Integration of Mental Health Comorbidity in Medical Specialty Programs in 20 Countries

Background: The increasing prevalence of chronic illnesses has been accompanied by a concomitant increase in mental-physical comorbidity. This comorbidity occurs in approximately 30% of individuals, constituting a major problem in medical practice. Methods: A descriptive, cross-sectional study of academic medical specialization programs from 20 different countries was carried out to establish which medical specialties take mental health into account in the design of their training programs and what mental health topics these programs address. Findings: Internal medicine, family medicine, neurology, pediatrics and geriatrics were the specialties that included mental health topics in their programs, with some differences found among the 20 countries. In four countries: Bangladesh, Serbia, the Netherlands, and France, 50% of all postgraduate specialty training programs include mental health content. In ten countries: Germany, Sweden, United Kingdom, Mexico, Belgium, India, Russia, Canada, Israel, and Spain, between 20%-49% of all postgraduate specialty training programs include mental health content. In six countries: Brazil, Chile, Colombia, Croatia, Kenya, and the United States, under 20% of all postgraduate specialty training programs include mental health content. Interpretation: While the comorbidity of mental-physical disorders continues to grow, medical practice is becoming fragmented into ever more specific specialties that disregard comprehensive care. For the attention of physical-mental comorbidity, it is necessary to increase mental health content in specialized academic programs, so that all medical professionals are sensitive to the influence of mental pathology in physical illness. Funding Statement: This study was funded by the Department of Research, UNAM School of Medicine. Declaration of Interests: All the authors declare no conflicts of interest. Ethics Approval Statement: Not required.