bulletin 80 Bulletin 80 • September 2010 When musculoskeletal conditions and mental disorders occur together Summary • Musculoskeletal conditions and mental disorders cause few deaths but much pain, disability and distress. Both are common and are recognised as major health concerns. eir occurrence together in the same person (known as comorbidity ) complicates their treatment and management. • is bulletin presents the most reliable, robust and up-to-date estimates of the number of people with both musculoskeletal conditions and mental disorders; estimates that are important in assessing the need for integrated care. • More than 6.1 million Australians aged 16–85 years suffer from a musculoskeletal condition at a point in time (38% of that population) and 3.2 million (20%) experience a mental disorder in a 12-month period. Contents Summary .................................................................................................................................................................................................... 1 Introduction ............................................................................................................................................................................................... 2 The nature of musculoskeletal conditions .................................................................................................................................................. 3 The nature of mental disorders .................................................................................................................................................................. 5 Comorbidity—its causes and consequences ............................................................................................................................................. 7 Prevalence of comorbidity.......................................................................................................................................................................... 8 Observed and expected prevalence of comorbidity ................................................................................................................................. 10 Comorbidity among people with musculoskeletal conditions ................................................................................................................. 10 Comorbidity among people with mental disorders ..................................................................................................................................11 Types of mental disorders in people with musculoskeletal conditions .....................................................................................................12 Conclusion .................................................................................................................................................................................................14 Acknowledgments ....................................................................................................................................................................................14 References .................................................................................................................................................................................................15 Appendix: Statistical table and methods ................................................................................................................................................. 16 (summary continued overleaf)
20
Embed
When musculoskeletal conditions and mental disorders occur ...
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
bulle
tin
80Bulletin 80 • September 2010
When musculoskeletal conditions and mental disorders occur together
ContentsSummary .................................................................................................................................................................................................... 1Introduction ............................................................................................................................................................................................... 2The nature of musculoskeletal conditions .................................................................................................................................................. 3The nature of mental disorders .................................................................................................................................................................. 5Comorbidity—its causes and consequences ............................................................................................................................................. 7Prevalence of comorbidity .......................................................................................................................................................................... 8Observed and expected prevalence of comorbidity ................................................................................................................................. 10Comorbidity among people with musculoskeletal conditions ................................................................................................................. 10Comorbidity among people with mental disorders ..................................................................................................................................11Types of mental disorders in people with musculoskeletal conditions .....................................................................................................12Conclusion .................................................................................................................................................................................................14Acknowledgments ....................................................................................................................................................................................14References .................................................................................................................................................................................................15Appendix: Statistical table and methods ................................................................................................................................................. 16
Box 1: Common musculoskeletal conditionsArthritis A group of conditions involving inflammation of the joints, causing
pain, stiffness, deformity and disability. More than 100 different forms of arthritis are recognised, prominent among which are osteoarthritis, rheumatoid arthritis and gout.
Osteoarthritis The most common form of arthritis, caused mainly by the accumulated wear of the cartilage in joints. This wear and tear disrupts the normal function of the joint, causing pain and functional limitations. The condition affects mainly the hands, spine, and weight-bearing joints, such as the hips, knees and ankles.
Rheumatoid arthritis A chronic, inflammatory, autoimmune disease in which the immune system attacks the tissues lining the joints. The inflamed joints often cause pain, heat and swelling, and can lead to functional limitations and severe disability.
Gout Gout is characterised by painful swelling in various joints, in particular the great toe. The condition, resulting from poor handling of uric acid by the body, affects the entire body but manifests chiefly in joints.
Back pain Pain coming from the spine, muscles, nerves or other structures in the back. It mostly arises as a direct result of disease or injury involving spinal tissues. However, the pain arising from disease or injury of tissues and organs outside the spine can also be perceived as coming from the back (referred pain).
Osteoporosis A condition where the bone density thins and weakens, resulting in an increased risk of fracture—sometimes described as ‘porous bones’. Osteoporotic fractures are common among the elderly, with the spine, hip and wrist being common sites.
Box 2: Major types of mental disordersAnxiety disorders, characterised by symptoms of anxiety, fear and avoidance behaviour, include panic disorders, phobias, obsessive–compulsive disorder and post-traumatic stress disorder. Anxiety disorders have a lifetime adult prevalence rate of more than 26% in Australia (ABS 2008).Depression is a mood disorder characterised by feelings of sadness, loss of interest or pleasure in nearly all activities, feelings of hopelessness and suicidal thoughts or self-blame. It is one of the most common mental disorders in the community. Depression, along with dysthymia (a mild form of depression) and bipolar affective disorder, collectively referred to as affective disorders, have a lifetime adult prevalence rate of 15% in Australia (ABS 2008). Substance-use disorders result from harmful use or dependence on drugs and/or alcohol. Their lifetime prevalence rate in Australian adults is around 25% (ABS 2008).Schizophrenia is a group of severe psychiatric disorders that are characterised by major disturbances in thought, emotion and behaviour. The symptoms may include delusions, hallucinations, and disorganised thoughts and behaviours. Schizophrenia usually starts in late adolescence or early adult life, and occurs in less than 1% of the adult population.
