US Pharm. 2008;33(1):12.

Serious psychological disorders (SPD) such as anxiety, depression, schizophrenia, and attention-deficit disorder have contributed to 48 million office-based physician visits, 3.7 million emergency department visits, 5.7 million outpatient visits, and 51.7 million ambulatory-care visits, according to the Centers for Disease Control and Prevention. The National Center for Health Statistics reports that the 30-day prevalence of SPD in non!= institutionalized adults was 3.1% from 2001 to 2004; prevalence was higher in women than in men.

Socioeconomics
Adults with SPD were more likely than those without it to have less than a high-school education (34% versus 17%) and less likely to have a college degree (9% versus 25%). Forty-four percent of persons with SPD had a family income of less than $20,000 a year, versus 20% of those without SPD. Those with SPD were less likely to live with other family members and twice as likely to be divorced.



Comorbidity
Almost one-half of persons with SPD had fair or poor health, versus 11% of persons without SPD. Those with SPD were more likely to ever have been diagnosed with heart (14%) or lung disease (24%), diabetes (13%), arthritis (40%), or stroke (8%), and were twice as likely to have two or more chronic diseases (35% versus 17%). Forty-two percent of persons with SPD were current smokers versus 21% of those without SPD; they also were more likely to be obese (33% versus 23%).

Accessibility
Persons with SPD were more likely to forgo needed health care and to be unable to get prescription drugs because of the cost. They were more than four times more likely to have Medicaid and significantly more likely to be uninsured.

Persons with SPD were more likely to have seen a health care professional within the last six months (81% versus 69%) and were three times as likely to have had 10 or more visits within the past year (39% versus 13%). Thirty-two percent talked to a mental health professional within the past year, versus only 5% of those without SPD.

Functionality
Persons with SPD were more likely to have vision and hearing impairment. A larger proportion of persons with SPD had difficulty walking (41%) and climbing stairs (35%) than those without SPD (10% and 7%). Thirty-four percent had difficulty getting out to go shopping or for other activities; 32% had difficulty with social activities, versus less than 5% of those without SPD. Eighteen percent of persons with SPD had difficulty with relaxing at home by reading, watching TV, or listening to music versus less than 2% of those without SPD.

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