Venn diagram

The overlap between long term conditions relating to physical health and mental health conditions is substantial. According to a report from the King's Fund and the Mental Health Foundation, over a third of people in England with a physical long term condition also have mental health problems; on the flipside, nearly half of people in England with a mental health problem also have a long term physical health condition. Either way, this amounts to something like 4.6 million people and between £8 billion and £13 billion per year in healthcare spending. The report argues that we could do better and that the main route to improvement is through integration. Doing nothing to address the emotional and mental health problems attendant on long term conditions risks the ability of people to manage their physical health. A study from the US looks at how to improve medical adherence amongst people in primary care with co-morbid long term physical and mental conditions (diabetes, coronary heart disease and depression). An analysis of results from the CO-MED trial focuses on depression treatment in patients with general medical conditions. A Cochrane systematic review of self monitoring of blood glucose for people with type 2 diabetes finds this has limited effect on glycaemic control in patients not using insulin. A study underway in Australia, Diabetes MILES, assesses the psychological aspects of living with diabetes: an early publication examines the methods and sample characteristics.