Data from a total of 5494 inpatients was analyzed. The mean age of this patient sample was 62.2 years, 95% CI [61.75, 62.65]. There were more females (57.8%) than males and the majority of patients were unmarried (53.2%). Additionally, 83.6% were unemployed or retired and 26% reported having obtained less than a high school education. Overall, more than half (53%) of the entire sample was diagnosed with a current DSM-5 mental disorder during hospitalization. Major depressive disorders accounted for 42%, neurocognitive (33%), anxiety (11%), substance-related (8%), and schizophrenia spectrum (6%) of the five most frequently diagnoses made by the CPSP clinical team. Further, 97% of all patients evidenced a chronic physical condition. Ninety-nine per cent (99.4%) of male patients had a chronic physical condition compared to 95% of female patients. Fifty-nine percent (59%) of male patients had comorbid mental and physical conditions compared to 48% of females.
Specific DSM-5 diagnoses
Among major depressive disorders diagnoses (MDD), recurrent episodes (70%) were most frequently diagnosed and recurrent episodes with psychotic characteristics (6.9%), the least frequent. Within neurocognitive disorders (NCD), delirium due to another medical condition (24.8%) was most commonly diagnosed and unspecified delirium (6.8%) the least common. Generalized anxiety disorder (72.5%) was the most frequently diagnosed anxiety disorder and alcohol use disorder (48%) the most frequently diagnosed substance-related disorder. Schizophrenia and brief psychotic disorder were the most and least common diagnosed within the schizophrenia spectrum disorders, 34.6% and 6.7%, respectively.
Comorbid chronic physical conditions and diagnosed mental disorders
Overall, cardiovascular disease, orthopedic conditions, chronic respiratory, gastrointestinal and cancer diagnoses were the most prevalent comorbid medical conditions in this sample. Thirty-five percent (35%) of this sample were evaluated in the skilled nursing unit, 24% coronary care, 22% intensive care and 19% cardiovascular surgery unit. Among patients diagnosed with major depressive disorders, slightly more than one in five patients (24%) also lived with a co-occurring cardiovascular disease. The least frequent co-occurring chronic physical disease among patients with depressive disorders was immunologic disease, accounting for 0.2% of all ICD-10 diagnoses among this patient group. Chronic neurological diseases were the most common co-occurring physical conditions among patients diagnosed with a DSM-5 neurocognitive condition (22%), and chronic endocrine disorders (1%) were the least common. Slightly more than one out of every four patients (27%) diagnosed with an anxiety disorder also had a co-occurring cardiovascular disease. Chronic immunologic disorders were least common among this group of patients, accounting for 0.3% of ICD-10 diagnoses. Similarly, patients diagnosed with a substance-related disorder had higher cardiovascular disease comorbidity (18%) than any other chronic physical condition. Lastly, among patients diagnosed with a schizophrenia spectrum disorder, 5.8% also lived with a co-occurring cardiovascular disease.
Routine standardized clinical evaluations as part of the administrative standing orders accounted for 84% of all DSM-5 diagnoses made and the remaining 16% were made from physician or patient requested consults. The two most common diagnoses resulting from the administrative standing orders (routine standardized clinical interviews—the liaison component) were neurocognitive and major depressive disorders, accounting for 20% and 19%, respectively. Diagnoses made from all consults, however, consisted primarily of major depressive disorders (37%), followed by substance use disorders (9%).
