Journal of Happiness Studies

, Volume 16, Issue 1, pp 135–148 | Cite as

A National Representative Study of the Relative Impact of Physical and Psychological Problems on Life Satisfaction

  • Carmelo VázquezEmail author
  • Juan J. Rahona
  • Diego Gómez
  • Francisco Felix Caballero
  • Gonzalo Hervás
Research Paper


This study assessed the influence of different physical and psychological illnesses on life satisfaction in individuals. A nationally representative sample (N = 2,966) of non-institutionalized Spanish adults between the ages of 18 and 65 years completed a self-report measure on treated physical and psychological problems as well as a measure of overall life satisfaction. The results showed that although physical and psychological problems both had an impact on life satisfaction, greater effect sizes were generally found for psychological rather than for physical illness. Regression analysis, which controlled for the effects of comorbidity and sociodemographic variables (e.g. age, gender, marital status, employment status, and education level), revealed a significant impact on life satisfaction in cancer and migraine (in the domain of physical problems), and in depression, lack of concentration, insomnia, and stress/anxiety (in the domain of psychological problems). Further multivariate analyses were conducted to estimate decreases in the Satisfaction With Life Scale for each of the conditions assessed. A lack of significant interactions revealed that the effect of comorbid physical and/or psychological problems could be additive. The present results show that people who are afflicted with psychological problems exhibit a marked decrease in life satisfaction. As a whole, this negative impact is significantly greater than the decrease associated with physical problems.


Life satisfaction Mental problems Physical problems Well-being Mental health Public policy 



We thank Margarita Alvarez, Jesús Gallardo, and Isabel de Julian (Coca-Cola Institute of Happiness) for their assistance in all stages of this research and anonymous reviewers for their comments on previous versions of the manuscript.


