Disability mediates the impact of common conditions on perceived health.

<h4>Background</h4>We examined the extent to which disability mediates the observed associations of common mental and physical conditions with perceived health.<h4>Methods and findings</h4>WHO World Mental Health (WMH) Surveys carried out in 22 countries worldwide (n = 51,344...

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Main Authors: Jordi Alonso, Gemma Vilagut, Núria D Adroher, Somnath Chatterji, Yanling He, Laura Helena Andrade, Evelyn Bromet, Ronny Bruffaerts, John Fayyad, Silvia Florescu, Giovanni de Girolamo, Oye Gureje, Josep Maria Haro, Hristo Hinkov, Chiyi Hu, Noboru Iwata, Sing Lee, Daphna Levinson, Jean Pierre Lépine, Herbert Matschinger, Maria Elena Medina-Mora, Siobhan O'Neill, J Hans Ormel, Jose A Posada-Villa, Nezar Ismet Taib, Miguel Xavier, Ronald C Kessler
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23762442/?tool=EBI
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author Jordi Alonso
Gemma Vilagut
Núria D Adroher
Somnath Chatterji
Yanling He
Laura Helena Andrade
Evelyn Bromet
Ronny Bruffaerts
John Fayyad
Silvia Florescu
Giovanni de Girolamo
Oye Gureje
Josep Maria Haro
Hristo Hinkov
Chiyi Hu
Noboru Iwata
Sing Lee
Daphna Levinson
Jean Pierre Lépine
Herbert Matschinger
Maria Elena Medina-Mora
Siobhan O'Neill
J Hans Ormel
Jose A Posada-Villa
Nezar Ismet Taib
Miguel Xavier
Ronald C Kessler
author_facet Jordi Alonso
Gemma Vilagut
Núria D Adroher
Somnath Chatterji
Yanling He
Laura Helena Andrade
Evelyn Bromet
Ronny Bruffaerts
John Fayyad
Silvia Florescu
Giovanni de Girolamo
Oye Gureje
Josep Maria Haro
Hristo Hinkov
Chiyi Hu
Noboru Iwata
Sing Lee
Daphna Levinson
Jean Pierre Lépine
Herbert Matschinger
Maria Elena Medina-Mora
Siobhan O'Neill
J Hans Ormel
Jose A Posada-Villa
Nezar Ismet Taib
Miguel Xavier
Ronald C Kessler
author_sort Jordi Alonso
collection DOAJ
description <h4>Background</h4>We examined the extent to which disability mediates the observed associations of common mental and physical conditions with perceived health.<h4>Methods and findings</h4>WHO World Mental Health (WMH) Surveys carried out in 22 countries worldwide (n = 51,344 respondents, 72.0% response rate). We assessed nine common mental conditions with the WHO Composite International Diagnostic Interview (CIDI), and ten chronic physical with a checklist. A visual analog scale (VAS) score (0, worst to 100, best) measured perceived health in the previous 30 days. Disability was assessed using a modified WHO Disability Assessment Schedule (WHODAS), including: cognition, mobility, self-care, getting along, role functioning (life activities), family burden, stigma, and discrimination. Path analysis was used to estimate total effects of conditions on perceived health VAS and their separate direct and indirect (through the WHODAS dimensions) effects. Twelve-month prevalence was 14.4% for any mental and 51.4% for any physical condition. 31.7% of respondents reported difficulties in role functioning, 11.4% in mobility, 8.3% in stigma, 8.1% in family burden and 6.9% in cognition. Other difficulties were much less common. Mean VAS score was 81.0 (SD = 0.1). Decrements in VAS scores were highest for neurological conditions (9.8), depression (8.2) and bipolar disorder (8.1). Across conditions, 36.8% (IQR: 31.2-51.5%) of the total decrement in perceived health associated with the condition were mediated by WHODAS disabilities (significant for 17 of 19 conditions). Role functioning was the dominant mediator for both mental and physical conditions. Stigma and family burden were also important mediators for mental conditions, and mobility for physical conditions.<h4>Conclusions</h4>More than a third of the decrement in perceived health associated with common conditions is mediated by disability. Although the decrement is similar for physical and mental conditions, the pattern of mediation is different. Research is needed on the benefits for perceived health of targeted interventions aimed at particular disability dimensions.
