Quality of Life Research

, Volume 24, Issue 3, pp 651–659 | Cite as

Low functional status as a predictor of incidence of emotional disorders in the general population

  • Gabriela Barbaglia
  • Margreet ten Have
  • Saskia van Dorsselaer
  • Jordi Alonso
  • Gemma Vilagut
  • Ron de Graaf
Article

Abstract

Purpose

To examine the association between baseline functional status and any emotional disorder at follow-up, after controlling for potential confounders. The effect modification of previous mental disorders and physical conditions was assessed.

Methods

Data are from the Netherlands Mental Health Survey and Incidence Study-2, a representative population-based, 3-year longitudinal study completed in 2012. Individuals at risk of a new or a recurrent emotional disorder were selected at baseline (n = 4,574). The appearance of any emotional disorder between waves, assessed with the Composite International Diagnostic Interview 3.0, was the outcome. Functional status at baseline was assessed with the physical (PCS) and mental component summary (MCS) of the Short Form-36 Health Survey version 1 and with the number of disability days collected with the World Health Organization Disability Assessment Scale II. Multivariable logistic regression models adjusted by socio-demographic and lifestyle factors were fitted. Interaction terms between previous mental disorders or physical conditions with the predictors were tested.

Results

At baseline, 12.1 % had low PCS score, 5.9 % had low MCS score and 30.3 % reported any disability days. The incidence of emotional disorders in 3 years was 9.1 % [95 % confidence interval (95 % CI) 8.1–10.3]. Having low PCS or low MCS at baseline [PCS adjusted OR (aOR) 1.51, p value = 0.02; MCS aOR 1.90, p = 0.002] or reporting more than 15 disability days (aOR 1.63, p = 0.035) was significantly associated with 3-year incidence of emotional disorders. Having a previous mental disorder modified the relationship between MCS and incidence. Among those with a low MCS score, a previous mental disorder considerably increased the risk of incident emotional disorders (aOR 2.72, p = <0.001).

Conclusions

Low functional status is an independent risk factor for developing emotional disorders in the general population. Appropriate identification followed by early intervention may contribute to reduce their associated burden.

Keywords

Functional status Emotional disorders SF-36 Disability Incidence 

Notes

Acknowledgments

The authors would like to thank Carlos García Forero for his support in statistical matters and Dave Mc Farlane for his help in improving the understanding of the manuscript. The Netherlands Mental health Survey and Incidence Study-2 (NEMESIS-2) is conducted by the Netherlands Institute of Mental Health and Addiction in Utrecht. Financial support has been received from the Ministry of Health, Welfare and Sport, with supplemental support from the Netherlands Organization for Health Research and Development (ZonMw) and the Genetic Risk and Outcome of Psychosis (GROUP) investigators. Gabriela Barbaglia received support from the Spanish Ministry of Science and Innovation “Rio Hortega grant” (CM 10-00099), Spain.

