Burden of chronic conditions among persons with HIV/AIDS and psychiatric comorbidity

Background: Improved survivorship among persons living with HIV translates into higher risk of medical comorbidities. Objective : We assessed the association between intersection of physical (HIV) and mental health (psychiatric) conditions and intermediate outcomes. Methods: Cross-sectional study of Medical Expenditure Panel Survey (MEPS)-Household Component between 1996 and 2016. We created four groups for persons aged ≥18: (1) HIV + psychiatric comorbidity, (2) HIV, (3) psychiatric comorbidity, and (4) no-HIV/no-psychiatric comorbidity. We compared the burden of medical comorbidities (metabolic disorders, cardiovascular disease, cancers, infectious diseases, pain, and substance use) across groups using chi square tests. We used logistic regression to determine the association between group status and medical comorbidity. Results: Of 218,133,630 (weighted) persons aged ≥18, 0.18% were HIV-positive. Forty-three percent of HIV group and 19% of no-HIV group had psychiatric comorbidities. Half of the HIV+ psychiatric disorder group had at least one medical comorbidity. Compared to the no-HIV/no-psychiatric comorbidity group, the HIV + psychiatric comorbidity group had highest odds of medical comorbidity (OR= 3.69, 95% CI = 2.99, 4.52). Conclusion: Persons presenting with HIV + psychiatric comorbidity had higher odds of medical comorbidities of pain, cancer, cardiovascular disease, substance use, metabolic disorders and infectious diseases, beyond that experienced by persons with HIV infection or psychiatric disorders, independently. Future research will focus on the mediating effects of social determinants and biological factors on outcomes as quality of life, cost and mortality. This will facilitate a shift away from the single-disease framework and compress morbidity of the aging cohort of HIV-infected persons.

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Impact of Medical Comorbidity on Medication Management of Schizophrenia

CNS Spectrums ◽

10.1017/s1092852900015960 ◽

2007 ◽

Vol 12 (S21) ◽

pp. 15-17

Author(s):

Dan W. Haupt

Keyword(s):

Cardiovascular Disease ◽

Mental Illness ◽

General Population ◽

Serious Mental Illness ◽

Medication Management ◽

Population Sample ◽

Unipolar Depression ◽

Medical Comorbidity ◽

Medical Comorbidities ◽

Poor Access

Schizophrenia is associated with increased medical comorbidity likely caused by interactions between life-style, environment, and the disease itself. High rates of medical comorbidity exist among all forms of serious mental illness. Affective disorders such as bipolar disorder and unipolar depression are associated with 1.5–2 times the mortality rate observed in the general population, and high rates of HIV and hepatitis A, B, and C exist among patients with severe mental illness. However, schizophrenia is particularly affected by medical comorbidities, and is associated with a 20% shorter-than-normal lifespan. This discussion focuses on rates of medical comorbidity in people with schizophrenia and the effects of medication on cardiometabolic risk factors. It is also important to recognize that lifestyle and environmental factors associated with serious mental illness, as well as poor access to healthcare, contribute to the elevated rates of medical illnesses observed in these populations as well.Studies of the association between schizophrenia and medical comorbidities have suggested that the introduction of second-generation antipsychotics (SGAs) may be responsible for the increases observed in cardiovascular disease rates in this patient population, and that cardiovascular disease mortality may be shifting to an earlier stage of life. Ösby and colleagues observed that while overall cardiovascular mortality in schizophrenia patients in Sweden increased from 1976–1995, an even greater increase occurred in men from 1991–1995. This latter increase corresponded temporally to an increased use of SGAs.Osborne and colleagues recently confirmed the observation made by Osby and colleagues. They compared 46,000 people with serious mental illness and a general population sample of ∼300,000 people from 1987–2002.

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A171 FACTORS OF SOCIAL PARTICIPATION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwab002.169 ◽

2021 ◽

Vol 4 (Supplement_1) ◽

pp. 182-183

Author(s):

S Su ◽

R Marrie ◽

C N Bernstein

Keyword(s):

