Disability Mediates the Impact of Common Conditions on Perceived Health

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 Hormel, Jose A Posada-Villa, Nezar Ismet Taib, Miguel Xavier and Ronald C Kessler

PLOS ONE, 2013, vol. 8, issue 6, 1-13

Abstract: Background: We examined the extent to which disability mediates the observed associations of common mental and physical conditions with perceived health. Methods and Findings: 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. Conclusions: 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.

Date: 2013
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0065858

DOI: 10.1371/journal.pone.0065858

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