title: Mental health service use by older adults: the role of chronic pain.
abstract: OBJECTIVE
  Mental health disorders commonly co-occur in patients with chronic pain, but little is known about the role of chronic pain in mental health service use. In this study, the authors explored the role of chronic pain in mental health service use by adults according to age group.
  
  
  METHODS
  The authors conducted a cross-sectional analysis of survey data from the second wave of the Health Care for Communities telephone survey collected in 2000-2001. Participants consisted of U.S. civilian adults (N = 6629) from randomly selected U.S. households. Common mental disorders were assessed using the short-form versions of the World Health Organization's Composite International Diagnostic Interview. Chronic pain conditions and mental health services received were identified by self-report. Physical and mental functioning was assessed using the Short Form-12.
  
  
  RESULTS
  Adults older than age 60 had higher rates of chronic pain and lower rates of mental health service use compared with those aged 18-60 years. In multiple logistic regression models, an interaction effect was found between age and chronic pain (odds ratio: 3.0 [1.1-8.0]) with chronic pain significantly increasing the odds of any mental health care in the past year in adults older than 60 years of age.
  
  
  CONCLUSIONS
  Chronic pain increases the likelihood of mental health service use among older adults. Chronic pain may facilitate the presentation of distress in medical settings for these adults.
authors.affiliation: Department of Psychiatry & Behavioral Sciences , University of Washington School of Medicine, Seattle, WA 98195-6560, USA. jkbrenn@u.washington.edu
authors.forename: Jennifer Brennan
authors.initials: JB
authors.lastname: Braden
authors.forename: Lily
authors.initials: L
authors.lastname: Zhang
authors.forename: Ming-Yu
authors.initials: MY
authors.lastname: Fan
authors.forename: Jürgen
authors.initials: J
authors.lastname: Unützer
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Edlund
authors.forename: Mark D
authors.initials: MD
authors.lastname: Sullivan
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D002908:Chronic Disease; D003156:Community Mental Health Services / Q000706:statistics & numerical data; D015897:Comorbidity; D003625:Data Collection; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology; D008875:Middle Aged; D016017:Odds Ratio; D010146:Pain / Q000453:epidemiology; D059408:Pain Management; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D014600:Utilization Review