title: Association between nonspecific severe psychological distress as an indicator of serious mental illness and increasing levels of medical multimorbidity.
abstract: OBJECTIVE
  We sought to determine whether severe psychological distress (SPD) and serious mental illnesses (SMIs) are associated with a specific set of chronic medical conditions (CMCs) and the association between SPD-SMIs and increasing levels of medical multimorbidity and complexity (i.e., from 1 to 3 or more CMCs).
  
  
  METHODS
  We used data from 3 administrations (2008-2010) of the National Survey on Drug Use and Health collected from 110 455 adult participants. We used binary and ordinal logistic regressions adjusting for sociodemographics and substance abuse to examine the associations between SPD-SMIs and increasing levels of multimorbidity.
  
  
  RESULTS
  SPD-SMI was associated with higher probabilities for many CMCs generally, but we found no specific pattern for any class of conditions for SPD-SMIs and multimorbidity. The association between SPD-SMIs and multimorbidity strengthened as the number of CMCs increased.
  
  
  CONCLUSIONS
  The finding of no discernible risk pattern for any specific CMC grouping supports broad medical assessment strategies and closely coordinated primary and behavioral health care for those with SPD-SMIs, as called for in the Patient Protection and Affordable Care Act.
authors.affiliation: James A. Swartz and Ian Jantz are with the Jane Addams College of Social Work, University of Illinois at Chicago.
authors.forename: James A
authors.initials: JA
authors.lastname: Swartz
authors.forename: Ian
authors.initials: I
authors.lastname: Jantz
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology; D015897:Comorbidity; D003710:Demography; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000453:epidemiology*