Inflammatory Bowel Disease ◽

Linear Regression ◽

Social Participation ◽

Bowel Disease ◽

Psychiatric Comorbidity ◽

Psychiatric Symptoms ◽

Multivariate Linear Regression ◽

Medical Comorbidity ◽

Medical Comorbidities ◽

Inflammatory Bowel

Abstract Background Inflammatory bowel disease (IBD) including Crohn’s disease (CD) and ulcerative colitis (UC) imposes a significant burden on health-related quality of life, particularly in social domains. We sought to investigate the factors that limit social participation in patients with IBD. Aims Our first aim was to identify if active IBD symptoms had an effect on an objective measure of social participation. Our secondary aim was to determine if psychiatric comorbidity and/or active psychiatric symptoms in IBD patients had an influence on social participation. Methods We assessed a cohort of 239 Manitobans with IBD. We collected sociodemographic information, medical comorbidities, disease phenotype, symptom activity and psychiatric comorbidity (using the Structured Clinical Interview for DSM-IV). Participants completed the 8-item Ability to Participate in Social Roles and Activities questionnaire, which assesses participation restriction, including problems experienced in social interaction, employment, transportation, community, social, and civic life. Results Poorer social participation score were associated with earning less than average income (p<0.001), being unemployed (p<0.001), actively smoking (p=0.006), higher symptom scores, and having an increasing number of chronic medical conditions (R= -0.296). History of depression (p<0.001) and anxiety (p=0.001) and having active depression (p<0.001) and anxiety (p=0.001) all predicted poor social participation scores. Patient’s with UC on 5-ASA (PO/PR) seem to have higher social participation than other therapies. Phenotype was not predictive. Based on multivariate linear regression analysis, 38.8% of variability in social participation was explained by medical comorbidity, psychiatric comorbidity, psychiatric symptoms, and IBD related symptoms. Conclusions The factors that predict social participation by IBD patients include income, employment, smoking, medical comorbidities, IBD symptom burden, and psychiatric comorbidities. Multivariate linear regression suggests that the most relevant factors are medical comorbidity, psychiatric comorbidity, psychiatric symptoms, and IBD symptoms. Funding Agencies CIHRCrohn’s and Colitis Canada

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Comparative Study of Psychiatric Comorbidity Differences in Patients with ADHD and Cocaine Substance Use Disorders and Patients ADHD and Cannabis Use Disorders

10.26226/morressier.588f064ed462b8028d8922e8 ◽

2017 ◽

Author(s):

Nieves Martínez-Luna

Keyword(s):

Substance Use ◽

Comparative Study ◽

Substance Use Disorders ◽

Psychiatric Comorbidity ◽

Cannabis Use ◽

Cannabis Use Disorders

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Impact of Waist Circumference and Body Mass Index on Risk of Cardiometabolic Disorder and Cardiovascular Disease in Chinese Adults: A National Diabetes and Metabolic Disorders Survey

PLoS ONE ◽

10.1371/journal.pone.0057319 ◽

2013 ◽

Vol 8 (3) ◽

pp. e57319 ◽

Cited By ~ 70

Author(s):

Xuhong Hou ◽

Juming Lu ◽

Jianping Weng ◽

Linong Ji ◽

Zhongyan Shan ◽

...

Keyword(s):

Cardiovascular Disease ◽

Body Mass Index ◽

Waist Circumference ◽

Body Mass ◽

Metabolic Disorders ◽

Chinese Adults ◽

Cardiometabolic Disorder

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Self-efficacy as a mediator of patient navigation interventions to engage persons living with HIV and substance use

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2021.108567 ◽

2021 ◽

Vol 221 ◽

pp. 108567

Author(s):

Sharleen M. Traynor ◽

Lisa R. Metsch ◽

Lauren Gooden ◽

Maxine Stitzer ◽

Tim Matheson ◽

...

Keyword(s):

Substance Use ◽

Self Efficacy ◽

Patient Navigation ◽

Persons Living With Hiv ◽

Living With Hiv

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ADHD, Religiosity, and Psychiatric Comorbidity in Adolescence and Adulthood

Journal of Attention Disorders ◽

10.1177/1087054720972803 ◽

2020 ◽

pp. 108705472097280

Author(s):

Rachel E. Dew ◽

Scott H. Kollins ◽

Harold G. Koenig

Keyword(s):

Substance Use ◽

Psychiatric Comorbidity ◽

Religious Life ◽

Add Health ◽

Religious Practice ◽

Health Study ◽

Adhd Symptoms ◽

Childhood Adhd ◽

Mediation And Moderation

Objective: Religiosity has been repeatedly proposed as protective in the development of depression, sociopathy and addictions. ADHD frequently co-occurs with these same conditions. Although ADHD symptoms may affect religious practice, religiosity in ADHD remains unexplored. Method: Analyses examined data from >8000 subjects aged 12 to 34 in four waves of the Add Health Study. Relationships of religious variables with childhood ADHD symptoms were statistically evaluated. Observed correlations of ADHD symptoms to depression, delinquency, and substance use were tested for mediation and moderation by religiosity. Results: ADHD symptoms correlated with lower levels of all religious variables at nearly all waves. In some analyses at Wave IV, prayer and attendance interacted with ADHD to predict worsened psychopathology. Conclusion: ADHD symptoms predicted lower engagement in religious life. In adulthood, some aspects of religiosity interacted with ADHD symptoms to predict worse outcomes. Further research should explore whether lower religiosity partially explains prevalent comorbidities in ADHD.

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