OBJECTIVE: It has been estimated that 92% of geriatric psychiatric patients have at least 1 comorbid physical disorder. The baby boomers will be turning 65 by 2011 and over 130 million people will be over 45 by 2050. The severe and persistently mentally population have not been extensively studied concerning comorbidities and physical and behavioral risk factors of cardiovascular disease. We propose to determine the cost of treatment and prevalence of these comorbidities and risk factors in this population. METHODS: We conducted a chart review of all adult inpatients (N=179) of a state psychiatric hospital during July and August 2000. All subjects had a medical history, physical exam, screening blood tests, ECG and medical service utilization data collected. The cost of treatment and prevalence of cardiovascular disease in our population was compared to a control group of Medicaid recipient's matched for age and sex. RESULTS: Subject Characteristics: 47 + 16 years; 113 male ; 29% African American, 10% Hispanic. Cardiovascular Disease Comorbidities: 40% ECG abnormalities, 15% Hypertension, 10% Diabetes, 7% Thyroid Dysfunction, 6% CAD. Physical and Behavioral Risk Factors: 69% overweight (BMI > 25), 38% obese (BMI > 30); 18% hyperlipidemia, 67% nicotine & 49% alcohol abuse, 35% chemically addicted. Cost of Treatment: Total cost: $2539 ($2257 - $2821), Cost of cardiovascular disease comorbidities: $3889 ($2105 - $5673). CONCLUSION: 49% had cardiovascular disease comorbidities. 62% had multiple behavioral and physical risk factors for developing cardiovascular disease in their life time. The sample size limits our ability to make population inferences yet an association between severe and persistently mentally ill patients and a increased risk for cardiovascular disease exists in our group (T=-8.101 ,df=356,P<.00001). This association is also evident in the greater cost of treatment $1985 ($1518-$2452) of the severe and persistently mentally ill compared to the control group (T=4.78, df=108, P<.00001).