bee7d8e459b39be00af4} to 15{7e66f01e68c52d858b59d425bd8f3886b02d30322136bee7d8e459b39be00af4} of cardio-metabolic deaths.”

One of the pointers to this association is the poor results of depression treatment for patients who also suffer from heart disease with the report’s author’s suggesting that the link “could be better addressed by an early focus on the physical health of those with mental disorders rather than a later focus on the mental health of those with chronic physical conditions”.

It seems that seeking help for mental health issues could also highlight the need to monitor physical health issues – something which has great significance for both those working in mental health but also those researching their own health.

The report’s conclusions find that “current efforts to improve the physical health of individuals with mental disorders may be too narrowly focused on the small group with the most severe mental disorders” and that treatment aimed to prevent the onset of chronic physical diseases should be introduced “as early in the course of the mental disorder as possible”.

The overall “message” from the report is that you can’t separate mental and physical health and seeking help for issues such as depression, anxiety and substance abuse will not only lead to mental wellbeing but also physical wellbeing – that classic idea of a healthy mind in a healthy body.

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