  1. Alonso, J., Ferrer, M., Gandek, B., Ware, J. E., Aaronson, N. K., Mosconi, P., et al. (2004). Health-related quality of life associated with chronic conditions in eight countries: Results from the International Quality of Life Assessment (IQOLA Project). Quality of Life Research, 13, 283–298.CrossRefGoogle Scholar
  2. Alonso, J., Petukhova, M., Vilagut, G., Chatterji, S., Heeringa, S., Üstün, T. B., et al. (2011). Days out of role due to common physical and mental conditions: Results from the WHO World Mental Health surveys. Molecular Psychiatry, 16, 1234–1246.CrossRefGoogle Scholar
  3. Bardage, C., & Isacson, D. (2001). Hypertension and health-related quality of life: An epidemiological study in Sweden. Journal of Clinical Epidemiology, 54, 172–181.CrossRefGoogle Scholar
  4. Bergsma, A., Veenhoven, R., Have, M., & Graaf, R. (2010). Do they know how happy they are? On the value of self-rated happiness of people with a mental disorder. Journal of Happiness Studies, 12, 793–806.CrossRefGoogle Scholar
  5. Blanchflower, D. G., & Oswald, A. J. (2004). Well-being over time in Britain and the USA. Journal of Public Economics, 88, 1359–1386.CrossRefGoogle Scholar
  6. Bok, D. (2010). The politics of happiness. What government can learn from the new research on well-being. Princeton: Princeton University Press.Google Scholar
  7. Bonicatto, S. C., Dew, M. A., Zaratiegui, R., Lorenzo, L., & Pecina, P. (2001). Adult outpatients with depression: Worse quality of life than in other chronic medical diseases in Argentina. Social Science and Medicine, 52, 911–919.CrossRefGoogle Scholar
  8. Bow-Thomas, C. C., Velligan, D. I., Miller, A. L., & Olsen, J. (1999). Predicting quality of life from symptomatology in schizophrenia at exacerbation and stabilization. Psychiatry Research, 86, 131–142.CrossRefGoogle Scholar
  9. Bruffaerts, R., Vilagut, G., Demyttenaere, K., Alonso, J., Alhamzawi, A., Andrade, L. H., et al. (2012). Role of common mental and physical disorders in partial disability around the world. The British Journal of Psychiatry, 200(6), 454–461.CrossRefGoogle Scholar
  10. Buntin, M. B., & Zaslavsky, A. M. (2004). Too much ado about two-part models and transformation? Comparing methods of modeling Medicare expenditures. Journal of Health Economics, 23, 525–542.CrossRefGoogle Scholar
  11. Chida, Y., & Steptoe, A. (2008). Positive psychological well-being and mortality: A quantitative review of prospective observational studies. Psychosomatic Medicine, 70, 741–756.CrossRefGoogle Scholar
  12. Chisholm, D., Lund, C., & Saxena, S. (2007). Cost of scaling up mental healthcare in low- and middle-income countries. British Journal of Psychiatry, 191, 528–535.CrossRefGoogle Scholar
  13. Cohen, J. (1988). Statistical power analysis for the behavioral sciences. New York: Academic Press.Google Scholar
  14. Deaton, A. (2008). Income, health, and well-being around the world: Evidence from the Gallup World Poll. Journal of Economic Perspectives, 22, 53–72.CrossRefGoogle Scholar
  15. Diener, E., & Chan, M. Y. (2011). Happy people live longer: Subjective well-being contributes to health and longevity. Applied Psychology: Health and Well-Being., 3(1), 1–43.Google Scholar
  16. Diener, E., Inglehart, R., & Tay, L. (2012). Theory and validity of life satisfaction scales. Social Indicators Research. doi:  10.1007/s11205-012-0076-y.
  17. Diener, E., Lucas, R., Schimmack, U., & Heliwell, J. (2009). Well-being for public policy. Oxford: Oxford University Press.CrossRefGoogle Scholar
  18. Dolan, P., & White, M. P. (2007). How can measures of subjective well-being be used to inform public policy? Perspectives on Psychological Science, 2, 71–85.CrossRefGoogle Scholar
  19. El-Gabalawy, R., Mackenzie, C. S., Shooshtari, S., & Sareen, J. (2011). Comorbid physical health conditions and anxiety disorders: A population-based exploration of prevalence and health outcomes among older adults. General Hospital Psychiatry, 33, 556–564.CrossRefGoogle Scholar
  20. Ferrer-i-Carbonell, A., Bernard, M. S., & van Praag, B. M. S. (2002). The subjective costs of health losses due to chronic diseases. An alternative model for monetary appraisal. Health Economics, 11, 709–722.CrossRefGoogle Scholar
  21. Forward Scotland and Scottish Council Foundation. (2008). A wellbeing framework for Scotland: A better way for measuring society’s progress in the 21st century. http//
  22. Friedman, H. S., Tucker, J. S., Tomlinson-Keasey, C., Schwartz, J. E., Wingard, D. L., & Criqui, M. H. (1993). Does childhood personality predict longevity? Journal of Personality and Social Psychology, 65, 176–185.CrossRefGoogle Scholar
  23. Funk, M., Drew, N., Freeman, M., & Faydi, E. (2010). Mental health and development: Targeting people with mental health conditions as a vulnerable group. Geneva: World Health Organization.
  24. Ganev, K. (2000). Long-term trends of symptoms and disability in schizophrenia and related disorders. Social Psychiatry and Psychiatric Epidemiology, 35, 389–395.CrossRefGoogle Scholar
