Impact of Multimorbidity on Mental Illness in the United Arab Emirates: A Review.

Multimorbidity, the co-existence of two or more non-communicable diseases, is increasing in prevalence globally. People with multimorbidity are at an increased risk of developing serious mental illnesses such as major depressive disorder, and anxiety disorders. UAE reports high rates of multimorbidity (metabolic syndrome, type II diabetes, hypertension, obesity). The prevalence of depression and anxiety disorders is significantly elevated in these patients, contributing to increased stress on the healthcare system. Barriers to effective mental healthcare delivery in these patients with multimorbidity include stigma, cultural and linguistic diversity, limited insurance coverage and shortage of mental healthcare professionals, particularly in rural areas. Clinically, depression and anxiety are often associated with somatic symptoms, complicating diagnosis in primary care. Evidence supports implementing measurement-based care using tools such as PHQ-9, GAD-7, and HADS for diagnosing and monitoring treatment in patients with depression and anxiety disorders. Collaborative care models, including primary care physicians, specialists, and clinical pharmacists, are essential for managing people with multimorbidity. UAE initiatives, such as the integrated mental health network SAKINA and the IFHAS population-based screening program, have reduced stigma, enhanced early identification, and increased access to mental health services. This narrative review explores the burden of depression due to multimorbidity in the UAE; corresponding challenges on healthcare delivery, especially in primary care; and national initiatives aimed at integrating mental health into primary care.