Mood Disorders in Middle-Aged and Older Veterans With Multimorbidity

Abstract

Objective This study identified the prevalence of and relationship between mood disorders and multimorbidity in middle-aged and older veterans. Method Cross-sectional data were obtained from veterans who received primary care services at VA Pittsburgh Healthcare System from January 2007 to December 2011 (n = 34,786). Results Most veterans had three or more organ systems with chronic disease (95.3%), of which 4.1% had a depressive disorder, 2.5% had an anxiety disorder, and 0.7% had co-occurring depression and anxiety. The odds of having a mood disorder increased with each additional organ system with chronic disease, with odds being the greatest in those with 10 to 13 organ systems with chronic disease. Younger age, female gender, non-married marital status, and having a service connected disability were also significant predictors of having a mood disorder. Discussion These findings suggest a need to integrate mental health assessment and treatment in chronic health care management for veterans.

Systematic review on the instruments used for measuring the association of the level of multimorbidity and clinically important outcomes

“…They were Cumulative Illness Rating Scale (CIRS) 17 18 and Organ Systems with Chronic Disease Count (Organ-CDC). 19 …”

“…Organ systems with CDC Presence of depressive or anxiety disorder 19 CIRS Disability, 17 frailty, 17 healthcare utilisation, 54 hospitalisation (3 years), 18 mortality 18 Functional decline 18 C=Weighted indices ACE Healthcare expenditure 23 Cambridge MM Score Mortality, 97 primary care consultation, 97 unplanned admission 97 CCI Ambulatory care-sensitive hospitalisations (acute and chronic), 106 disability, 17 emergency department visits (1 year), 21 emergency hospital admission (2 years), 119 frailty, 17 functional decline (2 years), 119 future physical functioning, 28 healthcare expenditure, 21 hip fractures, 103 hospitalisation (1 year), 21 64 80 99 109 hospitalisation (3 years), 18 mortality (1 year), 50 63 99 109 mortality (3 years), 18 (5 years), 51 63 (10 years), 51 63 (15, 20, 25 years), 51 number of primary care consultations (3 years), 48 number of primary care physician visits (1 year), 107 number of specialist visits (1 year), 107 potentially preventable unplanned admission (1 year), 96 presence of critical illness, 46 primary healthcare cost, 47 mortality (1 year), 57 58 (3 years), 48 59 (5 years), 58 60 62 (7 years), 86 (10 years), 28 readmission within 30 days (1 year), 21 successful ageing 61 Functional decline, 18 primary care visits,…”

“…They were Cumulative Illness Rating Scale (CIRS) 17 18 and Organ Systems with Chronic Disease Count (Organ-CDC). 19 Weighted indices There were 17 unique weighted instruments found in the included studies. The original CCI with its different modifications was the most frequently used instrument and was used in 29 studies.…”

Attachment-Based Relationship Satisfaction in Deployed and Non-Deployed Military Veterans with Prevalent PTSD, Anxiety, and Depression

“…Veterans also have a high risk of experiencing depressive and anxiety disorders (DiNapoli et al, 2017;Ikin et al, 2010;Milanak et al, 2013). Twelve percent of veterans in one moderately sized primary care prevalence study met diagnostic criteria for Generalized Anxiety Disorder (GAD), and 40% of participants had co-occurring GAD and PTSD (Milanak et al, 2013).…”

“…To the best of these researchers' knowledge, no peerreviewed articles examining both non-deployed and deployed samples using attachment theory as a guiding theoretical framework to predict relationship satisfaction while controlling for extraneous variables of generalized anxiety, depression, and PTSD have been published. It is crucial to control depression, generalized anxiety, and PTSD since they commonly co-occur within the veteran population (Contractor et al, 2015;DiNapoli et al, 2017;Ikin et al, 2010;Milanak et al, 2013;Pittman et al, 2012). Building upon previous research from Ponder and Carbajal (2020) who used correlational analyses, this study used a larger sample size to investigate the following research question: How do attachment avoidance and attachment anxiety explain the differences in a nondeployed and deployed sample of veterans predicting their own relationship satisfaction, while controlling for the extraneous variables of generalized anxiety, depression, and PTSD?…”