  25. Graham, C., Higuera, L., & Lora, E. (2011). Which health conditions cause the most unhappiness? Health Economics, 20(12), 1431–1447.CrossRefGoogle Scholar
  26. Gravelle, H., & Sutton, M. (2006). Income, relative income, and self-reported health in Britain 19792000. Centre of Health Economics, University of York.
  27. Grossi, E., Blessi, G. T., Sacco, P. L., & Buscema, M. (2012). The interaction between culture, health and psychological well-being: Data mining from the Italian culture and well-being project. Journal of Happiness Studies, 13, 129–148.Google Scholar
  28. Hampson, S. E., Goldberg, L. R., Vogt, T. M., & Dubanoski, J. P. (2006). Forty years on: Teachers’ assessments of children’s personality traits predict self-reported health behaviors and outcomes at midlife. Health Psychology Review, 25, 57–64.CrossRefGoogle Scholar
  29. Heliwell, J., Layard, R., & Sachs, J. (2012). (Eds.) World happiness report. New York: The Earth Institute (Columbia University).
  30. Ho, B. C., Nopoulos, P., Flaum, M., Arndt, S., & Andreasen, N. C. (1998). Two-year outcome in first-episode schizophrenia: Predictive value of symptoms for quality of life. American Journal of Psychiatry, 155, 1196–1201.CrossRefGoogle Scholar
  31. Howell, R. T., Kern, M. L., & Lyubomirsky, S. (2007). Health benefits: Meta-analytically determining the impact of well-being on objective health outcomes. Health Psychology Review, 1, 83–136.CrossRefGoogle Scholar
  32. INE, Instituto Nacional de Estadística (2010). Estimacion de población, 20022010. Madrid: Instituto Nacional de Estadística.
  33. Jian, H., & Lubetkin, E. (2005). The impact of obesity on health-related quality-of-life in the general adult US population. Journal of Public Health, 7, 156–164.Google Scholar
  34. Lam, J. A., & Rosenheck, R. A. (2000). Correlates of improvement in quality of life among homeless persons with serious mental illness. Psychiatric Services, 51, 116–118.CrossRefGoogle Scholar
  35. Layard, R. (2010). Measuring subjective well-being. Science, 327, 534–535.CrossRefGoogle Scholar
  36. Lehman, A. F. (1988). Quality of life interview for chronically mentally ill. Evaluation and Program Planning, 11, 51–62.CrossRefGoogle Scholar
  37. Lopez, A. D., Mathers, C. D., Ezzati, M., Jamison, D. T., & Murray, C. J. (2006). Global and regional burden of disease and risk factors, 2001: Systematic analysis of population health data. The Lancet, 367, 1747–1757.CrossRefGoogle Scholar
  38. Lubeck, D. P., & Hubert, H. B. (2005). Self-report was a viable method for obtaining health care utilization data in community dwelling seniors. Journal of Clinical Epidemiology, 58, 286–290.CrossRefGoogle Scholar
  39. Lyubomirsky, S., King, L., & Diener, E. (2005). The benefits of frequent positive affect: Does happiness lead to success? Psychological Bulletin, 131, 803–855.CrossRefGoogle Scholar
  40. Mathers, C. D., & Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030. PLoS Medicine, 3(11), e442. doi: 10.1371/journal.pmed.0030442.CrossRefGoogle Scholar
  41. Merikangas, K. R., Ames, M., Cui, L., Stang, P. E., Ustun, T. B., Von Korff, M., et al. (2007). The impact of comorbidity of mental and physical conditions on role disability in the US adult household population. Archives of General Psychiatry, 64, 1180–1188.CrossRefGoogle Scholar
  42. Moriarty, D. G., Zack, M. M., & Kobau, R. (2003). The Centers for Disease Control and Prevention’s healthy days measures—Population tracking of perceived physical and mental health over time. Health and Quality of Life Outcomes, 1, 1–8.CrossRefGoogle Scholar
  43. Murray, C.J.L., & Lopez, A.D. (1996). The global burden of disease and injury series (volume 1): A comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge, MA: Harvard School of Public Health on behalf of the World Health Organization and the World Bank, Harvard University Press.Google Scholar
  44. Narvaez, J. M., Twamley, E. W., McKibbin, C. L., Heaton, R. K., & Patterson, T. L. (2008). Subjective and objective quality of life in schizophrenia. Schizophrenia Research, 98, 201–208.CrossRefGoogle Scholar
  45. Oswald, A. J., & Powdthavee, N. (2007). Obesity, unhappiness, and the challenge of affluence: Theory and evidence. Economic Journal, 1, 441–454.CrossRefGoogle Scholar
  46. Oswald, A. J., & Wu, S. (2010). Objective confirmation of subjective measures of human well-being: Evidence from the USA. Science, 327, 576–579.CrossRefGoogle Scholar
  47. Pavot, W., & Diener, E. (1993). Review of the Satisfaction With Life Scale. Psychological Assessment, 5, 164–172.CrossRefGoogle Scholar
  48. Pavot, W., & Diener, E. (2008). The Satisfaction With Life Scale and the emerging construct of life satisfaction. The Journal of Positive Psychology, 3, 137–152.CrossRefGoogle Scholar
  49. Pinto-Meza, A., Fernández, A., Fullana, M. A., Haro, J. M., Palao, D., Luciano, J. V., et al. (2009). Impact of mental disorders and chronic physical conditions in health-related quality of life among primary care patients: Results from an epidemiological study. Quality of Life Research, 18, 1011–1018.CrossRefGoogle Scholar
