lunes, 10 de noviembre de 2014

Preventing Chronic Disease | Building an Evidence Base for the Co-Occurrence of Chronic Disease and Psychiatric Distress and Impairment - CDC

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Preventing Chronic Disease | Building an Evidence Base for the Co-Occurrence of Chronic Disease and Psychiatric Distress and Impairment - CDC



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Building an Evidence Base for the Co-Occurrence of Chronic Disease and Psychiatric Distress and Impairment

Gina M. Piane, DrPH, MPH; Tyler C. Smith, PhD, MS

Suggested citation for this article: Piane GM, Smith TC. Building an Evidence Base for the Co-Occurrence of Chronic Disease and Psychiatric Distress and Impairment. Prev Chronic Dis 2014;11:140211. DOI: http://dx.doi.org/10.5888/pcd11.140211External Web Site Icon.

MEDSCAPE CME

Medscape, LLC is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit.
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medscape, LLC and Preventing Chronic Disease. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians.
Medscape, LLC designates this Journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 75% minimum passing score and complete the evaluation at www.medscape.org/journal/pcd; (4) view/print certificate.
Release date: October 23, 2014; Expiration date: October 23, 2015

Learning Objectives

Upon completion of this activity, participants will be able to:
  • Analyze the epidemiology of chronic medical disease and mental illness among adults in the United States.
  • Evaluate the association between chronic disease and psychiatric distress in the current study.
  • Assess demographic variables that may strengthen the association between chronic disease and psychiatric distress.
  • Assess other variables that may strengthen the association between chronic disease and psychiatric distress.

 
EDITORS

Rosemarie Perrin, Editor, Preventing Chronic Disease. Disclosure: Rosemarie Perrin has disclosed no relevant financial relationships.
CME AUTHOR
Charles P. Vega, MD, Clinical Professor of Family Medicine, University of California, Irvine. Disclosure: Charles P. Vega, MD, has disclosed the following relevant financial relationships: Served as an advisor or consultant for: McNeil Pharmaceuticals.
AUTHORS AND CREDENTIALS
Disclosures: Gina M. Piane, DrPH, MPH, and Tyler C. Smith have disclosed no relevant financial relationships.

Affiliations: Gina M. Piane, DrPH, MPH, Department of Community Health, School of Health and Human Services, National University, San Diego, California; Tyler C. Smith, PhD, MS, National University, San Diego, California.
PEER REVIEWED

Abstract

Introduction
Mental disorders and chronic diseases have been reported to independently affect half of the US population. The objective of this study was to evaluate the comorbid nature of these conditions.
Methods
We analyzed data from 39,954 participants from the 2009 California Health Interview Survey who reported both psychological distress and impairment, on the basis of the Kessler 6 and the Sheehan Disability Scale, and 1 or more of 4 chronic diseases (type 2 diabetes, high blood pressure, asthma, heart disease). Weighted and nonweighted multivariable logistic regression were used to investigate the association between psychological distress and impairment and chronic disease, after adjusting for sex, age, race, current smoking, binge drinking in the previous year, moderate physical activity, and body mass index.
Results
After controlling for covariates in the model, we found a significant dose–response relationship between reported chronic diseases and psychiatric distress and impairment that ranged from 1.50 for 1 reported chronic disease to 4.68 for 4 reported chronic diseases.
Conclusion
The growing chronic disease burden should be understood clinically in the context of mental health conditions. Further research is needed to identify ways to integrate mental health and chronic disease prevention in primary care.

Acknowledgments

The views expressed in this article are those of the authors and do not reflect the official policy or position of National University. We thank the UCLA Center for Health Policy Research for surveying, cleaning, and managing these data and for making them available for research purposes as a public use data file. We thank the CHIS participants, without whom these analyses would not be possible. This article reflects work completed as part of teaching and scholarship responsibilities, and no additional financial support was received.

Author Information

Corresponding Author: Gina Piane, DrPH, MPH, Department of Community Health, School of Health and Human Services, National University, 3678 Aero Court, San Diego, CA 92123. Telephone: 714-429-5474. E-mail: GPiane@nu.edu.
Author Affiliation: Tyler C. Smith, National University, San Diego, California.

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