Association of biological sex and mental disorder diagnoses in a general hospital setting
An unadjusted multinomial logistic regression model revealed that biological sex is differentially associated with being diagnosed with a current mental disorder during hospitalization. The overall model was significant χ
2 (5) = 215.659, p < 0.001, and biological sex accounted for 4.1% of the variance found within the mental disorder diagnosis categories (Nagelkerke pseudo R
2 = 0.041). Overall, male patients had higher odds of being diagnosed with a current DSM-5 diagnosis compared to females. However, being diagnosed with an anxiety disorder was not significantly associated with biological sex. Female patients were 15.7% less likely to be diagnosed with MDD compared to male (OR: 0.842, 95% CI [0.732, 0.968], p = 0.01). This is to say males were 1.18 times more likely to have been diagnosed with a current MDD at bedside than females. Moreover, males evidenced 1.78 higher odds of being diagnosed with a form of NCD compared to females (OR: 0.561, CI [0.484, 0.651], p < 0.001). Male patients also evidenced much higher odds (7.46) of being diagnosed with a substance related disorder compared to females (OR: 0.134, CI [0.094, 0.190], p < 0.001). Lastly, female patients were 49.5% less likely to be diagnosed with a schizophrenia spectrum disorder than males (OR: 0.505, CI [0.371, 0.688], p < 0.001). Stated differently, male patients evidenced 1.98 higher odds of being diagnosed with a schizophrenia spectrum disorder during hospitalization see Tables
1,
2,
3.
Table 1
Sociodemographic Characteristics (n = 5494)
Age group (years) |
21–30 | 425 | 7.7 |
31–40 | 342 | 6.2 |
41–50 | 441 | 8 |
51–60 | 923 | 16.8 |
61–70 | 1416 | 25.8 |
71–80 | 1286 | 23.4 |
81–90 | 568 | 10.3 |
≥ 91 | 93 | 1.7 |
Biological sex |
Female | 3175 | 57.8 |
Male | 2319 | 42.2 |
Civil status |
Not married | 2924 | 53.2 |
Married | 2570 | 46.8 |
Employment status |
Not employed (including retired) | 4593 | 83.6 |
Employed | 901 | 16.4 |
Education level |
No formal education | 93 | 1.7 |
< High school | 1348 | 24.5 |
High school | 2181 | 39.7 |
Postsecondary and beyond | 1872 | 34.1 |
Monthly household income (USD) |
$0 | 120 | 2.2 |
≤ $300 | 612 | 11.1 |
$301–$900 | 2091 | 38.1 |
$901–$1500 | 1457 | 26.5 |
$1501–$2100 | 602 | 11 |
≥ $2101 | 612 | 11.1 |
Table 2
Profile of sociodemographic, previous mental disorder history and chronic co-morbid physical illness
Mean (95% CI) |
Age (years) | 57.63 (56.68, 58.58) | 73.41 (72.64, 74.17) | 56.90 (54.94, 58.86) | 51.71 (49.45, 53.97) | 49.83 (47.23, 52.64) | 62.30 (61.66, 62.94) |
Frequency (% within mental disorder category) |
Biological sex |
Female | 722 (59.5) | 492 (49.4) | 199 (63.4) | 41 (18.9) | 81 (46.8) | 1640 (63.5) |
Male | 492 (40.5) | 503 (50.6) | 115 (36.6) | 176 (81.1) | 92 (53.2) | 941 (36.5) |
Civil status |
Not married | 734 (60.5) | 521 (52.4) | 164 (52.2) | 153 (70.5) | 135 (78.0) | 1217 (47.2) |
Married | 480 (39.5) | 474 (47.6) | 150 (47.8) | 64 (29.5) | 38 (22.0) | 1364 (52.8) |
Education level |
No formal education | 17 (1.4) | 27 (2.7) | 4 (1.3) | 2 (0.9) | 2 (1.2) | 41 (1.6) |
Less than high school | 268 (22.1) | 323 (32.5) | 62 (19.7) | 55 (25.3) | 48 (27.7) | 592 (22.9) |
