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Primary Care and Co-occurring Disorders

Physical and Mental Health Co-occurring Disorders

The relationships between mental health and physical health are complex, and the excess morbidity and mortality of those with mental health and substance abuse disorders cannot be completely explained by behavioral factors.

Mental and substance abuse disorders often co-occur with medical illnesses. The presence of both illnesses is frequently unrecognized and, therefore, not treated effectively. Several physical health issues demonstrate this complexity. Depression has been the most widely examined of these relationships. Up to 14% of medical inpatients and 10% of patients in primary care settings have depression with other medical illnesses.

Coronary Heart Disease

  • Depression occurs in 40-65% of patients who have experienced a heart attack, and in 18-20% of people who have coronary heart disease, but who do not have a heart attack.
  • Depression may be an independent risk factor for death in patients who have experienced a heart attack and others who coronary heart disease.
  • Depression has been associated with increased risk of developing coronary heart disease.

Diabetes

  • People with adult onset diabetes have a 25% chance of having depression, and almost 80% have a re-occurrence of depression during a 5-year follow-up period.
  • Depressed patients have increased insulin resistance compared with non-depressed patients.

Cancer

  • One in four people with cancer also suffers from depression.
  • There has been some evidence that people with depression are at risk for various cancers. Recent studies have found that women with depression were at increased risk of breast cancer.

Stroke

  • Depression occurs in 10% to 27% of stroke survivors and usually lasts about one year.
  • An additional 15-40% of stroke survivors experience some symptoms of depression within two months after the stroke.

HIV/AIDS, Mental Health and Substance Abuse

  • It has been estimated that between 22%-32% of HIV-infected patients have depression.
  • There is evidence that depression may hasten progression of HIV to AIDS.
  • In up to 10% of HIV+ patients, a neuropsychiatric condition maybe the first sign of the disorder.
  • Substance abuse increases the risk of HIV infection through risky behaviors, unprotected sex while under the influence, and injection drug use (IDU). IDUžs accounted for 36% of all AIDS cases among African American and Hispanics in 1998.
  • Over 59% of AIDS cases among women are linked to injection drug use or sex with men who inject drugs.

Depression and Other Mental Illnesses

Depression often occurs with other mental disorders, such as anxiety or eating disorders.

  • Between 50 and 75% of eating disorder patients (anorexia nervosa and bulimia) have a lifetime history of major depressive disorder.
  • Depression co-exits in 13% of patents with a panic disorder.
  • Between 10-30% of children with Attention-Deficit/Hyperactivity Disorder (AD/HD) and 47% of adults with AD/HD also have depression.

Mental Illness and Substance Abuse

Mental disorders often co-exist with alcohol or other substance abuse disorders.

  • One in three depressed people suffers from some form of substance abuse or dependence.
  • 37% of alcohol abusers and 53% of drug abusers have at least one serious mental illness.
  • Of all people diagnosed with mental illness, 29% abuse either alcohol or drugs.

Treatment for Co-Existing Illnesses

With co-occurring problems, both problems should ideally be treated simultaneously. However, if one problem is substance abuse, the first step of treatment is usually detoxification to allow the body to cleanse itself of alcohol or other drugs. Once this is accomplished, both illnesses are treated simultaneously.

About Us

The Mental Health Association of Franklin County is a private, not-for-profit organization established in 1956 to provide mental health education and consumer support services for the residents of Franklin County. We are the only agency in Franklin County whose broad mission is to educate the public about mental health and mental illness.

We provide information and referral to community mental health services, support groups for families and persons with mental illness, community and professional education, advocacy for people receiving mental health or alcohol/drug treatment, a newsletter for first-time parents, and media outreach among other services.

We also act as a clearinghouse for information on mental health topics. We receive funding from the United Way of Central Ohio and the Franklin County ADAMH Board. For more information call us at (614) 221-1441.

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