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Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 11/2008

01-11-2008 | ORIGINAL PAPER

Psychiatric disorders are associated with hospital care utilization in persons with hypertension

Results from the National Epidemiologic Survey on alcohol and related conditions

Authors: Julie A. Wagner, PhD, Robert H. Pietrzak, MPH, Nancy M. Petry, PhD

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 11/2008

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Abstract

Background

Psychiatric disorders and hypertension both independently increase risk for heart disease, cardiac events, and healthcare utilization. However, the contribution of specific psychiatric disorders to healthcare utilization in persons with hypertension is unknown.

Objective

To evaluate associations between psychiatric disorders and receipt of hospital care in people with hypertension.

Design

Cross-sectional epidemiologic survey.

Subjects

A total of 8,812 hypertensive individuals drawn from a randomly selected sample of 43,093 US adults.

Main outcomes

Participants were assessed in-person for a range of mental disorders (using the Diagnostic and Statistical Manual of Mental Disorders-IV), hypertension status (self-report), and past-year occurrence of emergency room treatment and overnight hospital stay (self-report).

Results

After controlling for demographics and clinical variables, persons having any lifetime mood, anxiety, or personality disorders had increased likelihood of emergency room treatment [odds ratios (ORs) = 1.26, 1.18, and 1.47, respectively]. Persons having any mood or personality disorder had increased likelihood of overnight hospital stay (ORs  = 1.24 and 1.31, respectively). The specific disorders significantly associated with emergency room treatment were lifetime major depression, lifetime manic disorder, past-year major depression, past-year manic disorder, past-year panic disorder without agoraphobia, and paranoid, histrionic, antisocial, obsessive–compulsive personality disorders, with ORs ranging from 1.25 to 2.41. The specific disorders significantly associated with overnight hospital stay were lifetime dysthymia, lifetime manic disorder, past-year major depression, past-year manic disorder, and histrionic, antisocial, and paranoid personality disorders, with ORs ranging from 1.40 to 1.87.

Conclusion

Results suggest that addressing mental health problems in persons with hypertension may decrease healthcare utilization.
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Metadata
Title
Psychiatric disorders are associated with hospital care utilization in persons with hypertension
Results from the National Epidemiologic Survey on alcohol and related conditions
Authors
Julie A. Wagner, PhD
Robert H. Pietrzak, MPH
Nancy M. Petry, PhD
Publication date
01-11-2008
Publisher
D. Steinkopff-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 11/2008
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-008-0377-2

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