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Hospital care for mental health and substance abuse conditions in Parkinson's disease
Author(s) -
Willis Allison. W.,
Thibault Dylan P.,
Schmidt Peter N.,
Dorsey E. Ray,
Weintraub Daniel
Publication year - 2016
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.26832
Subject(s) - psychiatry , medicine , odds ratio , bipolar disorder , suicidal ideation , substance abuse , depression (economics) , mania , mental health , alcohol abuse , psychosis , anxiety , poison control , suicide prevention , mood , medical emergency , economics , macroeconomics
Objective The objective of this study was to examine mental health conditions among hospitalized individuals with Parkinson's disease in the United States. Methods This was a serial cross‐sectional study of hospitalizations of individuals aged ≥60 identified in the Nationwide Inpatient Sample dataset from 2000 to 2010. We identified all hospitalizations with a diagnosis of PD, alcohol abuse, anxiety, bipolar disorder, depression, impulse control disorders, mania, psychosis, substance abuse, and attempted suicide/suicidal ideation. National estimates of each mental health condition were compared between hospitalized individuals with and without PD. Hierarchical logistic regression models determined which inpatient mental health diagnoses were associated with PD, adjusting for demographic, payer, geographic, and hospital characteristics. Results We identified 3,918,703 mental health and substance abuse hospitalizations. Of these, 2.8% (n = 104, 437) involved a person also diagnosed with PD. The majority of mental health and substance abuse patients were white (86.9% of PD vs 83.3% of non‐PD). Women were more common than men in both groups (male:female prevalence ratio, PD: 0.78, 0.78‐0.79, non‐PD: 0.58, 0.57‐0.58). Depression (adjusted odds ratio 1.32, 1.31‐1.34), psychosis (adjusted odds ratio 1.25, 1.15‐1.33), bipolar disorder (adjusted odds ratio 2.74, 2.69‐2.79), impulse control disorders (adjusted odds ratio 1.51, 1.31‐1.75), and mania (adjusted odds ratio 1.43, 1.18‐1.74) were more likely among PD patients, alcohol abuse was less likely (adjusted odds ratio 0.26, 0.25‐0.27). We found no PD‐associated difference in suicide‐related care. Conclusions PD patients have unique patterns of acute care for mental health and substance abuse. Research is needed to guide PD treatment in individuals with pre‐existing psychiatric illnesses, determine cross provider reliability of psychiatric diagnoses in PD patients, and inform efforts to improve psychiatric outcomes. © 2016 International Parkinson and Movement Disorder Society.