Emotional health problems are the most important cause of disability in adults of working age: a study in the four counties of the old Oxford region.

OBJECTIVE: To assess the contribution of emotional health problems to the burden of disability affecting people of working age.
DESIGN: Analysis of data collected in a postal questionnaire survey of a random sample of people aged 18-64 years.
SETTING: The four counties of the old Oxford region in 1991.
SUBJECTS: 9332 people who responded to a questionnaire survey mailed to 14,000 people randomly selected from the Family Health Service Authority registers of the four counties of Berkshire, Buckinghamshire, Oxfordshire, and Northamptonshire. OUTCOMES MEASURES: Interference with work or other regular daily activity as reported in questions 4 and 5 of the health status measure SF-36.
RESULTS: In this population the prevalence of disability attributable to emotional health problems was greater than that attributable to all physical health problems combined. People reporting that their work or other regular daily activity was affected by their emotional health were much less likely to report a long-standing illness, consultation with a GP or consultation with a hospital doctor than people reporting a physical health problem.
CONCLUSIONS: Emotional health problems are a more important cause of disability in adults of working age than all physical health problems put together. Their importance is underestimated in health needs assessment exercises, which are based on NHS consultation rates or reporting of chronic illness. Research into the causes, prevention, and management of emotional health problems should be a national priority for the health service.