FUNCTIONAL IMPAIRMENT AND COOCCURRING PSYCHIATRIC-DISORDERS IN MEDICALLY HOSPITALIZED MEN

Background: Although previous research has described a high prevalence of psychiatric comorbidity among general medical and surgical patient s, prevalence estimates based on diagnostic criteria and the assessmen t of health care outcomes including functional status has not been con ducted for a broad range of psychiatric disorders. Methods: A random s ample of male medical and surgical admissions to 3 Department of Veter ans Affairs Medical Centers was enrolled in the study. Subjects were a dministered a computerized structured psychiatric diagnostic interview and completed a multidimensional measure of health-related functionin g, the Medical Outcomes Study 36-Item Short-Form Health Survey. Result s: Of 1007 medical and surgical inpatients, almost half (46.6%) met li fetime criteria for at least I Diagnostic and Statistical Manual of Me ntal Disorders, Revised Third Edition disorder, most commonly for alco hol abuse or dependence (32.5%), posttraumatic stress disorder (10.0%) , and major depression or dysthymia (9.0%). Almost one fifth reported recent symptoms, most frequently for major depression or dysthymia (7. 0%). Go-occurring psychiatric disorders were associated with substanti al and significant (P<.001) impairment on all dimensions of functionin g, with the greatest decrements observed in physical and emotional rol e functioning. Anxiety and mood disorders were associated with the mos t and somewhat similar reductions in functioning. Conclusions: The pre valence of co-occurring psychiatric disorders was substantial but cons istent with other studies of populations receiving health services. Gi ven the observed additional burden of psychiatric disorders on functio ning in medically hospitalized patients, the study indicates the impor tance of identification and treatment of co-occurring psychiatric diso rders in this highrisk and clinically challenging group of patients.