Multiple chronic medical conditions: Prevalence and risk factors - results from the Singapore Mental Health Study

Objective: The objective was to establish the prevalence and risk factors for multiple chronic medical conditions (MCMC) in the Singapore population. Methods: Data for the study were extracted from the Singapore Mental Health Study, a population-based, cross-sectional, epidemiological study of Singapore residents aged 18 years and above. Face-to-face interviews were completed with 6616 respondents from December 2009 to December 2010, and the survey response rate was 75.9%. The assessment of psychiatric conditions was established using version 3.0 of the WHO World Mental Health Composite International Diagnostic Interview (WMH-CIDI). A modified version of the CIDI checklist of chronic medical conditions was used to capture data on 15 chronic medical conditions which were reclassified into eight types of physical conditions. Results: A total of 25.4% of the population reported having one chronic condition, and 16.3% had MCMC. Those who were older (aged 35 years and above vs. those aged 18-34 years), economically inactive, unemployed, overweight and obese had higher odds of having MCMC. Adjusting for covariates in multinomial regression analyses, mood and alcohol use disorder (AUD) were significantly associated with higher risk of MCMC. Conclusions: The study identified two important yet potentially modifiable risk factors for MCMC - psychiatric conditions and obesity - in the general population. Screening for mood and alcohol use disorder, as well as lifestyle interventions targeted at obesity, must be a part of disease management for MCMC.