Journal
GENERAL HOSPITAL PSYCHIATRY
Volume 47, Issue -, Pages 61-67Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.genhosppsych.2017.05.004
Keywords
Recognition; Diagnosis; Anxiety; Depression; Primary care
Categories
Funding
- Office of Academic Affiliations VA Advanced Fellowship Program in Mental Illness Research and Treatment
- Department of Veterans Affairs South Central Mental Illness Research Education and Clinical Center (MIRECC)
- VA HSR D Grant [09-088]
- resources and facilities of the Veterans Administration Center for Innovations in Quality, Effectiveness and Safety [CIN 13-413]
- Michael E. DeBakey VA Medical Center, Houston, Texas
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Objective: This study sought to identify patient factors associated with mental health (MH) recognition and treatment in medically ill Veterans. Method: Retrospective data from patient electronic medical records (EMR) and self-report data were reviewed for 180 Veterans with cardiopulmonary conditions who met diagnostic criteria for anxiety, depression, or posttraumatic stress disorder on the Mini-International Neuropsychiatric Interview. Multivariate logistic regression examined the association of medical record MH recognition and MH service use with patient factors, including anxiety and depression severity, self-efficacy, locus of control, coping, illness intrusiveness, and healthrelated quality of life (QOL). Results: Seventy veterans (39%) had an MH diagnosis documented in their EMR, and 101 (56%) received at least one MH service (>= 1 MH encounter or psychiatric medications). Greater depression (p = 0.047) and adaptive coping (p = 0.012) were associated with increased likelihood of EMR documentation of MH diagnoses. EMR MH diagnosis (p < 0.001), higher internal locus of control (p = 0.037), and poorer physical health-related QOL (p = 0.014) were associated with greater likelihood of MH service use. Discussion: Veterans with cardiopulmonary conditions experiencing MH problems are under-recognized. Improved MH screening is needed, particularly for patients with poor adaptive coping skills, low internal locus of control, or poor physical health-related QOL.
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