Factors associated with co-occurring medical conditions among adults with serious mental disorders

Background: This study examined the prevalence and treatment of 17 co-occurring physical health conditions among adults with serious mental health disorders, and factors associated with prevalence of the 5 most common medical co-morbidities.

Methods: Data were collected from 457 adults attending publicly funded mental health programs who participated in community health screenings held in 4 U.S. states. Face-to-face interviews included standardized items from the National Health Interview Survey and the National Health and Nutrition Examination Survey. Ordinary least squares regression analysis examined associations between prevalence of the 5 most common co-morbid conditions and respondents' demographic, clinical, attitudinal, and health insurance statuses.

Results: Compared to the U.S. population, prevalence was significantly higher for 14 out of 17 medical conditions assessed. The 5 most common were hyperlipidemia (45%), hypertension (44%), asthma (28%), arthritis (22%), and diabetes (21%). Controlling for age, study site, and Medicaid status, racial/ethnic minorities were almost twice as likely as Caucasians to be diagnosed with hypertension and diabetes; women were almost twice as likely as men to be diagnosed with diabetes; and people with schizophrenia were around half as likely as those with other disorders to be diagnosed with hypertension and arthritis. Age was positively related to all conditions except asthma. Treatment prevalence was below 70% for approximately half of ongoing conditions.

Conclusions: These results suggest a high level of medical vulnerability and need for coordination of health and mental health services in this population. Associations with age, minority status, and gender point to the need for targeted health care strategies.