Co-morbid Conditions in the context of neurodiversity. There is emerging evidence that neurodivergence is associated with multiple intertwined health conditions and that being neurodivergent correlates with increased morbidity and mortality relating to all organ systems.
There is emerging evidence that neurodivergence is not just limited to the restrictive criteria contained within the various classification systems but that the neurodivergent population often has multiple intertwined health conditions, forming part of a larger ‘constellation’1. Links have been demonstrated between neurodivergence and hypermobility (Ehlers Danlos syndrome), dysautonomia (POTS) and chronic pain2 and there is an increasing recognition of the co-occurrence of neurodiversity with many gastrointestinal conditions such as irritable bowel syndrome, bowel dysmotility, vitamin deficiencies, and metabolic disorders including obesity3.
Increasingly, research shows that being neurodivergent correlates to increased morbidity and mortality relating to all organ systems4,5.
Neurodivergent people are also likely to present with social comorbidities including friendship and relationship difficulties, educational and occupational under-achievement, greater risk of morbidity and mortality, substance misuse and increased rates of homelessness, unemployment and involvement with the criminal justice system6,7.
Neurodivergent patients also often experience co-existing mental health problems8 including insomnia, disordered eating9 , depression and anxiety, addictions, self-harm, and suicidality10. Lack of understanding of neurodiversity may lead to misdiagnoses and labels that may or may not be correct such as mood disorders, bipolar, personality and other mental health disorders11,12.
Taken in the round, it is apparent that neurodivergent patients make up a large proportion of primary care patients. A GP would be wise to consider neurodivergence in patients presenting with any of the above comorbidities, and vice versa. As well as our patient population, there is also an increasing awareness of the numbers of GPs, trainees and medical students who identify as neurodivergent and need support.
We have proposed a motion about resources for primary care in this field at the 2023 England Local Medical Committees (LMC) conference - it was overwhelmingly supported and carried on a vote. Read about the motion here (page 9, motion 5).