References

  1. 1.
    World Health Organization. (2001). International classification of functioning, disability and health: ICF.Google Scholar
  2. 2.
    Edwards, T. M., Stern, A., Clarke, D. D., Ivbijaro, G., & Kasney, L. M. (2010). The treatment of patients with medically unexplained symptoms in primary care: a review of the literature. Mental Health in Family Medicine, 7, 209–221.PubMedCentralPubMedGoogle Scholar
  3. 3.
    Schaefert, R., Hausteiner-Wiehle, C., Hauser, W., Ronel, J., Herrmann, M., & Henningsen, P. (2012). Non-specific, functional, and somatoform bodily complaints. Deutsches Ärzteblatt International, 109, 803–813.PubMedCentralPubMedGoogle Scholar
  4. 4.
    Rief, W., & Hiller, W. (1999). Toward empirically based criteria for the classification of somatoform disorders. Journal of Psychosomatic Research, 46, 507–518.CrossRefPubMedGoogle Scholar
  5. 5.
    Deary, V., Chalder, T., & Sharpe, M. (2007). The cognitive behavioural model of medically unexplained symptoms: A theoretical and empirical review. Clinical Psychology Review, 27, 781–797.CrossRefPubMedGoogle Scholar
  6. 6.
    Kroenke, K., Spitzer, R. L., Williams, J. B., Linzer, M., Hahn, S. R., deGruy, F. V, I. I. I., et al. (1994). Physical symptoms in primary care. Predictors of psychiatric disorders and functional impairment. Archives of Family Medicine, 3, 774–779.CrossRefPubMedGoogle Scholar
  7. 7.
    Smith, G. R, Jr, Monson, R. A., & Ray, D. C. (1986). Patients with multiple unexplained symptoms. Their characteristics, functional health, and health care utilization. Archives of Internal Medicine, 146, 69–72.CrossRefPubMedGoogle Scholar
  8. 8.
    Aamland, A., Malterud, K., & Werner, E. L. (2012). Phenomena associated with sick leave among primary care patients with medically unexplained physical symptoms: A systematic review. Scandinavian Journal of Primary Health Care, 30, 147–155.CrossRefPubMedCentralPubMedGoogle Scholar
  9. 9.
    Kroenke, K., & Mangelsdorff, A. D. (1989). Common symptoms in ambulatory care: Incidence, evaluation, therapy, and outcome. American Journal of Medicine, 86, 262–266.CrossRefPubMedGoogle Scholar
  10. 10.
    de Graaf, R., Bijl, R. V., Ten, H. M., Beekman, A. T., & Vollebergh, W. A. (2004). Rapid onset of comorbidity of common mental disorders: Findings from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Acta Psychiatrica Scandinavica, 109, 55–63.CrossRefPubMedGoogle Scholar
  11. 11.
    Muntaner, C., Eaton, W. W., & Diala, C. C. (2000). Social inequalities in mental health: A review of concepts and underlying assumptions. Health (London), 4, 89–113.CrossRefGoogle Scholar
  12. 12.
    de Graaf, R., Ten Have, M., & van Dorsselaer, S. (2010). The Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2): Design and methods. International Journal of Methods in Psychiatric Research, 19, 125–141.CrossRefPubMedGoogle Scholar
  13. 13.
    Demidenko, E. (2008). Sample size and optimal design for logistic regression with binary interaction. Statistics in Medicine, 27, 36–46.CrossRefPubMedGoogle Scholar
  14. 14.
    Ware, J. E., Snow, K. K., Kosinski, M., & Gandek, B. (1993). SF-36 health survey manual and interpretation guide. Boston, MA: The Health Institute.Google Scholar
  15. 15.
    Kazis, L. E., Anderson, J. J., & Meenan, R. F. (1989). Effect sizes for interpreting changes in health status. Medical Care, 27, S178–S189.CrossRefPubMedGoogle Scholar
  16. 16.
    Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
  17. 17.
    Von Korff, M., Crane, P. K., Alonso, J., Vilagut, G., Angermeyer, M. C., Bruffaerts, R., et al. (2008). Modified WHODAS-II provides valid measure of global disability but filter items increased skewness. Journal of Clinical Epidemiology, 61, 1132–1143.CrossRefGoogle Scholar
  18. 18.
    Kessler, R. C., Greenberg, P. E., Mickelson, K. D., Meneades, L. M., & Wang, P. S. (2001). The effects of chronic medical conditions on work loss and work cutback. Journal of Occupational and Environmental Medicine, 43, 218–225.CrossRefPubMedGoogle Scholar
  19. 19.
    de Graaf, R., Tuithof, M., van Dorsselaer, S., & Ten Have, M. (2012). Comparing the effects on work performance of mental and physical disorders. Social Psychiatry and Psychiatric Epidemiology, 47(11), 1873–1883.Google Scholar
  20. 20.
    Alonso, J., Angermeyer, M. C., Bernert, S., Bruffaerts, R., Brugha, T. S., Bryson, H., et al. (2004). Disability and quality of life impact of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatrica Scandinavica, 109(s420), 38–46.Google Scholar
  21. 21.
