How the medical comorbidity of depressed patients differs across health care settings: results from the Medical Outcomes Study
UMass Chan Affiliations
Department of Quantitative Health SciencesDocument Type
Journal ArticlePublication Date
1991-12-11Keywords
AdultArthritis
Chronic Disease
Comorbidity
Depressive Disorder
*Family Practice
Fees, Medical
Health Status Indicators
Humans
Hypertension
Male
Outcome Assessment (Health Care)
Physician's Practice Patterns
Prepaid Health Plans
Prevalence
Psychiatric Status Rating Scales
*Psychiatry
United States
Biostatistics
Epidemiology
Health Services Research
Metadata
Show full item recordAbstract
OBJECTIVE: Although depression is one of the most common problems of medical and psychiatric outpatients, it has not been clear whether the extent of medical comorbidity among depressed patients varies across major types of clinical settings in which depressed patients receive care--especially by type of treating clinician (general medical versus mental health specialty) or type of payment for services (prepaid versus fee-for-service). METHODS: The authors examined these issues using data on 1,152 adult outpatients with current depressive symptoms and a lifetime history of unipolar depressive disorder who received care in one of three health care delivery systems in three U.S. sites. RESULTS: Depressed patients had a similarly high prevalence (64.9%-71.0%) of any of eight common chronic medical conditions whether they were seen in the general medical or specialty mental health sector; however, those visiting medical clinicians had a significantly higher prevalence of the two most common chronic medical conditions, hypertension and arthritis. Among depressed patients with hypertension, those visiting the general medical sector were more likely to be taking antihypertensive medication than were those visiting the mental health specialty sector. Type of payment (prepaid versus fee-for-service) was unrelated to either prevalence or severity of comorbid medical conditions, suggesting that the typical depressed patient in all types of practices studied had medical comorbidity. CONCLUSIONS: These data suggest that clinicians in all health care settings must be prepared to encounter chronic medical conditions and complaints in the depressed patients who visit them.Source
Am J Psychiatry. 1991 Dec;148(12):1688-96. Link to article on publisher's sitePermanent Link to this Item
http://hdl.handle.net/20.500.14038/47356PubMed ID
1957931Related Resources
Link to Article in PubMedRelated items
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