High school | 508 (41.8) | 375 (37.7) | 123 (39.2) | 111 (51.2) | 81 (46.8) | 983 (38.1) |
Postsecondary and beyond | 421 (34.7) | 270 (27.1) | 125 (39.8) | 49 (22.6) | 42 (24.3) | 965 (37.4) |
Employment status |
Not employed | 1044 (86.0) | 921 (92.6) | 234 (74.5) | 168 (77.4) | 159 (91.9) | 2067 (80.1) |
Employed | 170 (14.0) | 74 (7.4) | 80 (25.5) | 49 (22.6) | 14 (8.1) | 514 (19.9) |
Monthly household income |
≤ $300 | 221 (18.2) | 130 (13.1) | 29 (9.2) | 54 (24.9) | 48 (27.7) | 250 (9.7) |
$301–$900 | 462 (38.1) | 403 (40.5) | 131 (41.7) | 82 (37.8) | 83 (48.0) | 930 (36.0) |
$901–$1500 | 310 (25.5) | 269 (27.0) | 79 (25.2) | 46 (21.2) | 27 (15.6) | 726 (28.1) |
$1501–$2100 | 107 (8.8) | 96 (9.6) | 35 (11.1) | 20 (9.2) | 8 (4.6) | 336 (13.0) |
≥ $2100 | 114 (9.4) | 97 (9.7) | 40 (12.7) | 15 (6.9) | 7 (4.0) | 339 (13.1) |
History of substance use/abuse |
Positive history | 391 (32.2) | 238 (23.9) | 87 (27.7) | 196 (90.3) | 68 (39.3) | 568 (22.0) |
Negative history | 823 (67.8) | 757 (76.1) | 227 (72.3) | 21 (9.7) | 105 (60.7) | 2013 (78.0) |
Previous mental disorder |
Recurring mental disorder | 774 (63.8) | 225 (22.6) | 159 (50.6) | 102 (47.0) | 152 (87.9) | 459 (17.8) |
No recurring mental disorder | 440 (36.2) | 770 (77.4) | 155 (49.4) | 115 (53.0) | 21 (12.1) | 2122 (82.2) |
Chronic co-morbid physical illness |
Cardiovascular Disease | 291 (24.0) | 198 (19.9) | 84 (26.8) | 40 (18.4) | 10 (5.8) | 689 (26.7) |
Orthopedic | 77 (6.3) | 110 (11.1) | 34 (10.8) | 16 (7.4) | 1 (0.6) | 485 (18.8) |
Respiratory | 96 (7.9) | 110 (11.1) | 34 (10.8) | 9 (4.1) | 10 (5.8) | 123 (4.8) |
Gastrointestinal | 74 (6.1) | 76 (7.6) | 22 (7.0) | 17 (7.8) | 8 (4.6) | 155 (6.0) |
Cancer (unspecified) | 38 (3.1) | 17 (1.7) | 10 (3.2) | 6 (2.8) | 2 (1.2) | 146 (5.7) |
Other | 632 (52.1) | 482 (48.4) | 129 (41.1) | 128 (59.0) | 142 (82.0) | 830 (32.2) |
No diagnosis | 6 (0.5) | 2 (0.2) | 1 (0.3) | 1 (0.5) | 0 | 153 (5.9) |
Table 3
Specific DSM-5 diagnoses, consultation and liaison services
Major depressive disorders (MDD) (n = 1214) |
MDD, recurrent episode | 855 | 70.4 |
MDD, single episode | 122 | 10.1 |
MDD, recurrent with psychotic characteristics | 84 | 6.9 |
Other | 153 | 12.6 |
Neurocognitive disorders (NCD) (n = 995) |
Delirium due to another medical condition | 247 | 24.7 |
Unspecified NCD | 148 | 14.8 |
Delirium due to multiple etiologies | 92 | 9.3 |
Mild NCD due to vascular disease | 80 | 8.0 |
Unspecified delirium | 68 | 6.8 |
Other | 360 | 36.2 |
Anxiety disorders (n = 314) |
Generalized anxiety disorder (GAD) | 228 | 72.5 |
Panic disorder | 54 | 17.2 |
Other | 32 | 10.1 |
Substance-related (n = 217) |
Alcohol use disorder | 104 | 48.0 |
Tobacco use disorder | 93 | 42.8 |
Other | 20 | 9.2 |
Schizophrenia spectrum (n = 173) |
Schizophrenia | 60 | 34.6 |
Unspecified schizophrenia spectrum and other psychotic disorder | 36 | 20.7 |
Brief psychotic disorder | 11 | 6.7 |
Other | 66 | 38.0 |
Type of service |
Consultation | 856 | 16 |
Standing order | 4638 | 84 |
Adjusted multinomial model
The overall adjusted model was significant χ
2 (70) = 2463.171, p < 0.001, with covariate variables accounting for 38.5% of the variance found within the DSM-5 diagnosis categories (Nagelkerke pseudo R
2 = 0.385). Reference Table
4 for adjusted multinomial logistic regression values.
