Mental Illness and Mental Healthcare Receipt among Hospitalized Veterans with Serious Physical Illnesses.

Mental Illness and Mental Healthcare Receipt among Hospitalized Veterans with Serious Physical Illnesses.

Publication TypeJournal Article
Year of Publication2017
AuthorsGarrido MM, Prigerson HG, Neupane S, Penrod JD, Johnson CE, Boockvar KS
JournalJ Palliat Med
Date Published2017 Mar
KeywordsAged, Aged, 80 and over, Anxiety Disorders, Chronic Disease, Comorbidity, Depression, Female, Hospitals, Veterans, Humans, Inpatients, Male, Middle Aged, Retrospective Studies, United States, Veterans

BACKGROUND: Psychosocial distress among patients with limited life expectancy influences treatment decisions, treatment adherence, and physical health. Veterans may be at elevated risk of psychosocial distress at the end of life, and understanding their mental healthcare needs may help identify hospitalized patients to whom psychiatric services should be targeted.

OBJECTIVE: To examine mental illness prevalence and mental health treatment rates among a national sample of hospitalized veterans with serious physical illnesses. Design, Subjects, and Measurements: This was a retrospective study of 11,286 veterans hospitalized in a Veterans Health Administration acute care facility in fiscal year 2011 with diagnoses of advanced cancer, congestive heart failure, chronic obstructive pulmonary disease, and/or advanced HIV/AIDS. Prevalent and incident mental illness diagnoses during and before hospitalization and rates of psychotherapy and psychotropic use among patients with incident depression and anxiety were measured.

RESULTS: At least one-quarter of the patients in our sample had a mental illness or substance use disorder. The most common diagnoses at hospitalization were depression (11.4%), followed by alcohol abuse or dependence (5.5%), and post-traumatic stress disorder (4.9%). Of the 831 patients with incident past-year depression and 258 with incident past-year anxiety, nearly two-thirds received at least some psychotherapy or guideline-concordant medication within 90 days of diagnosis. Of 191 patients with incident depression and 47 with incident anxiety at time of hospitalization, fewer than half received mental healthcare before discharge.

CONCLUSIONS: Many veterans hospitalized with serious physical illnesses have comorbid mental illnesses and may benefit from depression and anxiety treatment.

Alternate JournalJ Palliat Med
PubMed ID27835066
PubMed Central IDPMC5333567
Grant ListIK2 HX000767 / HX / HSRD VA / United States
R35 CA197730 / CA / NCI NIH HHS / United States
UL1 TR002384 / TR / NCATS NIH HHS / United States

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