{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T22:57:32Z","timestamp":1765666652799,"version":"build-2065373602"},"reference-count":17,"publisher":"BMJ","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Epidemiol Community Health"],"published-print":{"date-parts":[[2004,12]]},"abstract":"<jats:p>\n                  <jats:bold>Study objective:<\/jats:bold> To estimate the annual period prevalence of co-occurring psychiatric illness and substance misuse among patients in primary care.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Design:<\/jats:bold> Analysis of the general practice research database.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Setting:<\/jats:bold> England and Wales, 1993\u20131998.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Participants:<\/jats:bold> Registered patients at 230 general practices representing 3.1% of the population. A comorbid case was defined as one with both a psychiatric diagnosis and substance misuse diagnosis (not including alcohol or tobacco) within a calendar year. A potentially chronic comorbid case was one that met this definition and, in addition, was treated in subsequent years for either a psychiatric condition or substance misuse.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Main results:<\/jats:bold> The annual period prevalence of comorbidity increased from 50\/100 000 patient years of exposure (PYE) to 80\/100 000 PYE, an increase of 62% during the study period. Rates of comorbid psychoses, comorbid schizophrenia, and comorbid paranoia increased by 147%, 128%, and 144%. The average age of comorbid cases decreased from 38 years to 34 years. Over 80% of comorbid cases were newly diagnosed in each study year, although many are treated in subsequent years for either psychiatric illness or substance misuse.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Conclusions:<\/jats:bold> This study provides data on the nature and extent of comorbidity in primary care in England and Wales. As the comorbidity rate is increasing by about 10% each year, and as comorbid cases are becoming younger, it is probable that the comorbidity rate will have increased beyond the study end point.<\/jats:p>","DOI":"10.1136\/jech.2003.017384","type":"journal-article","created":{"date-parts":[[2004,11,16]],"date-time":"2004-11-16T13:28:21Z","timestamp":1100611701000},"page":"1036-1041","source":"Crossref","is-referenced-by-count":35,"title":["Prevalence of comorbid psychiatric illness and substance misuse in primary care in England and Wales"],"prefix":"10.1136","volume":"58","author":[{"given":"Martin","family":"Frisher","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliet","family":"Collins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Millson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilana","family":"Crome","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Croft","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2004,11,16]]},"reference":[{"key":"2025100306063951000_58.12.1036.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.318.7177.137"},{"key":"2025100306063951000_58.12.1036.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)92058-7"},{"key":"2025100306063951000_58.12.1036.3","unstructured":"Anonymous. 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