Table 4
Adjusted multinomial logistic regression
Major depressive disorders |
Intercept | − 1.724 | 0.211 | 66.951 | < 0.001 | | | |
Age (years) | − 0.010 | 0.003 | 14.326 | < 0.001 | 0.99 | 0.98 | 0.99 |
Femalea | − 0.263 | 0.086 | 9.431 | 0.002 | 0.76 | 0.65 | 0.909 |
Unmarriedb | 0.346 | 0.080 | 18.617 | < 0.001 | 1.41 | 1.20 | 1.65 |
Not employedc | 0.426 | 0.117 | 13.331 | < 0.001 | 1.53 | 1.21 | 1.92 |
No formal educationd | 0.141 | 0.316 | 0.199 | 0.65 | 1.15 | 0.62 | 2.13 |
< High schoold | 0.098 | 0.111 | 0.783 | 0.37 | 1.10 | 0.88 | 1.37 |
High schoold | 0.069 | 0.092 | 0.562 | 0.453 | 1.07 | 0.89 | 1.28 |
≤ $300e | 0.755 | 0.165 | 20.912 | < 0.001 | 2.12 | 1.53 | 2.94 |
$301–$900e | 0.313 | 0.140 | 4.964 | 0.02 | 1.36 | 1.03 | 1.79 |
$901–$1500e | 0.211 | 0.142 | 2.209 | 0.13 | 1.23 | 0.93 | 1.63 |
$1501–$2100e | − 0.025 | 0.169 | 0.022 | 0.88 | 0.97 | 0.70 | 1.35 |
Previous mental disorder | 2.032 | 0.082 | 620.783 | < 0.001 | 7.62 | 6.50 | 8.95 |
Substance use/abuse historyg | 0.211 | 0.092 | 5.248 | 0.02 | 1.23 | 1.03 | 1.48 |
Neurocognitive disorders |
Intercept | − 5.177 | 0.279 | 344.717 | < 0.001 | | | |
Age (years) | 0.056 | 0.003 | 259.377 | < 0.001 | 1.051 | 1.058 | 1.065 |
Femalea | − 0.601 | 0.086 | 49.125 | < 0.001 | 0.54 | 0.46 | 0.64 |
Unmarriedb | 0.239 | 0.082 | 8.504 | 0.004 | 1.27 | 1.08 | 1.49 |
Not employedc | 0.247 | 0.145 | 2.886 | 0.08 | 1.28 | 0.96 | 1.70 |
No formal educationd | 0.162 | 0.275 | 0.349 | 0.55 | 1.17 | 0.68 | 2.01 |
< High schoold | 0.134 | 0.108 | 1.544 | 0.21 | 1.14 | 0.92 | 1.41 |
High schoold | 0.103 | 0.099 | 1.086 | 0.29 | 1.10 | 0.91 | 1.34 |
≤ $300e | 0.563 | 0.174 | 10.511 | 0.001 | 1.75 | 1.25 | 2.46 |
$301–$900e | 0.240 | 0.144 | 2.791 | 0.09 | 1.27 | 0.95 | 1.68 |
$901–$1500e | 0.100 | 0.146 | 0.470 | 0.49 | 1.10 | 0.83 | 1.47 |
$1501–$2100 | − 0.028 | 0.173 | 0.027 | 0.87 | 0.97 | 0.69 | 1.36 |
Previous mental disorder | 0.646 | 0.098 | 43.326 | < 0.001 | 1.90 | 1.57 | 2.31 |
Substance use/abuse historyg | − 0.070 | 0.098 | 0.510 | 0.47 | 0.933 | 0.770 | 1.12 |
Anxiety disorders |
Intercept | − 1.899 | 0.313 | 36.860 | < 0.001 | | | |
Age (years) | − 0.012 | 0.004 | 8.235 | 0.004 | 0.989 | 0.981 | 0.997 |
Femalea | − 0.088 | 0.138 | 0.410 | 0.52 | 0.91 | 0.69 | 1.19 |
