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)

Eur Psychiatry. 2015 Sep;30(6):793-800. doi: 10.1016/j.eurpsy.2015.06.003. Epub 2015 Jul 10.

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.

Keywords: Disability; Impairment; Mental disorders; Quality of life.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Comorbidity
  • Diagnostic and Statistical Manual of Mental Disorders
  • Disability Evaluation
  • Female
  • Germany / epidemiology
  • Humans
  • Interview, Psychological
  • Male
  • Mental Disorders* / diagnosis
  • Mental Disorders* / epidemiology
  • Mental Disorders* / physiopathology
  • Mental Disorders* / psychology
  • Mental Health / statistics & numerical data
  • Middle Aged
  • Quality of Life / psychology*
  • Somatoform Disorders / epidemiology*
  • Surveys and Questionnaires