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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oai:doaj.org-article:6c28ea7aa2b241749f768e3b192745ad2021-11-18T07:42:43ZDisability mediates the impact of common conditions on perceived health.1932-620310.1371/journal.pone.0065858https://doaj.org/article/6c28ea7aa2b241749f768e3b192745ad2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23762442/?tool=EBIhttps://doaj.org/toc/1932-6203<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.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 KesslerPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 6, p e65858 (2013) |
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Medicine R Science Q 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. |
| 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. |
| format |
article |
| 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 |
| title |
Disability mediates the impact of common conditions on perceived health. |
| title_short |
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_sort |
disability mediates the impact of common conditions on perceived health. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2013 |
| url |
https://doaj.org/article/6c28ea7aa2b241749f768e3b192745ad |
| work_keys_str_mv |
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1718423102701961216 |