Unmarriedb | 0.055 | 0.127 | 0.189 | 0.66 | 1.05 | 0.82 | 1.35 |
Not employedc | − 0.209 | 0.162 | 1.654 | 0.19 | 0.81 | 0.59 | 1.11 |
No formal educationd | 0.053 | 0.544 | 0.010 | 0.92 | 1.05 | 0.36 | 3.06 |
< High schoold | 0.052 | 0.182 | 0.082 | 0.77 | 1.05 | 0.73 | 1.50 |
High schoold | 0.026 | 0.145 | 0.032 | 0.85 | 1.02 | 0.77 | 1.36 |
≤ $300e | 0.051 | 0.277 | 0.034 | 0.85 | 1.05 | 0.61 | 1.81 |
$301–$900e | 0.304 | 0.208 | 2.131 | 0.14 | 1.35 | 0.90 | 2.03 |
$901–$1500e | 0.033 | 0.214 | 0.023 | 0.87 | 1.03 | 0.67 | 1.57 |
$1501–$2100e | − 0.048 | 0.250 | 0.037 | 0.84 | 0.95 | 0.58 | 1.55 |
Previous mental disorderf | 1.495 | 0.127 | 138.713 | < 0.001 | 4.46 | 3.47 | 5.72 |
Substance use/abuse historyg | 0.154 | 0.148 | 1.083 | 0.29 | 1.16 | 0.873 | 1.55 |
Substance-related disorders |
Intercept | − 3.447 | 0.490 | 49.526 | < 0.001 | | | |
Age (years) | − 0.029 | 0.005 | 31.886 | < 0.001 | 0.97 | 0.96 | 0.98 |
Femalea | − 1.317 | 0.197 | 44.755 | < 0.001 | 0.26 | 0.18 | 0.39 |
Unmarriedb | 0.643 | 0.176 | 13.280 | < 0.001 | 1.90 | 1.34 | 2.68 |
Not employedc | − 0.001 | 0.204 | 0.000 | 0.99 | 0.99 | 0.67 | 1.49 |
No formal Educationd | − 0.279 | 0.793 | 0.124 | 0.72 | 0.75 | 0.16 | 3.57 |
< High schoold | 0.356 | 0.235 | 2.294 | 0.13 | 1.42 | 0.90 | 2.26 |
High schoold | 0.387 | 0.197 | 3.879 | 0.04 | 1.47 | 1.00 | 2.16 |
≤ $300e | 1.016 | 0.346 | 8.605 | 0.003 | 2.76 | 1.40 | 5.44 |
$301–$900e | 0.584 | 0.314 | 3.471 | 0.06 | 1.79 | 0.97 | 3.31 |
$901–$1500e | 0.417 | 0.326 | 1.631 | 0.20 | 1.51 | 0.80 | 2.87 |
$1501–$2100e | 0.396 | 0.373 | 1.123 | 0.28 | 1.48 | 0.71 | 3.08 |
Previous mental disorderf | 1.053 | 0.167 | 39.982 | < 0.001 | 2.86 | 2.06 | 3.97 |
Substance use/abuse historyg | 2.832 | 0.246 | 132.657 | < 0.001 | 16.98 | 10.48 | 27.49 |
Schizophrenia spectrum disorders |
Intercept | − 5.054 | 0.598 | 71.347 | < 0.001 | | | |
Age (years) | − 0.028 | 0.005 | 27.363 | < 0.001 | 0.97 | 0.96 | 0.98 |
Femalea | − 0.929 | 0.181 | 26.251 | < 0.001 | 0.39 | 0.27 | 0.56 |
Unmarriedb | 0.914 | 0.205 | 19.835 | < 0.001 | 2.49 | 1.66 | 3.73 |
Not employedc | 0.959 | 0.311 | 9.510 | 0.002 | 2.60 | 1.41 | 4.79 |
No formal Educationd | 0.512 | 0.781 | 0.430 | 0.51 | 1.66 | 0.36 | 7.71 |
< High schoold | 0.758 | 0.248 | 9.331 | 0.002 | 2.13 | 1.31 | 3.47 |
High schoold | 0.400 | 0.213 | 3.531 | 0.06 | 1.49 | 0.98 | 2.26 |
≤ $300e | 1.454 | 0.444 | 10.722 | 0.001 | 4.28 | 1.79 | 10.22 |
$301–$90e | 1.107 | 0.419 | 6.983 | 0.008 | 3.02 | 1.33 | 6.87 |
$901–$1500e | 0.382 | 0.444 | 0.738 | 0.39 | 1.46 | 0.61 | 3.49 |
$1501–$2100e | 0.090 | 0.540 | 0.028 | 0.86 | 1.09 | 0.38 | 3.15 |
Previous mental disorderf | 3.407 | 0.245 | 194.018 | < 0.001 | 30.16 | 18.67 | 48.72 |
Substance use/abuse historyg | 0.032 | 0.189 | 0.029 | 0.86 | 1.033 | 0.712 | 1.49 |
Major depressive disorders
Overall, age, biological sex, civil status, employment status, monthly household income, previous mental disorder and substance use/abuse history was significantly associated with receiving a current DSM-5 major depressive disorder diagnosis. For each one-year increase in age, patients evidenced a 1% less chance of being diagnosed with a current MDD (OR: 0.990, CI [0.985, 0.995]). Females evidenced 23% lower odds of being diagnosed compared to males (OR: 0.769, CI [0.650, 0.909]). In other words, males had 1.30 higher odds of being diagnosed with a current depressive disorder. Compared to married patients, the ones who reported being unmarried were 1.41 times more likely to have been diagnosed (OR: 1.41, CI [1.20, 1.65]). Those who reported having a monthly household income of $ ≤ 300 had 2.12 higher odds of being diagnosed compared to patients reporting a household income ≥ $2101 per month (OR: 2.12, CI [1.53, 2.94]). Patients with previous mental disorders evidenced 7.62 higher odds of being diagnosed with a current depressive disorder compared to patients without a previously diagnosed mental disorder (OR: 7.62, CI [6.50, 8.95]). Lastly, patients with a past history of substance use/abuse evidenced 1.23 higher odds of being diagnosed with depression compared to those with no history of substance use/abuse (OR: 1.23, CI [1.03, 1.48]). Level of education was not significantly associated with being diagnosed with a current depressive disorder diagnosis at bedside. After adjusting for multiple comparisons, only age, biological sex, civil status, employment status, monthly household incomes of ≤ $300, and previous mental disorder remained significant covariates of being diagnosed with a current MDD.
