Simon Mack1, Frank Jacobi2, Katja Beesdo-Baum2, Anja Gerschler2, Jens Strehle2, Michael Höfler2, Markus A Busch3, Ulrike Maske3, Ulfert Hapke3, Wolfgang Gaebel4, Jürgen Zielasek4, Wolfgang Maier5, Hans-Ulrich Wittchen2. 1. Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany. Electronic address: Simon.Mack@tu-dresden.de. 2. Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany. 3. Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany. 4. Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany. 5. Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany; German Center of Neurodegenerative Diseases (DZNE), Bonn, Germany.
Abstract
BACKGROUND: This paper provides nationally representative data on how current and past mental disorders are related to functional disability and health-related quality of life (QoL). METHODS: Results are based on a nationally representative sample (DEGS1-MH; n=4483 aged 18-79). Respondents were examined by clinical interviewers with the DSM-IV Composite International Diagnostic Interview (DIA-X/M-CIDI). Functional disability, i.e. number of disability days in the past 4weeks, and QoL, i.e. mental (MCS) and physical (PCS) component scale of the SF-36V2, were examined in subjects with 12-month mental disorders (=active cases [AC]) and compared to (a) subjects who never met diagnostic criteria (=unaffected individuals [UAI]), and (b) those with a history of mental disorders but not meeting the diagnostic criteria in the past 12months (=non-active cases [NAC]; partially or fully remitted). RESULTS: In comparison to UAI (mean: 1.9), AC reveals a 2-3 fold disability days/month (5.4, P<.001) and a substantially reduced MCS (UAI: 52.1; AC: 43.3, P<.001). NAC had a similar number of disability days as UAI, but significantly reduced MCS scores (49.9; P<.001). Disability days and QoL decrements were highest in internalizing disorders including somatoform disorders and most pronounced in comorbid cases. CONCLUSIONS: By and large, findings of a previous study were confirmed and extended for this nationally representative German sample. 12-month mental disorders, particularly internalizing, including somatoform disorders, are associated with high levels of disability and increased health-related QoL decrements. Partial or complete remission of the mental disorders is associated with a normalization of the numbers of disability days.
BACKGROUND: This paper provides nationally representative data on how current and past mental disorders are related to functional disability and health-related quality of life (QoL). METHODS: Results are based on a nationally representative sample (DEGS1-MH; n=4483 aged 18-79). Respondents were examined by clinical interviewers with the DSM-IV Composite International Diagnostic Interview (DIA-X/M-CIDI). Functional disability, i.e. number of disability days in the past 4weeks, and QoL, i.e. mental (MCS) and physical (PCS) component scale of the SF-36V2, were examined in subjects with 12-month mental disorders (=active cases [AC]) and compared to (a) subjects who never met diagnostic criteria (=unaffected individuals [UAI]), and (b) those with a history of mental disorders but not meeting the diagnostic criteria in the past 12months (=non-active cases [NAC]; partially or fully remitted). RESULTS: In comparison to UAI (mean: 1.9), AC reveals a 2-3 fold disability days/month (5.4, P<.001) and a substantially reduced MCS (UAI: 52.1; AC: 43.3, P<.001). NAC had a similar number of disability days as UAI, but significantly reduced MCS scores (49.9; P<.001). Disability days and QoL decrements were highest in internalizing disorders including somatoform disorders and most pronounced in comorbid cases. CONCLUSIONS: By and large, findings of a previous study were confirmed and extended for this nationally representative German sample. 12-month mental disorders, particularly internalizing, including somatoform disorders, are associated with high levels of disability and increased health-related QoL decrements. Partial or complete remission of the mental disorders is associated with a normalization of the numbers of disability days.
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