DISABILITY AND PSYCHIATRIC-DISORDERS IN AN URBAN-COMMUNITY - MEASUREMENT, PREVALENCE AND OUTCOMES

Background. The purpose of this analysis was to examine: (1) the preva lence of psychiatric disorders among disabled people, using seven diff erent measures of disability; (2) variation in disability between and within psychiatric diagnostic categories; and (3) relationship of diag nosis and disability to health service utilization. Method. Data were drawn from Phase I and Phase II of the Eastern Baltimore Mental Health Survey, part of the Epidemiologic Catchment Area Program (ECA) conduc ted in 1980-1 to survey mental morbidity within the adult population. A total of 810 individuals received both a household interview and a s tandardized clinical psychiatric evaluation. Estimated prevalence rate s were computed using appropriate survey sampling weights. Results. Pr evalence of disability ranged from 2.5 to 19.5%, varying with specific disability measure. Among those classified as disabled by any of the measures examined, 56 to 92% had a psychiatric disorder and serious ch ronic medical conditions were present in the majority of these cases ( 54 to 78%). Disability was expressed differently among the various dia gnostic groups. Diagnostic category and disability were significant in dependent predictors of medical service utilization and receipt of dis ability payments. Conclusions. The majority of disabled adults living in the community have diagnosable psychiatric disorders, with the majo rity of these individuals suffering from significant chronic medical c onditions as well, thus making co-morbidity the norm.