Prevalence of comorbid psychiatric illness and substance misuse in primary care in England and Wales. Frisher, M., Collins, J., Millson, D., Crome, I., & Croft, P. Journal of Epidemiology and Community Health, 58(12):1036--1041, December, 2004.
doi  abstract   bibtex   
STUDY OBJECTIVE: To estimate the annual period prevalence of co-occurring psychiatric illness and substance misuse among patients in primary care. DESIGN: Analysis of the general practice research database. SETTING: England and Wales, 1993-1998. PARTICIPANTS: Registered patients at 230 general practices representing 3.1% of the population. A comorbid case was defined as one with both a psychiatric diagnosis and substance misuse diagnosis (not including alcohol or tobacco) within a calendar year. A potentially chronic comorbid case was one that met this definition and, in addition, was treated in subsequent years for either a psychiatric condition or substance misuse. MAIN RESULTS: The annual period prevalence of comorbidity increased from 50/100 000 patient years of exposure (PYE) to 80/100 000 PYE, an increase of 62% during the study period. Rates of comorbid psychoses, comorbid schizophrenia, and comorbid paranoia increased by 147%, 128%, and 144%. The average age of comorbid cases decreased from 38 years to 34 years. Over 80% of comorbid cases were newly diagnosed in each study year, although many are treated in subsequent years for either psychiatric illness or substance misuse. CONCLUSIONS: This study provides data on the nature and extent of comorbidity in primary care in England and Wales. As the comorbidity rate is increasing by about 10% each year, and as comorbid cases are becoming younger, it is probable that the comorbidity rate will have increased beyond the study end point.
@article{frisher_prevalence_2004,
	title = {Prevalence of comorbid psychiatric illness and substance misuse in primary care in {England} and {Wales}},
	volume = {58},
	issn = {0143-005X},
	doi = {10.1136/jech.2003.017384},
	abstract = {STUDY OBJECTIVE: To estimate the annual period prevalence of co-occurring psychiatric illness and substance misuse among patients in primary care.
DESIGN: Analysis of the general practice research database.
SETTING: England and Wales, 1993-1998.
PARTICIPANTS: Registered patients at 230 general practices representing 3.1\% of the population. A comorbid case was defined as one with both a psychiatric diagnosis and substance misuse diagnosis (not including alcohol or tobacco) within a calendar year. A potentially chronic comorbid case was one that met this definition and, in addition, was treated in subsequent years for either a psychiatric condition or substance misuse.
MAIN RESULTS: The annual period prevalence of comorbidity increased from 50/100 000 patient years of exposure (PYE) to 80/100 000 PYE, an increase of 62\% during the study period. Rates of comorbid psychoses, comorbid schizophrenia, and comorbid paranoia increased by 147\%, 128\%, and 144\%. The average age of comorbid cases decreased from 38 years to 34 years. Over 80\% of comorbid cases were newly diagnosed in each study year, although many are treated in subsequent years for either psychiatric illness or substance misuse.
CONCLUSIONS: This study provides data on the nature and extent of comorbidity in primary care in England and Wales. As the comorbidity rate is increasing by about 10\% each year, and as comorbid cases are becoming younger, it is probable that the comorbidity rate will have increased beyond the study end point.},
	language = {eng},
	number = {12},
	journal = {Journal of Epidemiology and Community Health},
	author = {Frisher, Martin and Collins, Juliet and Millson, David and Crome, Ilana and Croft, Peter},
	month = dec,
	year = {2004},
	pmid = {15547069},
	pmcid = {PMC1732645},
	keywords = {Adolescent, Adult, Aged, Aged, 80 and over, Comorbidity, Diagnosis, Dual (Psychiatry), England, Female, Humans, Male, Mental Disorders, Middle Aged, Prevalence, Primary Health Care, Substance-Related Disorders, Wales},
	pages = {1036--1041}
}

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