Mammography rates 'abysmal' for mentally ill.(Gynecology)

NEW ORLEANS -- Women being treated for a mental health disorder may be getting shortchanged when it comes to preventive medical care, said Caroline C. Carney-Doebbeling, M.D.

A comparison of insurance claims data for 59,673 women with a mental illness diagnosis and 131,683 without one showed that the presence, type, and severity of the mental illness significantly influenced receipt of mammography during the 5-year period being considered, Dr. Carney-Doebbeling said at the annual meeting of the Society of General Internal Medicine.

The mammography rates for women diagnosed with severe anxiety and mood disorders "were abysmal," she noted.

Compared with women with no mental illness diagnosis, women who were classified as having moderately severe or highly severe symptoms of mental illness had odds ratios of 62% and 38%, respectively, for receiving a mammogram. Women with "low-severity" mental health symptoms were as likely as their peers without mental illness to undergo mammography, said Dr. Carney-Doebbeling of the University of Iowa.

The type of diagnosis also influenced mammography rates. "Women with any psychotic disorder, regardless of the severity, received fewer than half the number of mammograms as women in the control group," Dr. Carney-Doebbeling said.

The women who fared the worst were those with highly severe mental illness and a diagnosis of a somatoform disorder. "The likelihood of receiving a mammography in these women was only 17%," she said.

Data for the study came from an analysis of all Wellmark Blue Cross Blue Shield claims records during 1996-2001 for women aged 40-65 years who had filed at least one medical claim and who did not have a diagnosis of breast cancer. Women were classified as having a mental health disorder if this diagnosis was reflected in at least one claim during the eligibility period.