Laura E. Jones

Bio: Laura E. Jones is an academic researcher from University of Iowa. The author has contributed to research in topics: Population & Comorbidity. The author has an hindex of 11, co-authored 12 publications receiving 887 citations. Previous affiliations of Laura E. Jones include Center for Excellence in Education.

Medical comorbidity in women and men with schizophrenia: a population-based controlled study.

Abstract: BACKGROUND: Persons with persistent mental illness are at risk for failure to receive medical services. In order to deliver appropriate preventive and primary care for this population, it is important to determine which chronic medical conditions are most common.

Medical comorbidity in women and men with bipolar disorders: a population-based controlled study.

Abstract: OBJECTIVE Rarely has validated information on chronic medical comorbidity been presented for persons with bipolar disorder. To deliver appropriate health services, it is important to understand the prevalence of chronic medical conditions in this population. This study examines chronic medical comorbidity using validated methodology in persons with bipolar disorder. METHODS This is a retrospective study of a 100% sample of administrative claims (1996-2001) from Wellmark Blue Cross Blue Shield. Three thousand five hundred fifty-seven subjects had bipolar I disorder and did not have claims for schizophrenia or schizoaffective disorder. Controls had no documented claims for psychiatric conditions. Using validated methodology, inpatient and outpatient claims were used to determine prevalence of 44 chronic medical conditions. Odds ratios (ORs) were adjusted for age, gender, residence, and nonmental healthcare utilization. RESULTS Persons with bipolar disorder were young (mean age, 38.8 years) and significantly more likely to have medical comorbidity, including three or more chronic conditions (41% versus 12%, p < .001) compared with controls. Elevated ORs were found for conditions spanning all organ systems. Hyperlipidemia, lymphoma, and metastatic cancer were the only conditions less likely to occur in persons with bipolar disorder. CONCLUSION Bipolar disorders are associated with substantial chronic medical burden. Familiarity with conditions affecting this population may assist in programs aimed at providing medical care for the chronically mentally ill.

The influence of type and severity of mental illness on receipt of screening mammography

Abstract: BACKGROUND: Women with mental illness may be at risk for failure to receive recommended preventive services such as mammography. Little is known about whether the type or severity of mental illness influences receipt of preventive services. OBJECTIVE: To measure the influence of type and severity of mental illness on receipt of mammography. DESIGN: Retrospective study of administrative claims data, 1996 to 2001. SUBJECTS: Privately insured women age 40 to 64 years, with and without claims for mental illness, and who were eligible for mammography between 1996 and 2001. MEASUREMENT: Odds ratios (OR) for receipt of screening mammography, any mammography, and follow-up mammography, adjusted for age, rural location, utilization of nonmental health services, and severity and type of the mental disorder. Severity measures were based on utilization of outpatient and inpatient mental health services and presence of comorbid substance use disorder. RESULTS: Women with any mental disorder were significantly less likely to receive mammography than controls. This was strongly influenced by severity of mental illness (any mammography: moderate severity OR 0.62; confidence interval [CI] 0.59 to 0.66: high severity OR 0.38; CI 0.33 to 0.43). Whereas severity contributed to lower receipt of mammography among women with mood and anxiety disorders, women with psychotic, alcohol, and substance abuse disorders had decreased odds for receipt of mammography regardless of severity. CONCLUSIONS: Women with mental disorders are at risk for failure to receive mammography, a recommended preventive service. Women with severe mental illness or psychotic and substance abuse disorders should be targeted to ensure delivery of mammography.

Receipt of diabetes services by insured adults with and without claims for mental disorders.

Abstract: Objectives: We sought to determine whether receipt of the American Diabetes Association's recommended clinical services was similar among insured subjects with and without mental disorders during the period of 1996 to 2001. Research Design: Our study was a retrospective analysis of Blue Cross/Blue Shield of Iowa administrative claims data, 1996-2001. Subjects: We studied 26,020 adults with diabetes; 6,627 (25%) had a coexisting mental disorder. Measures: Service receipt included hemoglobin A1c (HbA 1 c ) testing, dilated eye examination, cholesterol measurement, and urine protein testing. We used Cox regression to calculate hazard ratios (HRs) for service receipt after adjusting for demographic, disease, and utilization factors. Results: Mental disorder subjects were more likely to be younger, women, urban residents, have diabetes complications and comorbidity, and to have increased healthcare utilization. Although they received more services (mean, 2.6) than subjects without mental disorders (mean, 2.3), they were less likely to have received a HbA 1 c test (HR 0.92; 99.9% confidence interval [CI] 0.87-0.97) and a cholesterol measurement (HR 0.92; 99.9% CI 0.86-0.98). Receipt of a dilated eye examination (HR 0.96; 99.9% CI 0.89-1.04) and urine protein test (HR 0.98; 99.9% CI 0.92-1.04) was similar. Service receipt varied by specific mental disorder categorization. Few subjects (< 6%) strictly adhered to the guidelines of the American Diabetes Association. Conclusions: Receipt of clinical preventive services for both populations was suboptimal. Importantly, subjects with mental disorders were more likely to have diabetic complications, even when controlling for utilization of healthcare services, possibly because of poorer receipt of HbA 1 c testing. Persons with mental disorders should be more aggressively educated about blood sugar control, given the high rate of complications in this population. Medical care directed at persons with comorbid medical and psychiatric disorders may be beneficial.

Relationship between depression and pancreatic cancer in the general population.

Abstract: Objective Prior research suggesting a relationship between pancreatic cancer and depression conducted on clinical populations has been subject to recall bias. We reexamined this association using longitudinal population-based data. Methods This was a retrospective cohort study using longitudinal insurance claims data. Results Men with mental disorders were more likely to develop pancreatic cancer than those without psychiatric claims (odds ratio 2.4, confidence interval 1.15-4.78). Depression more commonly preceded pancreatic cancer than it did other gastrointestinal malignancies (odds ratio 4.6, confidence interval 1.07-19.4) or all other cancers (odds ratio 4.1, confidence interval 1.05-16.0). Conclusions Depression and pancreatic cancer are associated in the general population.

The gap in life expectancy from preventable physical illness in psychiatric patients in Western Australia: Retrospective analysis of population based registers

Abstract: Objective To examine the mortality experience of psychiatric patients in Western Australia compared with the general population. Design Population based study. Setting Western Australia, 1985-2005. Participants Psychiatric patients (292 585) registered with mental health services in Western Australia. Main outcome measures Trends in life expectancy for psychiatric patients compared with the Western Australian population and causes of excess mortality, including physical health conditions and unnatural causes of death. Results When using active prevalence of disorder (contact with services in previous five years), the life expectancy gap increased from 13.5 to 15.9 years for males and from 10.4 to 12.0 years for females between 1985 and 2005. Additionally, 77.7% of excess deaths were attributed to physical health conditions, including cardiovascular disease (29.9%) and cancer (13.5%). Suicide was the cause of 13.9% of excess deaths. Conclusions Despite knowledge about excess mortality in people with mental illness, the gap in their life expectancy compared with the general population has widened since 1985. With most excess deaths being due to physical health conditions, public efforts should be directed towards improving physical health to reduce mortality in people with mental illness, in addition to ongoing efforts to prevent suicide.