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The British Journal of Psychiatry
Year: 2010  |  Volume: 196  |  Issue: 4  |  Page No.: 302 - 309

Burden of chronic physical conditions and mental disorders in primary care

A Fernandez, J. A. B Saameno, A Pinto Meza, J. V Luciano, J Autonell, D Palao, L Salvador Carulla, J. G Campayo, J. M Haro, A Serrano and the DASMAP investigators    

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, β = –0.20 (95% CI –0.18 to –0.21); pain, β = –0.08 (95%CI –0.06 to –0.09) and anxiety, β = –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.

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