title: Psychiatric comorbidities in patients with hypertension--a study of registered diagnoses 2009-2013 in the total population in Stockholm County, Sweden.
abstract: OBJECTIVE
  The objective of this study was to investigate the prevalence of concomitant hypertension and psychiatric disorders in the general population, using administrative healthcare data in Stockholm County.
  
  
  METHODS
  The study population, included all living persons who resided in Stockholm County 1 January 2011 (N = 2 ,058 ,408). Individuals with a diagnosis of hypertension were identified with data from all consultations in primary care, specialized outpatient care, and inpatient care 2009-2013. As outcome, data were obtained on all consultations because of certain psychiatric diagnoses between 2011 and 2013, including specifically depression, anxiety disorders, bipolar disorder, and schizophrenia. Age-adjusted odd ratios (ORs) with 95% confidence intervals (95% CI) were calculated for men and women with and without hypertension, with individuals without hypertension as referents.
  
  
  RESULTS
  The age-adjusted ORs for depression in persons with hypertension were 1.293 (95% CI 1.256-1.331,) for men and 1.036 (95% CI 1.013-1.058) for women. The age-adjusted ORs for anxiety in persons with hypertension were 1.279 (95% CI 1.238-1.322) for men and 1.050 (95% CI 1.024-1.076) for women. The OR for bipolar disease were 0.904 (95% CI 0.826-0.990) for men and 0.709 (95% CI 0.656-0.767) for women. For schizophrenia, the ORs were 0.568 (95% CI 0.511-0.632) for men and 0.537 (95% CI 0.478-0.603) for women.
  
  
  CONCLUSIONS
  Increased awareness of the risk of depression and anxiety among hypertensive patients is needed to combat hypertension, its complications, and psychiatric suffering in the population. Hypertension is probably underdiagnosed and neglected in individuals with severe psychiatric disorders. We warrant efforts to integrate psychiatric and hypertensive care.
authors.affiliation: aDepartment of Neurobiology, Division for Family Medicine, Karolinska Institutet, Care Sciences and Society, Huddinge bPublic Healthcare Services Committee Administration, Stockholm County Council cDepartment of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet dCentre for Psychiatry Research, Karolinska Institutet, Stockholm eDepartment of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden.
authors.forename: Ylva Kristoferson
authors.initials: YK
authors.lastname: Sandström
authors.forename: Gunnar
authors.initials: G
authors.lastname: Ljunggren
authors.forename: Per
authors.initials: P
authors.lastname: Wändell
authors.forename: Lars
authors.initials: L
authors.lastname: Wahlström
authors.forename: Axel C
authors.initials: AC
authors.lastname: Carlsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology; D001714:Bipolar Disorder / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011320:Primary Health Care; D012559:Schizophrenia / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult