SAT0568 THE IMPACT OF ARTHRITIS ON UTILIZATION OF MENTAL HEALTH TREATMENT FOR COMORBID MENTAL DISORDERS: FINDINGS FROM A NATIONALLY REPRESENTATIVE MENTAL HEALTH SURVEY
Authors: Alyssa Howren, Antonio Aviña, Mary De Vera
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Individuals with arthritis experience an increased prevalence and incidence of mood and anxiety disorders, however, it is unclear if they are receiving adequate treatment for their comorbid mental disorders. <h3>Objectives</h3> To conduct a population-based evaluation of the association between arthritis and utilization of mental health treatments among individuals with comorbid mental disorders. <h3>Methods</h3> We used nationally representative data from the 2012 Canadian Community Health Survey – Mental Health (CCHS-MH) to draw a sample of 1,810 participants with depression, anxiety, or bipolar disorder. Depression, anxiety, and bipolar disorder (bipolar I, bipolar II, or hypomania) were defined by a series of screening questions in the CCHS-MH derived from the World Health Organization version of the Composite International Diagnostic Interview. The explanatory variable was self-reported doctor-diagnosed arthritis and included all rheumatic diseases. The outcome of interest was utilization of mental health treatments in the previous 12 months, including: 1) medications; 2) professional services (e.g. physician, psychiatrist, nurse); or 3) non-professional services (e.g. family, self-help group, internet). Multivariable binomial logistic regression was used to evaluate whether utilization of mental health treatment differs among those with and without arthritis, adjusting for the confounding effects of age, sex, race/ethnicity, and household income. <h3>Results</h3> A total of 447 (20.5%) participants from our study sample reported having arthritis (66.9% female). Utilization of mental health treatments in the previous 12 months was reported by 82.4% individuals with arthritis and 79.5% without arthritis. The most common treatment utilized by those with arthritis was professional services (66.5%), followed by medication (61.8%) and non-professional services (51.5%). Participants without arthritis most often received mental health treatment in the form of non-professional services (67.3%), followed by professional services (58.1%) and medication (45.6%). The point estimate of the adjusted analysis suggested a positive association between arthritis and utilization of at least one type mental health treatment (odds ratio [OR] 1.41, 95% confidence interval [CI] 0.85, 2.34), though not statistically significant. In the sub-analysis, the ORs for the association between arthritis and specific mental health treatments were increased for medications (OR 1.30, 95% CI 0.86, 1.99) and for professional services (OR 1.27, 95% CI 0.83, 1.93), but decreased for non-professional services (OR 0.81, 95% CI 0.52, 1.27). <h3>Conclusion</h3> These nationally representative data show that a high proportion of individuals with arthritis seek treatment for their comorbid mental disorders. Findings of this study may also suggest a positive association between having arthritis and seeking care for comorbid mental disorders, which may be explained by an already established connection with the health care system to manage arthritis. Opportunities to improve mental health treatment among those with arthritis include optimizing access to non-professional services. <h3>Disclosure of Interests</h3> None declared