People with severe mental illness have low rates of screening for non-communicable diseases: Findings of a multi-country cross-sectional study in South Asia

Koralagamage Kavindu Appuhamy; Fraser Wiggins; Alex Mitchell; Helal Uddin Ahmed; Mark Ashworth; Faiza Aslam; Jan Boehnke; Olga Garcia; Richard I.G. Holt; Rumana Haque; Krishna Prasad Muliyala; Pratima Murthy; Asad Tamizuddin Nizami; Benjamin Perry; David Shiers; Najma Siddiqi; Kamran Siddiqi; Salim Virani; Gerardo A. Zavala

doi:10.1017/gmh.2026.10157

People with severe mental illness have low rates of screening for non-communicable diseases: Findings of a multi-country cross-sectional study in South Asia

Koralagamage Kavindu Appuhamy (Lead / Corresponding author)
, Fraser Wiggins
, Alex Mitchell
, Helal Uddin Ahmed
, Mark Ashworth
, Faiza Aslam
, Jan Boehnke
, Olga Garcia
, Richard I.G. Holt
, Rumana Haque
, Krishna Prasad Muliyala
, Pratima Murthy
, Asad Tamizuddin Nizami
, Benjamin Perry
, David Shiers
, Najma Siddiqi
, Kamran Siddiqi
, Salim Virani
, Gerardo A. Zavala

Health Sciences

Research output: Contribution to journal › Article › peer-review

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Abstract

People with severe mental illness (SMI) die 10–20 years earlier than the general population, largely due to non-communicable diseases (NCDs) such as hypertension and diabetes and risk factors such as hypercholesterolaemia. This cross-sectional study gathered data from people with SMI from three national mental health institutions in South Asia. Data was collected based on the WHO Stepwise approach to NCD risk factor surveillance and the prevalence of screening, diagnosis and treatment for diabetes, hypertension, and hypercholesterolaemia was assessed. Logistic regression models assessed the associations of sociodemographic characteristics with NCD screening. Three thousand nine hundred and eighty nine participants were recruited. Screening prevalence varied by country and disease, with hypertension being the most commonly screened NCD (Bangladesh = 52.5% [50.0–55.1], India = 43.1% [40.3–45.9], Pakistan = 60.9% [58.2–63.5]), and cholesterol was the least common (Bangladesh = 4.1% [3.2–5.2], India = 14.8% [12.9–17.0], Pakistan = 9.6% [8.1–11.3]). Characteristics such as BMI, age and education level were positively associated with screening, and females were more likely to be screened than males. There are low levels of screening for NCDs among individuals with SMI accessing tertiary institutions in South Asia, with significant sociodemographic disparities. Standardised screening protocols tailored to South Asian populations could mitigate the increased risk of NCDs in this population.

Original language	English
Article number	e45
Journal	Cambridge Prisms: Global Mental Health
Volume	13
DOIs	https://doi.org/10.1017/gmh.2026.10157
Publication status	Published - 24 Feb 2026

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 10 Reduced Inequalities

Keywords

screening
comorbidity
severe mental illness
noncommunicable diseases
South Asia

ASJC Scopus subject areas

Psychiatry and Mental health
Psychiatric Mental Health
Clinical Psychology
Epidemiology
Health(social science)
Health Policy

Access to Document

10.1017/gmh.2026.10157Licence: CC BY

Final Published VersionFinal published version, 389 KBLicence: CC BY

https://www.cambridge.org/core/product/identifier/S2054425126101575/type/journal_article

Cite this

Appuhamy, K. K., Wiggins, F., Mitchell, A., Uddin Ahmed, H., Ashworth, M., Aslam, F., Boehnke, J., Garcia, O., Holt, R. I. G., Haque, R., Muliyala, K. P., Murthy, P., Nizami, A. T., Perry, B., Shiers, D., Siddiqi, N., Siddiqi, K., Virani, S., & Zavala, G. A. (2026). People with severe mental illness have low rates of screening for non-communicable diseases: Findings of a multi-country cross-sectional study in South Asia. Cambridge Prisms: Global Mental Health, 13, Article e45. https://doi.org/10.1017/gmh.2026.10157