Neurocognitive disorders
For every one-year increase in age, the odds of being diagnosed with a current neurocognitive disorder was relatively similar (OR: 1.058, CI [1.051, 1.065]). Female patients evidenced 45% lower odds of being diagnosed compared to males (OR; 0.54, CI [0.46, 0.64]). This is to say males had 1.82 higher odds than females of being diagnosed with a current neurocognitive disorder. Unmarried patients were 1.27 times more likely to have received a current diagnosis compared to married patients (OR: 1.27, CI [1.08, 1.49]). Those who reported a monthly household income ≤ $300 evidenced 1.75 higher odds of being diagnosed compared to patients with incomes ≥ $2101 per month (OR: 1.75, CI [1.25, 2.46]). Patients with a previous mental disorder had 1.90 higher odds of receiving a neurocognitive diagnosis compared to patients without a previous illness (OR: 1.90, CI [1.57, 2.31]). Employment status, level of education, and history of substance use/abuse was not significantly associated with being diagnosed with a current DSM-5 neurocognitive disorder. Further, after adjusting for multiple comparisons, all sociodemographic and previous mental disorders remained significant.
Anxiety disorders
Only age and recurring illness was significantly associated with being diagnosed with a current anxiety condition. For every one-year increase in age, patients had 0.2% lower odds of being diagnosed (OR: 0.989, CI [0.981, 0.997]). Having a previous mental disorder was related to 4.46 higher odds of receiving a current diagnosis (OR: 4.46, CI [3.47, 5.72]). Both age and previous mental disorder remained significantly linked to a current anxiety disorder diagnosis after adjusting for multiple comparisons.
Each year increase in age was associated with 2.9% lower odds of being diagnosed with a current substance-related disorder (OR: 0.97, CI [0.96, 0.98]). Female patients evidenced 73.2% lower odds of being diagnosed compared to males (OR: 0.26, CI [0.18, 0.39]). Conversely, males evidenced 3.73 higher odds of being diagnosed with a substance-related disorder. Unmarried patients evidenced 1.90 higher odds of receiving a diagnosis compared to married patients (OR: 1.90, CI [1.34, 2.68]). Those who reported monthly household incomes of ≤ $300 were 2.76 times more likely to have been diagnosed compared to those with a monthly income of ≥ $2101 (OR: 2.76, CI [1.40, 5.44]). Having a previous mental disorder was associated with 2.86 higher odds of receiving a current diagnosis compared to not having a previous illness (OR: 2.86, CI [2.06, 3.97]). Lastly, those with a history of substance use/abuse were 16.98 times more likely to have been diagnosed with a current substance-related disorder compared to patients without substance use/abuse history (OR: 16.98, CI [10.48, 27.49]). Level of education and employment were not significantly associated with receiving a current DSM-5 substance-related diagnosis. All covariates remained significant after adjusting for multiple comparisons.
Schizophrenia spectrum disorders
Each one-year increase in age was associated with 2.8% less odds of being diagnosed with a current schizophrenia spectrum disorder (OR: 0.97, CI [0.96, 0.98]). Female patients were 60% less likely to have been diagnosed compared to males (OR: 0.39, CI [0.27, 0.56]). This is to say male patients evidenced 2.53 higher odds of being diagnosed with a schizophrenia spectrum disorder compared to females. Unmarried patients were 2.49 odds more likely to have been diagnosed compared to married patients (OR: 2.49, CI [1.66, 3.73]). Those with less than high school education evidenced 2.13 higher odds of being diagnosed (OR: 2.13, CI [1.31, 3.47]) compared to patients with postsecondary education attainment or beyond. Patients with monthly household incomes of ≤ $300 and $301–$900 had 4.28 and 3.05 higher odds, respectively, of being diagnosed compared to those with household incomes ≥ $2101 per month. Patients with a past history of mental disorders had 30.16 higher odds of receiving a diagnosis than patients without past mental disorder histories (OR = 30.20, CI [18.67, 48.72]). All covariates except less than high school education attainment and monthly household income of $301–$900 remained significant after adjusting for multiple comparisons.