The Associations Between Mental Disorders and Cascade of Care in Managing Hypertension, Diabetes, Dyslipidemia, Chronic Kidney Disease in China: A Pooled Cross-Sectional Analysis

Abstract Physical non-communicable diseases (NCDs) and mental disorder are a rapidly increasing health burden in low-and middle-income countries. This study aims to examine the relationships between mental disorder and cascade of care in managing four common physical NCDs (hypertension, diabetes, dyslipidemia, chronic kidney disease) in China. We utilized two waves of nationally-representative China Health and Retirement Longitudinal Study (CHARLS 2011, 2015) of older adult population aged 45 and above. A series of multivariate mixed-effect logistic regression was applied to evaluate the association between presence of mental disorder and physical chronic disease awareness, treatment, and control. We found that the odds of dyslipidemia (AOR=2.88, 95% CI=2.21-3.74) and kidney disease awareness (AOR=4.14, 95% CI=2.95-5.81) were higher for individuals with mental chronic conditions, compared to those without mental chronic conditions. The odds of having hypertension treatment was higher for subjects with mental disorder, compared to those without (AOR=1.57, 95% CI=1.23-2.01). The odds of having physical chronic conditions controlled was not significantly associated with having mental chronic conditions. These results indicated that adults with mental disorder have a greater likelihood of awareness of having dyslipidemia and kidney disease, and receiving treatment for hypertension. Strategies to address growing burden of physical-mental NCDs in China should include efforts to improve management of patients with comorbid health condition and improve access to continual high-quality treatment after the first diagnosis.