Days out of role due to common physical and mental conditions: results from the WHO World Mental Health surveys

J Alonso, M Petukhova, G Vilagut, S Chatterji, S Heeringa, T B Üstün, A O Alhamzawi, M C Viana, M Angermeyer, E Bromet, R Bruffaerts, G de Girolamo, S Florescu, O Gureje, J M Haro, H Hinkov, C-y Hu, E G Karam, V Kovess, D Levinson, M E Medina-Mora, Y Nakamura, J Ormel, J Posada-Villa, R Sagar, K M Scott, A Tsang, D R Williams, R C Kessler, J Alonso, M Petukhova, G Vilagut, S Chatterji, S Heeringa, T B Üstün, A O Alhamzawi, M C Viana, M Angermeyer, E Bromet, R Bruffaerts, G de Girolamo, S Florescu, O Gureje, J M Haro, H Hinkov, C-y Hu, E G Karam, V Kovess, D Levinson, M E Medina-Mora, Y Nakamura, J Ormel, J Posada-Villa, R Sagar, K M Scott, A Tsang, D R Williams, R C Kessler

Abstract

Days out of role because of health problems are a major source of lost human capital. We examined the relative importance of commonly occurring physical and mental disorders in accounting for days out of role in 24 countries that participated in the World Health Organization (WHO) World Mental Health (WMH) surveys. Face-to-face interviews were carried out with 62 971 respondents (72.0% pooled response rate). Presence of ten chronic physical disorders and nine mental disorders was assessed for each respondent along with information about the number of days in the past month each respondent reported being totally unable to work or carry out their other normal daily activities because of problems with either physical or mental health. Multiple regression analysis was used to estimate associations of specific conditions and comorbidities with days out of role, controlling by basic socio-demographics (age, gender, employment status and country). Overall, 12.8% of respondents had some day totally out of role, with a median of 51.1 a year. The strongest individual-level effects (days out of role per year) were associated with neurological disorders (17.4), bipolar disorder (17.3) and post-traumatic stress disorder (15.2). The strongest population-level effect was associated with pain conditions, which accounted for 21.5% of all days out of role (population attributable risk proportion). The 19 conditions accounted for 62.2% of all days out of role. Common health conditions, including mental disorders, make up a large proportion of the number of days out of role across a wide range of countries and should be addressed to substantially increase overall productivity.

Figures

Figure 1
Figure 1
Yearly days totally out of role because of each of the 19 health conditions considered: (a) Among those suffering from the condition (‘individual effect'); and (b) population attributable risk proportion (PARP). All countries: WHO World Mental Health surveys.