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spelling doaj.art-6c28ea7aa2b241749f768e3b192745ad2022-12-21T21:43:37ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0186e6585810.1371/journal.pone.0065858Disability mediates the impact of common conditions on perceived health.Jordi AlonsoGemma VilagutNúria D AdroherSomnath ChatterjiYanling HeLaura Helena AndradeEvelyn BrometRonny BruffaertsJohn FayyadSilvia FlorescuGiovanni de GirolamoOye GurejeJosep Maria HaroHristo HinkovChiyi HuNoboru IwataSing LeeDaphna LevinsonJean Pierre LépineHerbert MatschingerMaria Elena Medina-MoraSiobhan O'NeillJ Hans OrmelJose A Posada-VillaNezar Ismet TaibMiguel XavierRonald C Kessler<h4>Background</h4>We examined the extent to which disability mediates the observed associations of common mental and physical conditions with perceived health.<h4>Methods and findings</h4>WHO World Mental Health (WMH) Surveys carried out in 22 countries worldwide (n = 51,344 respondents, 72.0% response rate). We assessed nine common mental conditions with the WHO Composite International Diagnostic Interview (CIDI), and ten chronic physical with a checklist. A visual analog scale (VAS) score (0, worst to 100, best) measured perceived health in the previous 30 days. Disability was assessed using a modified WHO Disability Assessment Schedule (WHODAS), including: cognition, mobility, self-care, getting along, role functioning (life activities), family burden, stigma, and discrimination. Path analysis was used to estimate total effects of conditions on perceived health VAS and their separate direct and indirect (through the WHODAS dimensions) effects. Twelve-month prevalence was 14.4% for any mental and 51.4% for any physical condition. 31.7% of respondents reported difficulties in role functioning, 11.4% in mobility, 8.3% in stigma, 8.1% in family burden and 6.9% in cognition. Other difficulties were much less common. Mean VAS score was 81.0 (SD = 0.1). Decrements in VAS scores were highest for neurological conditions (9.8), depression (8.2) and bipolar disorder (8.1). Across conditions, 36.8% (IQR: 31.2-51.5%) of the total decrement in perceived health associated with the condition were mediated by WHODAS disabilities (significant for 17 of 19 conditions). Role functioning was the dominant mediator for both mental and physical conditions. Stigma and family burden were also important mediators for mental conditions, and mobility for physical conditions.<h4>Conclusions</h4>More than a third of the decrement in perceived health associated with common conditions is mediated by disability. Although the decrement is similar for physical and mental conditions, the pattern of mediation is different. Research is needed on the benefits for perceived health of targeted interventions aimed at particular disability dimensions.https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23762442/?tool=EBI
spellingShingle Jordi Alonso
Gemma Vilagut
Núria D Adroher
Somnath Chatterji
Yanling He
Laura Helena Andrade
Evelyn Bromet
Ronny Bruffaerts
John Fayyad
Silvia Florescu
Giovanni de Girolamo
Oye Gureje
Josep Maria Haro
Hristo Hinkov
Chiyi Hu
Noboru Iwata
Sing Lee
Daphna Levinson
Jean Pierre Lépine
Herbert Matschinger
Maria Elena Medina-Mora
Siobhan O'Neill
J Hans Ormel
Jose A Posada-Villa
Nezar Ismet Taib
Miguel Xavier
Ronald C Kessler
Disability mediates the impact of common conditions on perceived health.
PLoS ONE
title Disability mediates the impact of common conditions on perceived health.
title_full Disability mediates the impact of common conditions on perceived health.
title_fullStr Disability mediates the impact of common conditions on perceived health.
title_full_unstemmed Disability mediates the impact of common conditions on perceived health.
title_short Disability mediates the impact of common conditions on perceived health.
title_sort disability mediates the impact of common conditions on perceived health
url https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23762442/?tool=EBI
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