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STUDY PROTOCOL article
Front. Psychiatry
Sec. Public Mental Health
Volume 15 - 2024 |
doi: 10.3389/fpsyt.2024.1426054
This article is part of the Research Topic The Association Between Oral Health and Mental Health View all 6 articles
Can social adversity and mental, physical and oral multimorbidity form a syndemic? A concept and protocol paper
Provisionally accepted- 1 Centre for Dental Public Health and Primary Care, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, England, United Kingdom
- 2 Barts Health NHS Trust, London, England, United Kingdom
- 3 Homerton College, University of Cambridge, Cambridge, England, United Kingdom
- 4 UCLPartners,, London, United Kingdom
- 5 West London Mental Health NHS Trust, Southall, Ealing, United Kingdom
- 6 Brunel University London, Uxbridge, London, United Kingdom
- 7 Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England, United Kingdom
- 8 Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, England, United Kingdom
- 9 Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, England, United Kingdom
- 10 Department of Sedation and Special Care Dentistry, Guy’s Hospital,, London,, United Kingdom
- 11 Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
- 12 Early Psychosis Unit, University of Manchester,, Manchester,, United Kingdom
- 13 University of Keele,, Staffordshire,, United Kingdom
- 14 Department of Health Sciences, Faculty of Sciences, University of York, Heslington, Yorkshire and the Humber, United Kingdom
- 15 School of Health Sciences, Bangor University,, Gwynedd,, United Kingdom
- 16 Hull York Medical School, Hull, England, United Kingdom
- 17 Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, England, United Kingdom
- 18 London Behçet's Centre, Barts Health London,, London,, United Kingdom
- 19 School of Dentistry, University of Leeds,, Leeds,, United Kingdom
- 20 Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, Faculty of Population Health Sciences, University College London, London, England, United Kingdom
- 21 Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre,, Manchester,, United Kingdom
- 22 Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, England, United Kingdom
- 23 Department of Psychiatry, Nuffield Department of Primary Care Health Science, University of Oxford,, Oxford,, United Kingdom
- 24 Wadham College, University of Oxford, Oxford, England, United Kingdom
- 25 East London and Oxford Health NHS Foundation Trusts,, London,, United Kingdom
- 26 WPA Collaborating Centre Oxford,, Oxford,, United Kingdom
Background: Clustering mental, physical and oral conditions reduce drastically the life expectancy. These conditions are precipitated and perpetuated by adverse social, economic, environmental, political and healthcare contextual factors, and sustained through bidirectional interactions forming potentially a 'syndemic'. No previous study has investigated such potential syndemic. Thus, the present project aimed to (i) test for syndemic interactions between social adversity (socioeconomic adversity and traumatic events) and mental, physical and oral multimorbidity using the syndemic theoretical framework; and (ii) determine whether the syndemic relationships vary by age, sex and ethnicity.Methods: Data from three large-scale population-based databases: UK BioBank, US National Health and Nutrition Examination Survey (NHANES) and the Research with East London Adolescents Community Health Survey (RELACHS) will be analysed. Structural equation modelling (SEM) will be utilised to conceptualise syndemic factors and model complex relationships between directly observed and indirectly observed (latent) variables (syndemic constructs).Discussion: the syndemic conceptualisation provides a valuable framework to understand health and illness, and hence to better design and deliver effective and cost-effective preventative and curative integrated (syndemic) care to improve patient and population health. Such syndemic care aims to address the social determinants of health, whilst simultaneously managing all interlocked conditions.The present manuscript conceptualises and theorises a syndemic relationship between mental disorders, physical multimorbidity and oral diseases. It proposes a protocol to test this potential syndemic using three large-scale population-based databases. It concludes with discussing practice and policy implications in terms of integrated (syndemic) care to improve patient and population health.
Keywords: Mental Disorders, physical conditions, Dental diseases, Syndemics, Conceptualisation, methodology, Integrated Care, health equity
Received: 30 Apr 2024; Accepted: 12 Dec 2024.
Copyright: © 2024 Joury, Nakhleh, Beveridge, Tracy, Heidari, Shiers, Vereeken, Peckham, Gilbody, Das-Munshi, Fortune, Aggarwal, Mishu, Firth and Bhui. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Easter Joury, Centre for Dental Public Health and Primary Care, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, E1 2AD, England, United Kingdom
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