@article{e73826ac79a848bca6f1bfa496ab32fa,

title = "People with severe mental illness have low rates of screening for non-communicable diseases: Findings of a multi-country cross-sectional study in South Asia",

abstract = "People with severe mental illness (SMI) die 10–20 years earlier than the general population, largely due to non-communicable diseases (NCDs) such as hypertension and diabetes and risk factors such as hypercholesterolaemia. This cross-sectional study gathered data from people with SMI from three national mental health institutions in South Asia. Data was collected based on the WHO Stepwise approach to NCD risk factor surveillance and the prevalence of screening, diagnosis and treatment for diabetes, hypertension, and hypercholesterolaemia was assessed. Logistic regression models assessed the associations of sociodemographic characteristics with NCD screening. Three thousand nine hundred and eighty nine participants were recruited. Screening prevalence varied by country and disease, with hypertension being the most commonly screened NCD (Bangladesh = 52.5\% [50.0–55.1], India = 43.1\% [40.3–45.9], Pakistan = 60.9\% [58.2–63.5]), and cholesterol was the least common (Bangladesh = 4.1\% [3.2–5.2], India = 14.8\% [12.9–17.0], Pakistan = 9.6\% [8.1–11.3]). Characteristics such as BMI, age and education level were positively associated with screening, and females were more likely to be screened than males. There are low levels of screening for NCDs among individuals with SMI accessing tertiary institutions in South Asia, with significant sociodemographic disparities. Standardised screening protocols tailored to South Asian populations could mitigate the increased risk of NCDs in this population.",

keywords = "screening, comorbidity, severe mental illness, noncommunicable diseases, South Asia",

author = "Appuhamy, \{Koralagamage Kavindu\} and Fraser Wiggins and Alex Mitchell and \{Uddin Ahmed\}, Helal and Mark Ashworth and Faiza Aslam and Jan Boehnke and Olga Garcia and Holt, \{Richard I.G.\} and Rumana Haque and Muliyala, \{Krishna Prasad\} and Pratima Murthy and Nizami, \{Asad Tamizuddin\} and Benjamin Perry and David Shiers and Najma Siddiqi and Kamran Siddiqi and Salim Virani and Zavala, \{Gerardo A.\}",

note = "Publisher Copyright: {\textcopyright} The Author(s), 2026. Published by Cambridge University Press.",

year = "2026",

month = feb,

day = "24",

doi = "10.1017/gmh.2026.10157",

language = "English",

volume = "13",

}

Appuhamy, KK, Wiggins, F, Mitchell, A, Uddin Ahmed, H, Ashworth, M, Aslam, F, Boehnke, J, Garcia, O, Holt, RIG, Haque, R, Muliyala, KP, Murthy, P, Nizami, AT, Perry, B, Shiers, D, Siddiqi, N, Siddiqi, K, Virani, S & Zavala, GA 2026, 'People with severe mental illness have low rates of screening for non-communicable diseases: Findings of a multi-country cross-sectional study in South Asia', Cambridge Prisms: Global Mental Health, vol. 13, e45. https://doi.org/10.1017/gmh.2026.10157

People with severe mental illness have low rates of screening for non-communicable diseases: Findings of a multi-country cross-sectional study in South Asia. / Appuhamy, Koralagamage Kavindu (Lead / Corresponding author); Wiggins, Fraser; Mitchell, Alex et al.
In: Cambridge Prisms: Global Mental Health, Vol. 13, e45, 24.02.2026.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - People with severe mental illness have low rates of screening for non-communicable diseases

T2 - Findings of a multi-country cross-sectional study in South Asia

AU - Appuhamy, Koralagamage Kavindu

AU - Wiggins, Fraser

AU - Mitchell, Alex

AU - Uddin Ahmed, Helal

AU - Ashworth, Mark

AU - Aslam, Faiza

AU - Boehnke, Jan

AU - Garcia, Olga

AU - Holt, Richard I.G.

AU - Haque, Rumana

AU - Muliyala, Krishna Prasad

AU - Murthy, Pratima

AU - Nizami, Asad Tamizuddin

AU - Perry, Benjamin

AU - Shiers, David

AU - Siddiqi, Najma

AU - Siddiqi, Kamran

AU - Virani, Salim

AU - Zavala, Gerardo A.

