This blog is an interview with Tomáš Formánek, 3rd year PhD student at the University of Cambridge, who has been funded by the ARC East of England to investigate the risk of mortality and loss of life-years in people with pre-existing substance use disorders following the development of a wide range of physical health conditions.
Please introduce yourself
My name is Tomáš Formánek, I’m a 3rd year PhD student in the Department of Psychiatry at the University of Cambridge, supervised by Prof. Peter B. Jones. My background is in sociology, which I studied during my undergraduate and master’s student years. My current interests are in psychiatric epidemiology, specifically in using observational data to investigate the mental and physical health interplay. Complementarily, I’m also interested in causal inference on observational data.
Summarise your PhD project, the aims and what you did
My PhD project deals with the mental and physical health interplay, in the sense of investigating the risk of developing physical health conditions in people with mental disorders and vice versa, and the outcomes (such as mortality and loss of life-years) following the development of these conditions. To do this, I’m using large, mostly national, registers, containing routinely collected electronic health records.
What did you find and what does this mean?
Findings were published last month in The Lancet Psychiatry.
We investigated the risk of all-cause death and loss of life-years in people with pre-existing substance use disorders following the development of a wide range of physical health conditions, and when compared with matched counterparts without substance use disorders but with the same physical health condition. We found, that after the onset of 26 out of 28 physical health conditions, people with substance use disorders had an elevated risk of mortality. In addition to this, for most subsequent health conditions, people with pre-existing substance use disorders lost substantially more life-years than did their counterparts without substance use disorders.
These findings strongly suggest that clinical vigilance and high-quality integrated treatment for people with substance use disorders could be life-saving and should be given higher priority on the public health agenda.
How will your research findings be used?
Based on the evidence from similar studies, we believe that the key message of unacceptably elevated mortality among people with substance use disorders and comorbid health conditions is applicable in most if not all countries. Thus, we hope that governments and public health officials will pay serious attention to the problem showed in our study, and that other stakeholders will use the findings of this study to advocate for changes in how health-care for people with substance use disorders is provided.
What are your next steps?
I’m currently working on the extension of this study that is focused on mortality and loss of life-years following the developing of various physical health conditions in people with pre-existing severe mental illness. In parallel with this, I’m also working on a large multi-national study that is investigating the risk of developing a wide range of physical health conditions across the whole spectrum of mental disorders.
Finally, I am planning to replicate the study on substance use disorders based on data from other countries. In particular, I would like to disentangle the associations separately for people with alcohol and drug use disorders and I would also like to look into specific-causes of death (ie, natural and accidents and suicides).
What advice would you give someone who is considering applying to a PhD?
A PhD is a commitment for three or more years, so I believe that applicants should carefully consider whether they have an actual interest in what their project is supposed to be about. Without interest in the project, I think a PhD might easily become a stressful and unpleasant endeavour.
Then, I think that applicants should learn early on, that there is no such thing as the perfect study. However, this unachievable perfection should not stop them from doing research: they should produce studies as good as they currently can. In the future, with more knowledge and experience, they can critically reflect on the limitations and flaws of their previous studies, and produce more robust ones. And so on, in an endless loop!
- Formánek, T et al. Mortality and life-years lost following subsequent physical comorbidity in people with pre-existing substance use disorders: a national registry-based retrospective cohort study of hospitalised individuals in Czechia.The Lancet Psychiatry; 3 Nov 2022; DOI: 10.1016/S2215-0366(22)00335-2
- Substance use disorders linked to poor health outcomes in wide range of physical health conditions, University of Cambridge, viewed 7 Dec 2022. https://www.cam.ac.uk/research/news/substance-use-disorders-linked-to-poor-health-outcomes-in-wide-range-of-physical-health-conditions
- Find out more about ARC East of England Mental Health Research here
- For queries concerning this article, email ARC EoE Comms lead: firstname.lastname@example.org