Comorbidity between common mental disorders and chronic somatic diseases in primary care patients☆
Received 16 November 2009; accepted 25 January 2010. published online 02 March 2010.
Abstract
Objective
To estimate the prevalence of the most common mental disorders in primary care patients with chronic somatic diseases based on physicians' diagnoses and compared with healthy probands.
Method
A systematic sample of 7940 adult primary care patients was recruited by 1925 general practitioners (GPs) in a large cross-sectional national epidemiological study. The Primary Care Evaluation of Mental Disorders (PRIME-MD) was used as standardized instrument for the assessment of mental disorders. Medical diagnoses were provided by patient's GP.
Results
The prevalence rate of mental disorder was significantly higher in patients with chronic somatic diseases (56.8%) compared with physically healthy subjects (48.9%; OR: 1.37). Prevalence of depressive and anxiety disorders is higher among individuals with neurological, oncological or liver disease. The differences are significant in all comparisons, with the exception of anxiety disorders in patients with musculoskeletal disorders. There is an increase in prevalence rates of mental disorders according to the number of somatic diseases.
Conclusions
The study provides evidence of the comorbidity of common mental disorders and somatic diseases. We need a predominant focus on affective and anxiety disorders in primary care patients with chronic somatic diseases. Symptoms overlap makes it necessary to discriminate these differences more in detail in future studies.
eResearch and Development Unit, San Joan de Deu, 08950 Barcelona, Spain
Corresponding author. Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain. Tel.: +34 971 173081; fax: +34 971 173190.
☆ The project was possible due to an unrestricted educational grant from Almirall Spain.
ABSTRACT