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Disability and psychiatric disorders in an urban community: measurement, prevalence and outcomes

Published online by Cambridge University Press:  01 May 1998

S. S. BASSETT ,
G. A. CHASE ,
M. F. FOLSTEIN  and
D. A. REGIER
S. S. BASSETT
Affiliation:
From the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Biomathematics and Biostatistics, Georgetown Medical Center; Department of Psychiatry, New England Medical Center; and Division of Epidemiology and Services Research, National Institute of Mental Health, USA
G. A. CHASE
Affiliation:
From the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Biomathematics and Biostatistics, Georgetown Medical Center; Department of Psychiatry, New England Medical Center; and Division of Epidemiology and Services Research, National Institute of Mental Health, USA
M. F. FOLSTEIN
Affiliation:
From the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Biomathematics and Biostatistics, Georgetown Medical Center; Department of Psychiatry, New England Medical Center; and Division of Epidemiology and Services Research, National Institute of Mental Health, USA
D. A. REGIER
Affiliation:
From the Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Biomathematics and Biostatistics, Georgetown Medical Center; Department of Psychiatry, New England Medical Center; and Division of Epidemiology and Services Research, National Institute of Mental Health, USA
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Abstract

Background. The purpose of this analysis was to examine: (1) the prevalence of psychiatric disorders among disabled people, using seven different measures of disability; (2) variation in disability between and within psychiatric diagnostic categories; and (3) relationship of diagnosis and disability to health service utilization.

Method. Data were drawn from Phase I and Phase II of the Eastern Baltimore Mental Health Survey, part of the Epidemiologic Catchment Area Program (ECA) conducted in 1980–1 to survey mental morbidity within the adult population. A total of 810 individuals received both a household interview and a standardized clinical psychiatric evaluation. Estimated prevalence rates were computed using appropriate survey sampling weights.

Results. Prevalence of disability ranged from 2·5 to 19·5%, varying with specific disability measure. Among those classified as disabled by any of the measures examined, 56 to 92% had a psychiatric disorder and serious chronic medical conditions were present in the majority of these cases (54 to 78%). Disability was expressed differently among the various diagnostic groups. Diagnostic category and disability were significant independent predictors of medical service utilization and receipt of disability payments.

Conclusions. The majority of disabled adults living in the community have diagnosable psychiatric disorders, with the majority of these individuals suffering from significant chronic medical conditions as well, thus making co-morbidity the norm.

Type
Research Article
Information
Psychological Medicine , Volume 28 , Issue 3 , May 1998 , pp. 509 - 517
Copyright
© 1998 Cambridge University Press

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