Chronic medical conditions in a sample of the general population with anxiety, affective and substance use disorders

The authors studied the prevalence of eight chronic medical conditions in an adult population sample (N=2,554) with and without psychiatric disorders. Adjusted for age and sex, the prevalence ofany lifetime chronic medical condition for persons with any life-time affective, anxiety, or substance use disorder was 61.4%, 57.1 %, and 57.7%, respectively. Each of these percentages was significantly higher than that for per-sons with no lifetime psychiatric disorder (53.4%). Both lifetime affective and anxiety disorders were uniquely associated with a greater prevalence of any lifetime chronic medical condition, but the only psy-chiatric disorders uniquely associated with current (i.e., active) chronic medical conditions were anxiety disorders, suggesting that the association between anx-iety disorders and chronic medical conditions develops more quickly than associations between medical con-ditions and other psychiatric disorders. (Am J Psychiatry 1989; 146:1440-1446) P ersons with concurrent psychiatric disorders and chronic medical conditions are of great public health interest because they are likely to have func-tional limitations and incur high treatment costs (1-7). Dvoredsky and Cooley (8), for example, found that inpatients with combined medical and psychiatric dis-orders were more likely than patients with either type of disorder alone to be discharged to a nursing home. In addition, such persons are difficult to diagnose and treat (9-13), in part because of the overlapping symp-toms of medical and psychiatric disorders and the in