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Burden of chronic physical conditions and mental disorders in primary care

  • Anna Fernández (a1), Juan Ángel Bellón Saameño (a2), Alejandra Pinto-Meza (a3), Juan Vicente Luciano (a3), Jaume Autonell (a3), Diego Palao (a4), Luis Salvador-Carulla (a1), Javier García Campayo (a5), Josep Maria Haro (a6), Antoni Serrano (a7) 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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Copyright
Corresponding author
Correspondence: Anna Fernández, MSc, Sant Joan de Déu-SSM, Fundació Sant Joan de Déu, Research and Development Unit, Dr. Antoni Pujadas, 42, 08830 Sant Boi de Llobregat, Barcelona, Spain. Email: afernandez@sjd-ssm.com
Footnotes
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This study was funded by the ‘Direcció General de Planificaciói Avaluació Sanitària – Departament de Salut – Generalitat de Catalunya’ (Barcelona, Spain). A.F. and J.V.L. are grateful to the ‘Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III’ (Red RD06/0018/0017) for a predoctoral and a postdoctoral contract respectively.

Declaration of interest

None.

Footnotes
References
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Burden of chronic physical conditions and mental disorders in primary care

  • Anna Fernández (a1), Juan Ángel Bellón Saameño (a2), Alejandra Pinto-Meza (a3), Juan Vicente Luciano (a3), Jaume Autonell (a3), Diego Palao (a4), Luis Salvador-Carulla (a1), Javier García Campayo (a5), Josep Maria Haro (a6), Antoni Serrano (a7) and the Dasmap investigators...
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