PY - 2026/2/24

Y1 - 2026/2/24

N2 - People with severe mental illness (SMI) die 10–20 years earlier than the general population, largely due to non-communicable diseases (NCDs) such as hypertension and diabetes and risk factors such as hypercholesterolaemia. This cross-sectional study gathered data from people with SMI from three national mental health institutions in South Asia. Data was collected based on the WHO Stepwise approach to NCD risk factor surveillance and the prevalence of screening, diagnosis and treatment for diabetes, hypertension, and hypercholesterolaemia was assessed. Logistic regression models assessed the associations of sociodemographic characteristics with NCD screening. Three thousand nine hundred and eighty nine participants were recruited. Screening prevalence varied by country and disease, with hypertension being the most commonly screened NCD (Bangladesh = 52.5% [50.0–55.1], India = 43.1% [40.3–45.9], Pakistan = 60.9% [58.2–63.5]), and cholesterol was the least common (Bangladesh = 4.1% [3.2–5.2], India = 14.8% [12.9–17.0], Pakistan = 9.6% [8.1–11.3]). Characteristics such as BMI, age and education level were positively associated with screening, and females were more likely to be screened than males. There are low levels of screening for NCDs among individuals with SMI accessing tertiary institutions in South Asia, with significant sociodemographic disparities. Standardised screening protocols tailored to South Asian populations could mitigate the increased risk of NCDs in this population.

AB - People with severe mental illness (SMI) die 10–20 years earlier than the general population, largely due to non-communicable diseases (NCDs) such as hypertension and diabetes and risk factors such as hypercholesterolaemia. This cross-sectional study gathered data from people with SMI from three national mental health institutions in South Asia. Data was collected based on the WHO Stepwise approach to NCD risk factor surveillance and the prevalence of screening, diagnosis and treatment for diabetes, hypertension, and hypercholesterolaemia was assessed. Logistic regression models assessed the associations of sociodemographic characteristics with NCD screening. Three thousand nine hundred and eighty nine participants were recruited. Screening prevalence varied by country and disease, with hypertension being the most commonly screened NCD (Bangladesh = 52.5% [50.0–55.1], India = 43.1% [40.3–45.9], Pakistan = 60.9% [58.2–63.5]), and cholesterol was the least common (Bangladesh = 4.1% [3.2–5.2], India = 14.8% [12.9–17.0], Pakistan = 9.6% [8.1–11.3]). Characteristics such as BMI, age and education level were positively associated with screening, and females were more likely to be screened than males. There are low levels of screening for NCDs among individuals with SMI accessing tertiary institutions in South Asia, with significant sociodemographic disparities. Standardised screening protocols tailored to South Asian populations could mitigate the increased risk of NCDs in this population.

KW - screening

KW - comorbidity

KW - severe mental illness

KW - noncommunicable diseases

KW - South Asia

UR - https://www.scopus.com/pages/publications/105031169379

U2 - 10.1017/gmh.2026.10157

DO - 10.1017/gmh.2026.10157

M3 - Article

SN - 2054-4251

VL - 13

JO - Cambridge Prisms: Global Mental Health

JF - Cambridge Prisms: Global Mental Health

M1 - e45

ER -

People with severe mental illness have low rates of screening for non-communicable diseases: Findings of a multi-country cross-sectional study in South Asia

Abstract

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Improving Outcomes in Mental and Physical Comorbidity and Developing Research Capacity (IMPACT) in South Asia (joint with University of York)

Prevalence of physical health conditions and health risk behaviours in people with severe mental illness in South Asia: multi-country cross-sectional survey

Risk factors associated with overweight and obesity in people with severe mental illness in South Asia: cross-sectional study in Bangladesh, India, and Pakistan

Prevalence of physical health conditions and health risk behaviours in people with severe mental illness in South Asia: protocol for a cross-sectional study (IMPACT SMI survey)

Cite this

People with severe mental illness have low rates of screening for non-communicable diseases: Findings of a multi-country cross-sectional study in South Asia

Abstract

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Projects

Improving Outcomes in Mental and Physical Comorbidity and Developing Research Capacity (IMPACT) in South Asia (joint with University of York)

Research output

Prevalence of physical health conditions and health risk behaviours in people with severe mental illness in South Asia: multi-country cross-sectional survey

Risk factors associated with overweight and obesity in people with severe mental illness in South Asia: cross-sectional study in Bangladesh, India, and Pakistan

Prevalence of physical health conditions and health risk behaviours in people with severe mental illness in South Asia: protocol for a cross-sectional study (IMPACT SMI survey)

Cite this