Comorbidity between common mental disorders and chronic somatic diseases in primary care patients☆

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.

Keywords: Comorbidity, Mental disorders, Somatic diseases, Primary care, PRIME-MD