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Psychiatric Disease Burden Profiles Among Veterans With Epilepsy: The Association With Health Services Utilization

Dr. Pugh, Dr. Zeber, Dr. Copeland, and Mr. Tabares are affiliated with the Veterans Evidence-Based Research Dissemination Implementation Center, Health Services Research and Development Service, Department of Veterans Affairs, South Texas Veterans Healthcare System, 7400 Merton Minter Blvd. (11c6), San Antonio, TX 78229 (e-mail: pughm{at}uthscsa.edu). Dr. Pugh is also with the Department of Medicine, and Dr. Zeber and Dr. Copeland are also with the Department of Psychiatry, University of Texas Health Science Center at San Antonio. Ms. Cramer is with the Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.

OBJECTIVE: This brief report describes patterns of psychiatric comorbidities among patients with epilepsy and their relationship with health care utilization. METHODS: The study identified psychiatric comorbid conditions in a cohort of veterans identified as having epilepsy in fiscal year 1999. From these diagnoses, nine psychiatric disease burden profiles were created. Logistic regression examined variation in emergency, neurology, and primary care for groups having different profiles and compared them with those with only epilepsy. RESULTS: Of the 23,752 individuals identified, 48% had comorbid psychiatric conditions; most had multiple psychiatric diagnoses. Compared with patients with epilepsy only, those with comorbid psychiatric conditions were more likely to have emergency care and high primary care utilization; those with serious mental illness (psychotic disorders) were less likely to receive neurology care. CONCLUSIONS: Multiple co-occurring psychiatric diseases are common among patients with epilepsy. Addressing the mental health and medical needs of these patients, particularly those with serious mental illness, represents a challenge for health organizations.

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Psychiatr Serv 2008 59: 835. [Full Text] [PDF]

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