  50. Pirkola, S., Suvisaari, J., Elovainio, M., Partonen, T., Aalto, A., Honkonen, T., et al. (2009). General health and quality-of-life measures in active, recent, and comorbid mental disorders: A population-based health 2000 study. Comprehensive Psychiatry, 50, 108–114.CrossRefGoogle Scholar
  51. Pressman, S. D., & Cohen, S. (2005). Does positive affect influence health? Psychological Bulletin, 131, 925–971.CrossRefGoogle Scholar
  52. Prince, M., Patel, V., Saxena, S., Maj, M., Maselko, J., Phillips, M., et al. (2007). No health without mental health. The Lancet, 370, 859–877.CrossRefGoogle Scholar
  53. Ritter, P. L., Steward, A. L., Kaymaz, H., Sobel, D. S., Block, D. A., & Lorig, K. R. (2001). Self-reports of health care utilization compared to provider records. Journal of Clinical Epidemiology, 54, 136–141.CrossRefGoogle Scholar
  54. Ruggeri, M., Bisoffi, G., Fontecedro, L., & Warner, R. (2001). Subjective and objective dimensions of quality of life in psychiatric patients: A factor analytical approach. The South Verona Outcome Project 4. British Journal of Psychiatry, 178, 268–275.CrossRefGoogle Scholar
  55. Ryff, C. D., & Singer, B. (1998). The contours of positive human health. Psychological Inquiry, 9, 1–28.CrossRefGoogle Scholar
  56. Saarni, S. I., Suvisaari, J., Sintonen, H., Pirkola, S., Koskinen, S., Aromaa, A., et al. (2007). Impact of psychiatric disorders on health-related quality of life: General population survey. British Journal of Psychiatry, 190, 326–332.CrossRefGoogle Scholar
  57. Scott, K., Bruffarts, R., Tsang, A., et al. (2007). Depression-anxiety relationships with chronic physical conditions: Results from the World Mental Health Surveys. Journal of Affective Disorders, 103, 113–120.CrossRefGoogle Scholar
  58. StataCorp (2010). Stata statistical software. Release 11. College Station, TX: Stata Corporation.Google Scholar
  59. Stiglitz, J.E., Sen, A., & Fitoussi, J.P. (2009). Commission on the measurement of economic performance and social progress.
  60. Strine, T. W., Mokdad, A. H., Balluz, L. S., Gonzalez, O., Crider, R., Berry, J. T., et al. (2008). Depression and anxiety in the United States: Findings from the 2006 behavioral risk factor surveillance system. Psychiatric Services, 59, 1383–1390.CrossRefGoogle Scholar
  61. Tsuang, M. T., & Winokur, G. (1975). The Iowa 500: Field work in 35-year follow-up of depression, mania, and schizophrenia. Canadian Psychiatric Association Journal, 5, 359–365.Google Scholar
  62. Ustun, T., Ayuso-Mateos, J. L., Chatterji, S., Mathers, C., & Murray, C. J. (2004). Global burden of depressive disorders in the year 2000. The British Journal of Psychiatry, 184, 386–392.CrossRefGoogle Scholar
  63. Ustun, T. B., Rehm, J., Chatterji, S., Saxena, S., Trotter, R., Room, R., et al. (1999). Multiple-informant ranking of the disabling effects of different health conditions in 14 countries. WHO/NIH Joint Project CAR Study Group. Lancet, 354, 111–115.CrossRefGoogle Scholar
  64. Vázquez, C., Duque, A., & Hervás, G. (2013). Satisfaction With Life Scale in a representative sample of Spanish adults: Validation and normative data. Spanish Journal of Psychology, 16, E82. doi: 10.1017/sjp.2013.82.CrossRefGoogle Scholar
  65. Veenhoven, R. (2008). Healthy happiness: Effects of happiness on physical health and the consequences for preventive health care. Journal of Happiness Studies, 9, 449–469.CrossRefGoogle Scholar
  66. White, H. (1980). A heteroskedasticity-consistent covariance matrix and a direct test for heteroskedasticity. Econometrica, 48, 817–838.Google Scholar
  67. Whiteford, H. A., Degenhardt, L., Rehm, J., Baxter, A. J., Ferrari, A. J., Erskine, H. E., et al. (2013). Global burden of disease attributable to mental and substance use disorders: Findings from the Global Burden of Disease Study 2010. Lancet, 6736, 1–12.Google Scholar
  68. WHO (2009). Disease and injury regional estimates for 2004. Geneva: World Health Organization.
  69. Williams, A. (1999). Calculating the global burden of disease: Time for a strategic reappraisal? Journal of Health Economics, 8, 1–8.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Carmelo Vázquez
    • 1
    Email author
  • Juan J. Rahona
    • 1
  • Diego Gómez
    • 2
  • Francisco Felix Caballero
    • 3
    • 4
    • 5
  • Gonzalo Hervás
    • 1
  1. 1.School of PsychologyComplutense UniversityMadridSpain
  2. 2.Department of Developmental and Educational PsychologyUniversity of HuelvaHuelvaSpain
  3. 3.Instituto de Salud Carlos IIICentro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
  4. 4.Department of PsychiatryUniversidad Autónoma de MadridMadridSpain
  5. 5.Department of Psychiatry, Hospital Universitario de La PrincesaInstituto de Investigación Sanitaria Princesa (IP)MadridSpain

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