Psychiatric–Medical ComorbidityHealth care utilisation and quality of life in individuals with diabetes and comorbid mental disorders☆
Introduction
The present study examines the association of comorbid mental disorders with health care utilisation and quality of life (QoL) among persons with diabetes (PWD). The following questions are addressed: (1) Do PWD with and without mental comorbidity differ with respect to patterns of health care utilisation? (2) Are comorbid mental disorders in PWD associated with a reduced QoL?
Section snippets
Methods
PWD were recruited in the framework of the German National Health Interview and Examination Survey (GNHIES) [1]. In addition to self-administered questionnaires, participants completed a standardised computer-assisted personal interview (CAPI) conducted by trained study physicians. A definition of diabetes mellitus was based on the question: ‘Has a doctor ever told you …?’ All participants were screened for mental disorders (CIDI-S; N=7124). Subjects aged 65 years and younger who screened
Results
The total sample consisted of 146 PWD. Among these, 40 persons fulfilled the criteria for a mental disorder. PWD with mental disorders reported more physician visits than PWD without, although this difference was not significant (Table 1). Frequencies of mental health specialist visits did not differ significantly between the groups. Among 40 PWD with mental disorders, only seven individuals reported mental health specialist visits. Concerning hospitalisation days, PWD without mental disorders
Discussion
Comorbid mental disorders were found to be associated with lowered QoL in a nationally representative sample of PWD controlling for age and sex. This is shown not only for the psychosocial aspects of QoL, but also for some somatic aspects. These findings are supported by the results of a recent literature review, which demonstrated a negative relationship between QoL and somatic as well as psychiatric comorbidities among chronically ill patients [4].
Associations with health care utilisation
Acknowledgments
We would like to thank the Max Planck Institute for Psychiatry and the Department of Psychology and Psychotherapy of the TU Dresden for providing the GNHIES-MHS survey data [12].
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The authors declare that there is no duality of interest associated with this manuscript.