Table 1: Observed and expected comorbidity, musculoskeletal conditions and mental disorders
Age groupMusculoskeletal
conditionsMental
disordersObserved
comorbidityExpected
comorbidityExcess
comorbidity
Rate (per cent) Number
16–24 12.4 26.4 6.1 3.3 72,000
25–34 22.2 24.8 8.5 5.5 85,000
35–44 34.1 23.3 11.8 8.0 117,000
45–54 47.3 21.5 14.3 10.2 119,000
55–64 55.4 13.6 9.7 7.6 49,000
65–74 62.5 8.6 6.4 5.4 15,000
75–85 64.1 5.9 5.2 3.8 13,000
Total 38.4 20.0 9.6 7.7 470,000
Note: See Table A1 for population numbers. Excess comorbidity is estimated as the observed comorbidity rate x population – expected comorbidity rate x population for each age group. The total is the sum of the age-specific estimates.
Source: AIHW analysis of ABS 2007 Survey of Mental Health and Wellbeing CURF.
Comorbidity among people with musculoskeletal conditions
Table 2: Types of mental disorders in people with various musculoskeletal conditions, 2007
Musculoskeletal conditionAny anxiety
disorderAny affective
disorderAny substance-use
disorderAny mental
disorder
Number (’000)
Arthritis, rheumatism, gout 529 220 108 657
Back and neck problems 961 472 274 1,266
Any musculoskeletal condition 1,161 559 326 1,542
Rate (per cent)
Arthritis, rheumatism, gout 16.6 6.9 3.4 20.6
Back and neck problems 21.4 10.5 6.1 28.2
Any musculoskeletal condition 18.9 9.1 5.3 25.1
Notes 1. Based on 12-month prevalence. 2. Ages 16–85 years. 3. Numbers and percentages may not add up correctly because more than one musculoskeletal condition and mental disorder may be recorded. Source: AIHW analysis of ABS 2007 Survey of Mental Health and Wellbeing CURF.
Table 3: Types of mental disorders in people with musculoskeletal conditions, by sex, 2007
SexAny anxiety
disorderAny affective
disorderAny substance-use
disorderAny mental
disorder
Number (’000)
Males 469 222 201 671
Females 697 334 128 862
Persons 1,165 556 323 1,534
Rate (per cent)
Males 16.8 7.9 7.2 21.9
Females 20.8 9.9 3.6 28.2
Persons 18.9 9.1 5.3 25.1
Notes 1. Based on 12-month prevalence. 2. Ages 16–85 years. 3. Numbers and percentages may not add up correctly because more than one musculoskeletal condition and mental disorder may be recorded. Source: AIHW analysis of ABS 2007 Survey of Mental Health and Wellbeing CURF.
NotesMusculoskeletal conditions and mental disorders include comorbidity.Comorbidity in the occurrence of musculoskeletal conditions and mental disorders together in one person. Rate is the number as a percentage of the corresponding population.
Source: AIHW analysis of ABS 2007 National Survey of Mental Health and Wellbeing CURF.
This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced without prior written permission from the Australian Institute of Health and Welfare. Requests and enquiries concerning reproduction and rights should be directed to the Head, Communications, Media and Marketing Unit, Australian Institute of Health and Welfare, GPO Box 570, Canberra ACT 2601.
This publication is part of the Australian Institute of Health and Welfare’s Bulletin series. A complete list of the Institute’s publications is available from the Institute’s website <www.aihw.gov.au>.
ISSN 1446-9820 ISBN 978-1-74249-063-2
AIHW bulletin no. 80
Suggested citation
Australian Institute of Health and Welfare 2010. When musculoskeletal conditions and mental disorders occur together. Cat. no. AUS 129. Canberra: AIHW.
Australian Institute of Health and Welfare
Board Chair Hon. Peter Collins, AM, QC
Director Penny Allbon
Any enquiries about or comments on this publication should be directed to:
Dr Naila Rahman National Centre for Monitoring Arthritis and Musculoskeletal Conditions Australian Institute of Health and Welfare GPO Box 570 Canberra ACT 2601 Phone: (02) 6244 1057 Email: [email protected]
Published by the Australian Institute of Health and Welfare