Prevalence of behavioral health disorders and associated chronic disease burden in a commercially insured health system: findings of a case–control study

Young, John Q.; Kline-Simon, Andrea H.; Mordecai, Donald; Weisner, Constance

doi:10.1016/j.genhosppsych.2014.12.005

Cited by 36 publications

(34 citation statements)

References 29 publications

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“…Rates of psychiatric comorbidity ranged from 40.1% among adolescents with ADHD to 84.3% among those with bipolar disorder, rates that are significantly higher than has been seen among adults with BHCs in this health system. 8 Overall, patients with a BHC were not more likely to have a medical comorbidity compared with their peers without BHCs. However, of the 13 categories of medical conditions examined, we did find significantly higher odds across the majority of the conditions examined within each BHC compared with matched controls.…”

Section: Discussionmentioning

confidence: 89%

“…These categories were selected based on collaborations with the National Institute of Mental Health's Mental Health Research Network 28 and KPNC's Regional Mental Health Leadership and were used in our prior work. 8 The first mention for each BHC during the study period was included, so BHCs were not mutually exclusive. Patients insured by Medicare or Medicaid were excluded from the study.…”

Section: Methodsmentioning

confidence: 99%

“…2,3 Research on adults has found that there is significant comorbidity between BHCs and many chronic medical conditions, and that this co-occurrence can complicate treatment for all of the conditions. [4][5][6][7][8] The pediatric literature on the co-occurrence of mental health, substance use, and medical conditions is less robust, but has begun to document comorbidity between BHCs and some common chronic medical conditions. [9][10][11] A recent national population survey found that among 18-year-olds, 31.9% reported having an anxiety disorder, 14.3% a mood disorder, 19.6% a behavioral disorder, including attention-deficit/hyperactivity disorder (ADHD), and 11.4% a SUD at some point in their lives.…”

mentioning

confidence: 99%

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Point Prevalence of Co-Occurring Behavioral Health Conditions and Associated Chronic Disease Burden Among Adolescents

Kline-Simon

Weisner

Sterling

2016

Journal of the American Academy of Child & Adolescent Psych

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Section: Discussionmentioning

confidence: 89%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Point Prevalence of Co-Occurring Behavioral Health Conditions and Associated Chronic Disease Burden Among Adolescents

Kline-Simon

Weisner

Sterling

2016

Journal of the American Academy of Child & Adolescent Psych

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“…Each patient with one or more BHC was matched on sex, age, and medical facility to a patient without BHCs. Matching by medical facility accounted for any potential differences in services offered by geographic region (24). Rates of BHCs are higher in Medicaid and Medicare populations, so individuals insured by public programs were excluded to prevent oversampling of these patients in the BHC group.…”

Section: Study Participantsmentioning

confidence: 99%

Smoking Trends Among Adults With Behavioral Health Conditions in Integrated Health Care: A Retrospective Cohort Study

Young-Wolff

Kline-Simon

Das

et al. 2016

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Objective: Individuals with behavioral health conditions (BHCs) smoke at high rates and have limited success with quitting, despite impressive gains in recent decades in reducing the overall prevalence of smoking in the United States. This study examined smoking disparities among individuals with BHCs within an integrated health care delivery system with convenient access to tobacco treatments. Methods:The sample consisted of patients in an integrated health care delivery system in 2010-a group (N=155,733) with one or more of the five most prevalent BHCs (depressive disorders, anxiety disorders, substance use disorders, bipolar and related disorders, and attention-deficit hyperactivity disorder) and a group (N=155,733) without BHCs who were matched on age, sex, and medical home facility. The odds of smoking among patients with BHCs versus without BHCs were examined over four years using logistic regression generalized estimating equation models.Tobacco cessation medication utilization among a subset of smokers in 2010 was also examined.Results: Although smoking prevalence decreased from 2010 to 2013 overall, the likelihood of smoking decreased significantly more slowly among patients with BHCs compared with patients without BHCs (p,.001), most notably among patients with substance use and bipolar and related disorders. Tobacco cessation medication use was low, and smokers with BHCs were more likely than smokers without BHCs to utilize these products (6.2% versus 3.6%, p,.001). Conclusions:Smoking decreased more slowly among individuals with BHCs compared with individuals without BHCs, even within an integrated health care system, highlighting the need to prioritize smoking cessation within specialty behavioral health treatment.

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“…Individuals with major depressive disorder (MDD) have excess morbidity (Young et al, 2014) and mortality (Lou et al, 2014; Young et al, 2014; Zivin et al, 2012) as compared to the general population (Lou et al, 2014). One hypothesis regarding the cause of this excess morbidity and mortality that has gained much attention involves telomere biology.…”

Section: Introductionmentioning

confidence: 99%

Depression and telomere length: A meta-analysis

Ridout

Price

et al. 2016

Journal of Affective Disorders

208

148

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Background Several recent studies have investigated the relationship between telomere length and depression with inconsistent results. This meta-analysis examined whether telomere length and depression are associated and explored factors that might affect this association. Methods Studies measuring telomere length in subjects with clinically significant unipolar depression were included. A comprehensive search strategy identified studies in PubMed, MEDLINE, PsycINFO, Global Health, The Cochrane Library, and Web of Science. A structured data abstraction form was used and studies were appraised for inclusion or exclusion using a priori conditions. Analyses were conducted using standardized mean differences in a continuous random effects model. Results Thirty-eight studies (N = 34,347) met the inclusion criteria. The association between depression and telomere length was significant, with a Cohen's d effect size of -0.205 (p < 0.0001, I2 = 42%). Depression severity significantly associated with telomere length (p = 0.03). Trim and fill analysis indicated the presence of publication bias (p = 0.003), but that the association remained highly significant after accounting for the bias. Subgroup analysis revealed depression assessment tools, telomere measurement techniques, source tissue and comorbid medical conditions significantly affected the relationship. Limitations Other potentially important sub-groups, including antidepressant use, have not been investigated in sufficient detail or number yet and thus were not addressed in this meta-analysis. Conclusions There is a negative association between depression and telomere length. Further studies are needed to clarify potential causality underlying this association and to elucidate the biology linking depression and this cellular marker of stress exposure and aging.

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Prevalence of behavioral health disorders and associated chronic disease burden in a commercially insured health system: findings of a case–control study

Cited by 36 publications

References 29 publications

Point Prevalence of Co-Occurring Behavioral Health Conditions and Associated Chronic Disease Burden Among Adolescents

Point Prevalence of Co-Occurring Behavioral Health Conditions and Associated Chronic Disease Burden Among Adolescents

Smoking Trends Among Adults With Behavioral Health Conditions in Integrated Health Care: A Retrospective Cohort Study

Depression and telomere length: A meta-analysis

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