Mental distress and health-related quality of life among somatic inpatients: social gradients and hospital mental health implications based on the SomPsyNet study population

PurposeProactive integrated consultation-liaison psychosomatics and psychiatry in somatic hospitals may improve patients mental health beyond inpatient stay. The <<SomPsyNet>> project targets SOMatic inpatients and aims to prevent PSYchosocial distress by establishing a structured care NETwork based on a Stepped and Collaborative Care Model (SCCM). We used a hospital-based epidemiological perspective to quantify prevalence and social gradients in mental distress and health-related quality of life (HRQoL). MethodsWe enrolled inpatients from three tertiary somatic hospitals, estimating how sociodemographic factors were associated with clinically relevant depressive symptoms, anxiety symptoms, somatic symptom distress, overall mental distress ([&ge;]1 measure above cut-off), mental, physical, and generic HRQoL, as well as somatic symptom burden. ResultsOut of 3,179 participants, 37% showed mental distress. Mental, physical, and generic HRQoL were substantially impaired, while somatic symptom burden was moderate. Younger age and lower income were associated with higher odds of mental distress, lower mental HRQoL, and greater somatic symptom burden (all p-for-trend<0.05), yet younger patients showed better physical HRQoL, and higher income was associated with better generic HRQoL (p-for-trend<0.05). Having no Swiss citizenship or having an employment situation affected by disability, accident, or illness, was associated with worse outcomes across most (ps<0.01) or all (ps<0.05) indicators, respectively. Other factors showed less consistent associations. ConclusionsA substantial proportion of somatic inpatients in the hospitals studied experienced mental distress and showed impaired HRQoL. Findings identified priority groups for hospital public mental health and inform resource planning for stepped, collaborative care and culturally/linguistically adapted services in acute somatic settings. Statements and DeclarationsDeclaration of Competing Interest & Funding Independent of the Project: G.M. & R.S. received funding in the context of a Horizon Europe project from the Swiss State Secretariat for Education, Research and Innovation (SERI) under contract number 22.00094. Further, G.M. & R.S. received funding from Wings Health Inc. in the context of a proof-of-concept study. G.M. received funding from the Swiss Heart Foundation under project no. FF21101, from the Research Foundation of the International Psychoanalytic University (IPU) Berlin under projects no. 5087 and 5217, from the Swiss National Science Foundation (SNSF) under project no. 100014_135328, from the German Federal Ministry of Education and Research under budget item 68606, and from the Hasler Foundation under project no. 23004. G.M. is co-founder and holds stock in Therayou AG, which is active in the field of digital and blended mental healthcare. G.M. receives royalties from publishing companies as author, including a book published by Springer, and an honorarium from Lundbeck for speaking at a symposium. Furthermore, G.M. is compensated for providing psychotherapy to patients, acting as a supervisor, serving as a self-experience facilitator ( Selbsterfahrungsleiter), and for postgraduate training of psychotherapists and supervisors. R.S. is co-editor of the German AWMF S3-Guidelines on Functional Complaints, and contributed to the German guidelines on irritable bowel syndrome, and on Lyme Borreliosis. R.S. is chairman of the Basel Institute for Psychosomatic Medicine (BIPM) and founder and managing director of the Psychosomatic and Psychosocial Services GmbH, that develops and implements psychosomatic and psychosocial training and continuing education programs. The authors declare no other potential conflict of interests. The research activities were fully independent and there were no intellectual or financial proprietary claims.