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Logo of bmcpsycBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Psychiatry
 
BMC Psychiatry. 2011; 11: 147.
Published online Sep 12, 2011. doi:  10.1186/1471-244X-11-147
PMCID: PMC3184052
A prospective study of mental health care for comorbid depressed mood in older adults with painful osteoarthritis
Yehoshua Gleicher,1 Ruth Croxford,2,3 Jacqueline Hochman,4,5 and Gillian Hawkercorresponding author2,3,4,5
1Faculty of Medicine, University of Toronto, 1 Kings College Circle, Toronto, ON M5S 1A8, Canada
2Institute for Clinical Evaluative Sciences, G1 06, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
3Department of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, ON M5T 3M6, Canada
4Department of Medicine, Women's College Hospital, 76 Grenville Street, Toronto, ON M5S 1B2, Canada
5Women's College Research Institute, Women's College Hospital, 790 Bay Street, 7th Floor, Toronto, ON M5G 1N8, Canada
corresponding authorCorresponding author.
Yehoshua Gleicher: josh.gleicher/at/utoronto.ca; Ruth Croxford: ruth.croxford/at/ices.on.ca; Jacqueline Hochman: j.hochman/at/utoronto.ca; Gillian Hawker: g.hawker/at/utoronto.ca
Received April 29, 2011; Accepted September 12, 2011.
Abstract
Background
Comorbid depression is common among adults with painful osteoarthritis (OA). We evaluated the relationship between depressed mood and receipt of mental health (MH) care services.
Methods
In a cohort with OA, annual interviews assessed comorbidity, arthritis severity, and MH (SF-36 mental health score). Surveys were linked to administrative health databases to identify mental health-related visits to physicians in the two years following the baseline interview (1996-98). Prescriptions for anti-depressants were ascertained for participants aged 65+ years (eligible for drug benefits). The relationship between MH scores and MH-related physician visits was assessed using zero-inflated negative binomial regression, adjusting for confounders. For those aged 65+ years, logistic regression examined the probability of receiving any MH-related care (physician visit or anti-depressant prescription).
Results
Analyses were based on 2,005 (90.1%) individuals (mean age 70.8 years). Of 576 (28.7%) with probable depression (MH score < 60/100), 42.5% experienced one or more MH-related physician visits during follow-up. The likelihood of a physician visit was associated with sex (adjusted OR women vs. men = 5.87, p = 0.005) and MH score (adjusted OR per 10-point decrease in MH score = 1.63, p = 0.003). Among those aged 65+, 56.7% with probable depression received any MH care. The likelihood of receiving any MH care exhibited a significant interaction between MH score and self-reported health status (p = 0.0009); with good general health, worsening MH was associated with increased likelihood of MH care; as general health declined, this effect was attenuated.
Conclusions
Among older adults with painful OA, more than one-quarter had depressed mood, but almost half received no mental health care, suggesting a care gap.
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