BackgroundPopulation-based examination of comorbidity is an emerging field of study.AimsThe purpose of the present population level study is to expand our understanding of how cancer and mental illness are temporally associated.MethodA sample of 83 648 056 physician billing records for 664 838 (56% female) unique individuals over the age of 18 was stratified on ages 19–49 years and 50+ years, with temporal order of mental disorder and cancer forming the basis of comparison.ResultsMental disorders preceded cancers for both genders within each age strata. The full range of cancers and mental disorders preceding or following each pivot ICD class are described in terms of frequency of diagnosis and duration in days, with specific examples illustrated.ConclusionsThe temporal comorbidity between specific cancers and mental disorders may be useful in screening or clinical planning and may represent indicators of disease mechanism that warrant further screening or investigation.Declaration of interestNone.

Objective: This study examines, across physician billing, ambulatory and inpatient/emergency datasets, the health care utilization of individuals under the age of 18 years for physical disorders in relationship to the existence of a physician assigned psychiatric disorder. Methods:A retrospective sample of all visit records from three datasets (physician billing, ambulatory records, and inpatient/emergency records n = 12687710) was constructed for cases (n = 26392) and comparisons (n = 205281). The mean number of visits for physical disorders (excluding psychiatric disorders) was calculated for groups defined as cases and comparisons with and without psychiatric disorders.Results: Among Cases and Comparisons with and without psychiatric disorders, physical disorders are significantly greater for any with psychiatric disorder over the 16 years study period in both physician billing and ambulatory datasets. This result differs in the inpatient/emergency dataset in that cases have about 1/3 the number of admissions for physical diagnoses. Conclusion:It was unexpected that cases with a psychiatric diagnosis in the physician billing dataset had fewer physical disorder related inpatient and emergency admissions. We explore the putative explanations for the observed treatment bias related to physical disorders of children with psychiatric disorders.

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Introduction: The rate of mental disorders among children and adolescent has doubled in the Calgary Health Region over the last 15-years. Objective: To examine prevalence of depression in children and adolescent and determine the most frequent ICD diagnosis given a physician-assigned depression diagnosis. Aims: We examined the annual and 15-year cumulative prevalence of major depression in a population of children and adolescent in the Calgary Health Region and determined the most frequent diagnosis of physical disorders given a depression diagnosis. Methods: We used direct physician billing data for the Calgary health region (Calgary, Alberta) from 1994-2009 for treatment of any presenting concern (n = 763449). We identified 537 unique individuals (191 males) with a physician-assigned diagnosis of major depression. Odds ratios were used to identify the most frequent physical disorders given a depression diagnosis. Results: The 15-year cumulative prevalence among help-seeking population for major depression was 22.6 per 10,000. The annual rates of major depression increased twofold from 1.7 to 4.5 per 10,000. The cumulative prevalence rates of major depression were 29 (CI 26-33) per 10,000 for females and 16 (CI 14-18) per 10,000 for males. ICD codes under injury and poisoning were found to have the highest odds ratio followed by genitourinary system in relation to Major Depression diagnosis. Conclusion: The twofold increase of major depression is consistent with the overall doubling of mental disorders among children and adolescent in the Calgary health region and has important planning and policy implications.