Burden of chronic physical conditions and mental disorders in primary care

Br J Psychiatry. 2010 Apr;196(4):302-9. doi: 10.1192/bjp.bp.109.074211.

Abstract

Background: The World Health Organization (WHO) has stated that the three leading causes of burden of disease in 2030 are projected to include HIV/AIDS, unipolar depression and ischaemic heart disease.

Aims: To estimate health-related quality of life (HRQoL) and quality-adjusted life-year (QALY) losses associated with mental disorders and chronic physical conditions in primary healthcare using data from the diagnosis and treatment of mental disorders in primary care (DASMAP) study, an epidemiological survey carried out with primary care patients in Catalonia (Spain).

Method: A cross-sectional survey of a representative sample of 3815 primary care patients. A preference-based measure of health was derived from the 12-item Short Form Health Survey (SF-12): the Short Form-6D (SF-6D) multi-attribute health-status classification. Each profile generated by this questionnaire has a utility (or weight) assigned. We used non-parametric quantile regressions to model the association between both mental disorders and chronic physical condition and SF-6D scores.

Results: Conditions associated with SF-6D were: mood disorders, beta = -0.20 (95% CI -0.18 to -0.21); pain, beta = -0.08 (95%CI -0.06 to -0.09) and anxiety, beta = -0.04 (95% CI -0.03 to -0.06). The top three causes of QALY losses annually per 100 000 participants were pain (5064), mood disorders (2634) and anxiety (805).

Conclusions: Estimation of QALY losses showed that mood disorders ranked second behind pain-related chronic medical conditions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Chronic Disease / epidemiology*
  • Chronic Disease / rehabilitation
  • Epidemiologic Methods
  • Female
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Mental Disorders / rehabilitation
  • Middle Aged
  • Mood Disorders / epidemiology
  • Mood Disorders / rehabilitation
  • Primary Health Care / statistics & numerical data*
  • Psychometrics
  • Quality of Life
  • Quality-Adjusted Life Years
  • Spain / epidemiology
  • Young Adult