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Functional Disability and Quality of Life Decrements in Mental Disorders: Results From the Mental Health Module of the German Health Interview and Examination Survey for Adults (Degs1-Mh)

Published online by Cambridge University Press:  10 July 2015

Simon Mack ,
Frank Jacobi ,
Katja Beesdo-Baum ,
Anja Gerschler ,
Jens Strehle ,
Michael Höfler ,
Markus A. Busch ,
Ulrike Maske ,
Ulfert Hapke  and
Wolfgang Gaebel
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Simon Mack*
Affiliation:
Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
Frank Jacobi
Affiliation:
Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
Katja Beesdo-Baum
Affiliation:
Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
Anja Gerschler
Affiliation:
Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
Jens Strehle
Affiliation:
Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
Michael Höfler
Affiliation:
Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
Markus A. Busch
Affiliation:
Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
Ulrike Maske
Affiliation:
Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
Ulfert Hapke
Affiliation:
Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
Wolfgang Gaebel
Affiliation:
Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
Jürgen Zielasek
Affiliation:
Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
Wolfgang Maier
Affiliation:
Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany German Center of Neurodegenerative Diseases (DZNE), Bonn, Germany
Hans-Ulrich Wittchen
Affiliation:
Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
*
*Corresponding author at: TU Dresden, Clinical Psychology and Psychotherapy, Chemnitzer Str. 46, 01187 Dresden, Germany. E-mail address: [email protected] (S. Mack).
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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 4 weeks, 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 12 months (= 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.

Keywords

Mental disordersImpairmentDisabilityQuality of life
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 6 , September 2015 , pp. 793 - 800
Copyright
Copyright © Elsevier Masson SAS 2015

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