The clustering of physical health conditions and associations with co-occurring mental health problems and problematic alcohol use: a cross-sectional study

Katalin Ujhelyi Gomez, Orla McBride, Emmert Roberts, Colin Angus, Katherine Keyes, Colin Drummond, Iain Buchan, Kate Fleming, Ian Gilmore, Kim Donoghue, Laura Bonnet, Laura Goodwin

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
26 Downloads (Pure)


Background: There is strong evidence for the co-occurrence of mental health conditions and alcohol problems, yet physical health outcomes among this group are not well characterised. This study aimed to identify clusters of physical health conditions and their associations with mental health and problematic alcohol use in England’s general population. Methods: Cross-sectional analysis of the 2014 Adult Psychiatric Morbidity Survey (N = 7546) was conducted. The survey used standardised measures of problematic alcohol use and mental health conditions, including the Alcohol Use Disorders Identification Test (AUDIT) and the Clinical Interview Schedule-Revised. Participants self-reported any lifetime physical health conditions. Latent class analysis considered 12 common physical illnesses to identify clusters of multimorbidity. Multinomial logistic regression (adjusting for age, gender, ethnicity, education, and occupational grade) was used to explore associations between mental health, hazardous drinking (AUDIT 8 +), and co-occurring physical illnesses. Results: Five clusters were identified with statistically distinct and clinically meaningful disease patterns: ‘Physically Healthy’ (76.62%), ‘Emerging Multimorbidity’ (3.12%), ‘Hypertension & Arthritis’ (14.28%), ‘Digestive & Bowel Problems’’ (3.17%), and ‘Complex Multimorbidity’ (2.8%). Having a mental health problem was associated with increased odds of ‘Digestive & Bowel Problems’ (adjusted multinomial odds ratio (AMOR) = 1.58; 95% CI [1.15–2.17]) and ‘Complex Multimorbidity’ (AMOR = 2.02; 95% CI [1.49–2.74]). Individuals with co-occurring mental health conditions and problematic alcohol use also had higher odds of ‘Digestive & Bowel Problems’ (AMOR = 2.64; 95% CI [1.68–4.15]) and ‘Complex Multimorbidity’ (AMOR = 2.62; 95% CI [1.61–4.23]). Conclusions: Individuals with a mental health condition concurrent with problematic alcohol use experience a greater burden of physical illnesses, highlighting the need for timely treatment which is likely to include better integration of alcohol and mental health services.
Original languageEnglish
Article number89
Pages (from-to)1-14
Number of pages14
JournalBMC Psychiatry
Issue number1
Early online date6 Feb 2023
Publication statusPublished online - 6 Feb 2023

Bibliographical note

Funding Information:
Katalin Ujhelyi Gomez is funded by the National Institute for Health Research (NIHR) Applied Research Collaboration North West Coast (ARC NWC) at the University of Liverpool. The funding body had no role in the design of the study and collection, analysis, and interpretation of data or in writing the manuscript.

Funding Information:
This work was funded by the Strategic Priority Fund “Tackling multimorbidity at scale” programme [grant number MR/V005170/1] delivered by the Medical Research Council and the National Institute for Health and Care Research in partnership with the Economic and Social Research Council and in collaboration with the Engineering and Physical Sciences Research Council.

Publisher Copyright:
© 2023, The Author(s).


  • Research
  • Multimorbidity
  • Mental health
  • Alcohol
  • Physical health
  • Latent class analysis
  • Cross-Sectional Studies
  • Humans
  • Mental Health
  • Alcoholism/epidemiology
  • Adult
  • Health Status
  • Cluster Analysis
  • Alcoholism
  • Latent Class Analysis
  • Physical Health


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