Journal
JOURNAL OF AFFECTIVE DISORDERS
Volume 220, Issue -, Pages 1-7Publisher
ELSEVIER
DOI: 10.1016/j.jad.2017.05.027
Keywords
Comorbidity; Mood disorder; Anxiety disorder; Chronic condition
Categories
Funding
- Sao Paulo Research Foundation, Brazil (FAPESP) [2003/00204-3, 2011/50517-4]
- Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [14/05363-7]
- National Council for Scientific and Technological Development (CNPq) [307784/2016-9]
- United States National Institutes of Mental Health [R01MH070884]
- US Public Health Service [R13-MH066849, R01-MH069864, R01 DA016558]
- Fogarty International Center [FIRCA R03-TW006481]
- Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [14/05363-7, 03/00204-3, 11/50517-4] Funding Source: FAPESP
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Background: We assessed comorbid associations of 12-month DSM-IV mood/any anxiety disorders with chronic physical conditions within the Sao 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 Sao 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.
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