Serious Psychological Distress among US Adults with Arthritis: Prevalence and Barriers to Receiving Care Open Access

Abstract

Background: For those with arthritis, mental health comorbidities can exacerbate disability, interfere with disease management, and are associated with worse outcomes. Interventions to improve mental health among individuals with arthritis have demonstrated improvements in both psychological and physical outcomes, underscoring the importance of identifying and treating individuals with arthritis and concomitant mental health comorbidities.

Objectives: 1) Estimate the prevalence of SPD and other relevant characteristics among US adults with self-reported arthritis compared to those without arthritis, 2) determine the distribution of relevant characteristics among the adult population with arthritis and SPD, and 3) use multivariable modeling to examine characteristics associated with receiving mental health care in the past year for the subset of adults with arthritis and SPD.

Methods: This analysis used sample adult data from the 2011-2013 National Health Interview Survey (NHIS) (N=102,096). Prevalence of SPD and other characteristics were calculated for the populations with arthritis (N=24,954) and without arthritis (N=77,006). Using the subset of adults with arthritis and SPD (N=1762), logistic regression (proc surveylogistic) was used to identify correlates of receiving mental health care in the past year.

Results: The arthritis population has higher prevalence of SPD compared to the adult population without arthritis (6.8% vs. 2.4%). Among the subset of individuals with arthritis and SPD, being Asian (OR=0.2, 95% CI=0.0-0.8), lacking health insurance (OR=0.5, 95% CI=0.3-0.7) and having less education (OR=0.3, 95% CI=0.2-0.5) make it less likely to have seen a mental health professional in the past year (controlling for other variables). Not being able to afford mental health care was also associated with seeing a mental health professional in the past year (OR=1.6, 95% CI=1.1-2.4).

Conclusion: This data suggests the need to increase delivery of mental health services to individuals with arthritis and SPD, and revealed certain populations who may experience gaps in adequate mental health treatment (low education, lack of health insurance). Not being able to afford mental health care or counseling in the past year was also associated with seeing a mental health professional in the past year (OR=1.6, 95% CI 1.1-2.4) (a counterintuitive finding). This may suggest limits on coverage preventing the full extent of care required.

Table of Contents

INTRODUCTION. 1

METHODS. 2

RESULTS. 6

DISCUSSION. 10

CONCLUSION. 13

REFERENCES. 14

TABLE 1. 16

TABLE 2. 18

TABLE 3. 20

APPENDIX A: Variable Definitions and Recodes. 22

APPENDIX B: Other Models. 30

About this Master's Thesis

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School	Rollins School of Public Health
Department	Career Masters of Public Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Mental Health Health Sciences, Epidemiology
Keyword	Serious Psychological Distress Arthritis Barriers to Care
Committee Chair / Thesis Advisor	Darrow, Lyndsey, Emory University
Committee Members	Sullivan, Kevin M, Emory University Cisternas, Miriam, MGC Data Services
Partnering Agencies	Emory University schools, faculty or affiliated programs CDC

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