Melanie S Askari1, Laura Helena Andrade2, Alexandre Chiavegatto Filho3, Camila Magalhães Silveira2, Erica Siu2, Yuan-Pang Wang2, Maria Carmen Viana4, Silvia S Martins5. 1. Epidemiology Department, Columbia Mailman School of Public Health, United States. 2. Section of Psychiatric Epidemiology-LIM 23, Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil. 3. Department of Epidemiology, University of São Paulo School of Public Health, São Paulo, Brazil. 4. Departamento de Medicina Social, Universidade Federal do Espírito Santo, Brazil. 5. Epidemiology Department, Columbia Mailman School of Public Health, United States. Electronic address: ssm2183@columbia.edu.
Abstract
BACKGROUND: We assessed comorbid associations of 12-month DSM-IV mood/any anxiety disorders with chronic physical conditions within the São Paulo (SP) Megacity Mental Health cross-sectional survey of 5037 participants and explored whether strength of comorbid associations were modified when controlling for demographics. METHODS: Chi-square tests and logistic regressions were used to examine comorbid associations of DSM-IV mood/anxiety disorders as measured by the WHO Composite International Diagnostic Interview (CIDI 3.0), and self-reported chronic physical conditions among adults from the SP Megacity Mental Health Survey. RESULTS: Among those with any mood or anxiety disorder, chronic pain disorder was the most common physical condition (48.9% and 44.9%, respectively). Significant unadjusted odds ratios (OR) of comorbidity were found between diagnosis of two or more physical conditions and any mood disorders (3.08, 95% CI: 2.27-4.17), and any anxiety disorders (2.49, 95% CI: 1.95-3.17). Comorbidities remained significant when stratified by gender and controlling for marital status, household income, and education (latter two only included within anxiety models). LIMITATIONS: These results cannot be generalized to other cities or rural populations. Homeless and institutionalized populations were not surveyed. Due to cross-sectional study design, the direction of association between chronic disease/chronic disease risk factors and mood disorders is unclear. CONCLUSIONS: Dual burden of chronic physical conditions and mood/anxiety disorders is a notable problem among the São Paulo Megacity Survey population, with enhanced comorbidity experienced by community members with multiple physical conditions. Clinicians should consider these findings in understanding healthcare delivery for individuals suffering from both psychiatric disorders and chronic physical conditions.
BACKGROUND: We assessed comorbid associations of 12-month DSM-IV mood/any anxiety disorders with chronic physical conditions within the São Paulo (SP) Megacity Mental Health cross-sectional survey of 5037 participants and explored whether strength of comorbid associations were modified when controlling for demographics. METHODS: Chi-square tests and logistic regressions were used to examine comorbid associations of DSM-IV mood/anxiety disorders as measured by the WHO Composite International Diagnostic Interview (CIDI 3.0), and self-reported chronic physical conditions among adults from the SP Megacity Mental Health Survey. RESULTS: Among those with any mood or anxiety disorder, chronic pain disorder was the most common physical condition (48.9% and 44.9%, respectively). Significant unadjusted odds ratios (OR) of comorbidity were found between diagnosis of two or more physical conditions and any mood disorders (3.08, 95% CI: 2.27-4.17), and any anxiety disorders (2.49, 95% CI: 1.95-3.17). Comorbidities remained significant when stratified by gender and controlling for marital status, household income, and education (latter two only included within anxiety models). LIMITATIONS: These results cannot be generalized to other cities or rural populations. Homeless and institutionalized populations were not surveyed. Due to cross-sectional study design, the direction of association between chronic disease/chronic disease risk factors and mood disorders is unclear. CONCLUSIONS: Dual burden of chronic physical conditions and mood/anxiety disorders is a notable problem among the São Paulo Megacity Survey population, with enhanced comorbidity experienced by community members with multiple physical conditions. Clinicians should consider these findings in understanding healthcare delivery for individuals suffering from both psychiatric disorders and chronic physical conditions.
Authors: Tiana C L Moreira; Jefferson L Polize; Marceli Brito; Demostenes F da Silva Filho; Alexandre D P Chiavegato Filho; Maria Carmem Viana; Laura Helena Andrade; Thais Mauad Journal: J Expo Sci Environ Epidemiol Date: 2021-06-11 Impact factor: 5.563
Authors: Eric W de Heer; Jack Dekker; Aartjan T F Beekman; Harm W J van Marwijk; Tjalling J Holwerda; Pierre M Bet; Joost Roth; Lotte Timmerman; Christina M van der Feltz-Cornelis Journal: Front Psychiatry Date: 2018-04-05 Impact factor: 4.157