The presence of mental illness can influence the frequency of screening mammograms, find researchers in a large, recently published study. The nature of the mental illness, typically characterized by severity of the mental disorder, is linked to noncompliance for the recommended prevention effort.

The findings by Indiana University School of Medicine and Richard Roudebush VA Health Services Center for Excellence researchers can be found in the October issue of Journal of General Internal Medicine. Prior to this study, little was known about whether the type or severity of mental illness influences receipt of preventive services such as mammograms.

Mental Disorders Tied to Less Mammograms  “Although women with mental disorders are less likely to receive mammography than women who do not have mental disorders, we found that both the type and severity of mental illness does influence the receipt of mammograms. Women with psychotic disorders such as schizophrenia are significantly less likely to receive mammograms than women in the general population. However, women with mild depression do not differ markedly. But, as depression severity increases, so does the likelihood that women will not receive needed screening,” said senior author Caroline Carney Doebbeling, M.D., M.Sc., associate professor of psychiatry and medicine at the I.U. School of Medicine.

Severity contributed to lower receipt of mammography among women with mood and anxiety disorders, however women with psychotic, alcohol, and substance abuse disorders had decreased odds for receipt of mammography regardless of severity, the authors reported.

A comparison of insurance claims data for 59,673 women with a mental illness diagnosis and 131,683 women without this type of diagnosis indicated that the presence, type, and severity of the mental illness significantly influenced receipt of mammography throughout a five-year period. All the women in the study were between the ages of 40 and 64 and were privately insured.

Mammography has been shown to reduce death from breast cancer in women. The U.S. Preventive Services Task Force and the American Cancer Society recommend that all women undergo mammography a minimum of every 1 to 2 years beginning at age 40 years and annual screening beginning at age 50 years. According to the Centers for Disease Control, in 2002, 75.9 percent of women 40 years and older had a mammography screening in the past two years.

“Women with severe mental illness or psychotic and substance abuse disorders should be targeted to ensure delivery of mammography,” said Dr. Carney Doebbeling, who is both a psychiatrist and an internist.

Source: Indiana University