Functional disability as an explanation of the associations between chronic physical conditions and 12-month major depressive episode
Por:
Stegmann ME, Ormel J, de Graaf R, Haro JM, de Girolamo G, Demyttenaere K, Kovess V, Matschinger H, Vilagut G, Alonso J and Burger H
Publicada:
1 jul 2010
Resumen:
Background: The link between physical conditions and mental health is
poorly understood. Functional disability could explain the association
of physical conditions with major depressive episode (MDE) as an
intermediary factor.
Methods: Data was analyzed from a subsample (N = 8796) of the European
Study of the Epidemiology of Mental Disorders (ESEMeD), a
cross-sectional general population survey. MDE during the last 12 months
was assessed using a revision of the Composite International Diagnostic
Interview (CIDI 3.0). Lifetime chronic physical conditions were assessed
by self-report. Functional disability was measured using a version of
the World Health Organization Disability Assessment Schedule (WHODAS).
The associations of physical conditions with MDE and explanation by
functional disability were quantified using logistic regression.
Results: All physical conditions were significantly associated with MDE.
The increases in risk of MDE ranged from 30% for allergy to amply 100%
for arthritis and heart disease. When adjusted for physical comorbidity,
associations decreased and were no longer statistically significant for
allergy and diabetes. Functional disability explained between 17 and
64% of these associations, most substantially for stomach or duodenum
ulcer, arthritis and heart disease.
Limitations: Due to the cross-sectional nature of the study the temporal
relationship of the variables could not be assessed and the amount of
explanation cannot simply be interpreted as the amount of mediation.
Green Published, Green Accepted
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