Burden of chronic physical conditions and mental disorders in primary care.
BACKGROUND
The World Health Organization (WHO) has stated that the three leading causes of burden of disease in 2030 are projected to include HIV/AIDS, unipolar depression and ischaemic heart disease.


OBJECTIVE
To estimate health-related quality of life (HRQoL) and quality-adjusted life-year (QALY) losses associated with mental disorders and chronic physical conditions in primary healthcare using data from the diagnosis and treatment of mental disorders in primary care (DASMAP) study, an epidemiological survey carried out with primary care patients in Catalonia (Spain).


METHODS
A cross-sectional survey of a representative sample of 3815 primary care patients. A preference-based measure of health was derived from the 12-item Short Form Health Survey (SF-12): the Short Form-6D (SF-6D) multi-attribute health-status classification. Each profile generated by this questionnaire has a utility (or weight) assigned. We used non-parametric quantile regressions to model the association between both mental disorders and chronic physical condition and SF-6D scores.


RESULTS
Conditions associated with SF-6D were: mood disorders, beta = -0.20 (95% CI -0.18 to -0.21); pain, beta = -0.08 (95%CI -0.06 to -0.09) and anxiety, beta = -0.04 (95% CI -0.03 to -0.06). The top three causes of QALY losses annually per 100 000 participants were pain (5064), mood disorders (2634) and anxiety (805).


CONCLUSIONS
Estimation of QALY losses showed that mood disorders ranked second behind pain-related chronic medical conditions.
Fernández
Anna
A
Sant Joan de Déu-SSM, Fundació Sant Joan de Déu, Research and Development Unit, Dr. Antoni Pujadas, 42, 08830 Sant Boi de Llobregat, Barcelona, Spain. afernandez@sjd-ssm.com
Saameño
Juan Angel Bellón
JA
Pinto-Meza
Alejandra
A
Luciano
Juan Vicente
JV
Autonell
Jaume
J
Palao
Diego
D
Salvador-Carulla
Luis
L
Campayo
Javier García
JG
Haro
Josep Maria
JM
Serrano
Antoni
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology* / Q000534:rehabilitation; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000534:rehabilitation; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000534:rehabilitation; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011594:Psychometrics; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D013030:Spain / Q000453:epidemiology; D055815:Young Adult