Background. The purpose of this analysis was to examine:
(1) the prevalence of psychiatric disorders
among disabled people, using seven different measures of disability;
(2) variation in disability between and within psychiatric diagnostic categories;
and
(3) relationship of diagnosis 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) conducted in 1980–1 to survey
mental morbidity within the adult population. A total of 810 individuals
received both a household
interview and a standardized clinical psychiatric evaluation. Estimated
prevalence rates were
computed using appropriate survey sampling weights.
Results. Prevalence 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 chronic medical conditions were
present
in the majority of these cases (54 to 78%). Disability was expressed differently
among the various diagnostic groups. Diagnostic
category and disability were significant independent predictors of medical
service utilization and receipt of disability payments.
Conclusions. The majority of disabled adults living in the
community
have diagnosable psychiatric
disorders, with the majority of these individuals suffering from significant
chronic medical
conditions as well, thus making co-morbidity the norm.