title: Building an evidence base for the co-occurrence of chronic disease and psychiatric distress and impairment.
abstract: BACKGROUND
  Mental disorders and chronic diseases have been reported to independently affect half of the US population. The objective of this study was to evaluate the comorbid nature of these conditions.
  
  
  METHODS
  We analyzed data from 39,954 participants from the 2009 California Health Interview Survey who reported both psychological distress and impairment, on the basis of the Kessler 6 and the Sheehan Disability Scale, and 1 or more of 4 chronic diseases (type 2 diabetes, high blood pressure, asthma, heart disease). Weighted and nonweighted multivariable logistic regression were used to investigate the association between psychological distress and impairment and chronic disease, after adjusting for sex, age, race, current smoking, binge drinking in the previous year, moderate physical activity, and body mass index.
  
  
  RESULTS
  After controlling for covariates in the model, we found a significant dose-response relationship between reported chronic diseases and psychiatric distress and impairment that ranged from 1.50 for 1 reported chronic disease to 4.68 for 4 reported chronic diseases.
  
  
  CONCLUSIONS
  The growing chronic disease burden should be understood clinically in the context of mental health conditions. Further research is needed to identify ways to integrate mental health and chronic disease prevention in primary care.
authors.affiliation: Department of Community Health, School of Health and Human Services, National University, 3678 Aero Court, San Diego, CA 92123. E-mail: GPiane@nu.edu.
authors.forename: Gina M
authors.initials: GM
authors.lastname: Piane
authors.affiliation: National University, San Diego, California.
authors.forename: Tyler C
authors.initials: TC
authors.lastname: Smith
mesh_terms: D001249:Asthma / Q000523:psychology*; D002908:Chronic Disease / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D006306:Health Surveys; D006331:Heart Diseases / Q000523:psychology*; D006801:Humans; D006973:Hypertension / Q000523:psychology*; D008603:Mental Health / Q000706:statistics & numerical data*