    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. British Journal of Psychiatry, 200, 454–461.CrossRefPubMedCentralPubMedGoogle Scholar
  22. 22.
    Kessler, R. C., & Ustun, T. B. (2004). The World Mental Health (WMH) survey initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research, 13, 93–121.CrossRefPubMedGoogle Scholar
  23. 23.
    Haro, J. M., Palacin, C., Vilagut, G., Martinez, M., Bernal, M., Luque, I., et al. (2006). Prevalence of mental disorders and associated factors: Results from the ESEMeD-Spain study. Medicina Clínica (Barc), 126, 445–451.CrossRefGoogle Scholar
  24. 24.
    Brugha, T., Bebbington, P., Tennant, C., & Hurry, J. (1985). The list of threatening experiences: A subset of 12 life event categories with considerable long-term contextual threat. Psychological Medicine, 15, 189–194.CrossRefPubMedGoogle Scholar
  25. 25.
    Craig, C. L., Marshall, A. L., Sjostrom, M., Bauman, A. E., Booth, M. L., Ainsworth, B. E., et al. (2003). International physical activity questionnaire: 12-country reliability and validity. Medicine and Science in Sports and Exercise, 35, 1381–1395.CrossRefPubMedGoogle Scholar
  26. 26.
    Leidy, N. K. (1994). Functional status and the forward progress of merry-go-rounds: Toward a coherent analytical framework. Nursing Research, 43, 196–202.CrossRefPubMedGoogle Scholar
  27. 27.
    Collings, S. (2005). Disability and the detection of mental disorder in primary care. Social Psychiatry and Psychiatric Epidemiology, 40, 994–1002.CrossRefPubMedGoogle Scholar
  28. 28.
    Henningsen, P., Zimmermann, T., & Sattel, H. (2003). Medically unexplained physical symptoms, anxiety, and depression: A meta-analytic review. Psychosomatic Medicine, 65, 528–533.CrossRefPubMedGoogle Scholar
  29. 29.
    Kroenke, K., Jackson, J. L., & Chamberlin, J. (1997). Depressive and anxiety disorders in patients presenting with physical complaints: Clinical predictors and outcome. American Journal of Medicine, 103, 339–347.CrossRefPubMedGoogle Scholar
  30. 30.
    Ormel, J., Oldehinkel, A. J., Nolen, W. A., & Vollebergh, W. (2004). Psychosocial disability before, during, and after a major depressive episode: A 3-wave population-based study of state, scar, and trait effects. Archives of General Psychiatry, 61, 387–392; Clin.Pharmacol.Ther.Google Scholar
  31. 31.
    Iancu, S. C., Batelaan, N. M., Zweekhorst, M. B., Bunders, J. F., Veltman, D. J., Penninx, B. W., et al. (2014). Trajectories of functioning after remission from anxiety disorders: 2-year course and outcome predictors. Psychological Medicine, 44, 593–605.CrossRefPubMedGoogle Scholar
  32. 32.
    Buist-Bouwman, M. A., Ormel, J., de, G. R., & Vollebergh, W. A. (2004). Functioning after a major depressive episode: Complete or incomplete recovery? Journal of Affective Disorders, 82, 363–371.PubMedGoogle Scholar
  33. 33.
    Mathieson, F., Collings, S., & Dowell, A. (2009). Sub-threshold mental health syndromes: Finding an alternative to the medication of unhappiness. Journal of Primary Health Care, 1, 74–77.PubMedGoogle Scholar
  34. 34.
    Solomon, D. A., Leon, A. C., Endicott, J., Mueller, T. I., Coryell, W., Shea, M. T., et al. (2004). Psychosocial impairment and recurrence of major depression. Comprehensive Psychiatry, 45, 423–430.CrossRefPubMedGoogle Scholar
  35. 35.
    Gonzales, L. R., Lewinsohn, P. M., & Clarke, G. N. (1985). Longitudinal follow-up of unipolar depressives: An investigation of predictors of relapse. Journal of Consulting and Clinical Psychology, 53, 461–469.CrossRefPubMedGoogle Scholar
  36. 36.
    Faravelli, C., Ambonetti, A., Pallanti, S., & Pazzagli, A. (1986). Depressive relapses and incomplete recovery from index episode. American Journal of Psychiatry, 143, 888–891.CrossRefPubMedGoogle Scholar
  37. 37.
    Hemingway, H., Stafford, M., Stansfeld, S., Shipley, M., & Marmot, M. (1997). Is the SF-36 a valid measure of change in population health? Results from the Whitehall II Study. BMJ, 315, 1273–1279.CrossRefPubMedCentralPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Gabriela Barbaglia
    • 2
    • 3
    • 4
  • Margreet ten Have
    • 1
  • Saskia van Dorsselaer
    • 1
  • Jordi Alonso
    • 2
    • 3
    • 4
  • Gemma Vilagut
    • 2
    • 3
    • 4
  • Ron de Graaf
    • 1
  1. 1.Department of EpidemiologyNetherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
  2. 2.Health Services Research UnitIMIM-Institut Hospital del Mar d’Investigacions MèdiquesBarcelonaSpain
  3. 3.Universitat Pompeu FabraBarcelonaSpain
  4. 4.CIBERESPBarcelonaSpain

Personalised recommendations