References

    1. ACOEM Guidance Statement Healthy workforce/healthy economy: the role of health, productivity, and disability management in addressing the nation's health care crisis: why an emphasis on the health of the workforce is vital to the health of the economy. J Occup Environ Med. 2009;51:114–119.
    1. Davis K, Collins SR, Doty MM, Ho A, Holmgren A. Health and productivity among US workers. Issue Brief (Commonw Fund) 2005;856:1–10.
    1. Suhrcke M, Arce RA, McKee M, Rocco L. Economic Costs of Ill Health in the European Region. European Observatory on Health Systems and Policies, World Health Organization: Copenhaguen; 2008.
    1. Loeppke R, Taitel M, Haufle V, Parry T, Kessler RC, Jinnett K. Health and productivity as a business strategy: a multiemployer study. J Occup Environ Med. 2009;51:411–428.
    1. Merikangas KR, Ames M, Cui L, Stang PE, Ustun TB, Von Korff M, et al. The impact of comorbidity of mental and physical conditions on role disability in the US adult household population. Arch Gen Psychiatry. 2007;64:1180–1188.
    1. Andlin-Sobocki P, Jonsson B, Wittchen HU, Olesen J. Cost of disorders of the brain in Europe. Eur J Neurol. 2005;12 (Suppl 1:1–27.
    1. Von Korff MR.Global perspectives on mental-physical comorbidityIn: Von Korff MR, Scott KM, Gureje O (eds).Global Perspectives on Mental-Physical Comorbidity in the WHO World Mental Health Surveys Cambridge University Press: New York, NY; 20091–11.
    1. Stang PE, Brandenburg NA, Lane MC, Merikangas KR, Von Korff MR, Kessler RC. Mental and physical comorbid conditions and days in role among persons with arthritis. Psychosom Med. 2006;68:152–158.
    1. Kessler RC, Üstün TB. The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders. Cambridge University Press: New York, NY; 2008.
    1. World Bank Data & statistics, country groups by incomeAvailable at: , 2007
    1. Heeringa SG, Wells JE, Frost H, Mneimneh ZN, Chiu GT, Sampson NA, et al. Sample designs and sampling proceduresIn: Kessler RC, Üstün TB (eds).The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders Cambridge University Press: New York; 200814–32.
    1. Pennell BE, Mneimneh ZN, Bowers A, Chardoul S, Wells JE, Viana MC, et al. Implementation of the World Mental Health Surveys. Chapter 3. Part I. MethodsIn: Kessler RC, Üstün TB (eds).The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders Cambridge University Press: New York; 200833–57.
    1. Harkness J, Pennell BE, Villar A, Gebler N, Aguilar-Gaxiola S, Bilgen I.Translation procedures and translation assessment in the World Mental Health Survey InitiativeIn: Kessler RC, Üstün TB (eds).The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders Cambridge University Press: New York; 200891–113.
    1. Kessler RC, Ustun TB. The World Mental Health (WMH) survey initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) Int J Methods Psychiatr Res. 2004;13:93–121.
    1. First MB, Spitzer RL, Gibbon M, Williams JBW. Structured Clinical Interview for DSM-IV Axis I Disorders, Research Version, Non-Patient Edition (SCID-I/NP) Biometrics Research, New York State Psychiatric Institute: New York; 2002.
    1. Haro JM, Arbabzadeh-Bouchez S, Brugha TS, de Girolamo G, Guyer ME, Jin R, et al. Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health surveys. Int J Methods Psychiatr Res. 2006;15:167–180.
    1. Center for Disease Control and Prevention . Health, United States, 2004. US Government Printing Office: Washington, DC; 2004.
    1. Schoenborn CA, Adams PF, Schiller JS. Summary health statistics for the US population: National Health Interview Survey, 2000. Vital Health Stat 10. 2003;214:1–83.
    1. Knight M, Stewart-Brown S, Fletcher L. Estimating health needs: the impact of a checklist of conditions and quality of life measurement on health information derived from community surveys. J Public Health Med. 2001;23:179–186.
    1. Baker MM, Stabile M, Deri C. What Do Self-Reported, Objective Measures of Health Measure? National Bureau of Economic Research: Cambridge, MA; 2001.
    1. Von Korff M, Crane PK, Alonso J, Vilagut G, Angermeyer MC, Bruffaerts R, et al. Modified WHODAS-II provides valid measure of global disability but filter items increased skewness. J Clin Epidemiol. 2008;61:1132–1143.
    1. WHO WHODAS IIAvailable at: . Accessed 26 February 2010.
    1. Vazquez-Barquero JL, Vazquez Bourgon E, Herrera Castanedo S, Saiz J, Uriarte M, Morales F, et al. Versión en lengua española de un nuevo cuestionario de evaluación de discapacidades de la OMS (WHO-DAS-II): fase inicial de desarrollo y estudio piloto. Actas Esp Psiquiatr. 2000;28:77–87.
    1. Kessler RC, Ormel J, Demler O, Stang PE. Comorbid mental disorders account for the role impairment of commonly occurring chronic physical disorders: results from the National Comorbidity Survey. J Occup Environ Med. 2003;45:1257–1266.
    1. Revicki DA, Irwin D, Reblando J, Simon GE. The accuracy of self-reported disability days. Med Care. 1994;32:401–404.
    1. Kessler RC, Ames M, Hymel PA, Loeppke R, McKenas DK, Richling DE, et al. Using the World Health Organization Health and Work Performance Questionnaire (HPQ) to evaluate the indirect workplace costs of illness. J Occup Environ Med. 2004;46:S23–S37.
    1. Gureje O.The pattern and nature of mental-physical comorbidity: specific or generalIn: Von Korff MR, Scott KM, Gureje O (eds).Global Perspectives on Mental-Physical Comorbidity in the WHO World Mental Health Surveys Cambridge University Press: Cambridge, MA; 200951–83.
    1. Seber GAF, Wild CL. Nonlinear Regression. Wiley: New York; 1989.
    1. Buntin MB, Zaslavsky AM. Too much ado about two-part models and transformation? Comparing methods of modeling Medicare expenditures. J Health Econ. 2004;23:525–542.
    1. Wolter KM. Introduction to Variance Estimation. Springer-Verlag: New York; 1985.
    1. SAS Institute inc.(Copyright 2002-2003) SAS/STAT software, version 9.1 for Windows. SAS Institute Inc.: Cary, NC; 2002.
    1. Kriegsman DM, Penninx BW, van Eijk JT, Boeke AJ, Deeg DJ. Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients' self- reports and on determinants of inaccuracy. J Clin Epidemiol. 1996;49:1407–1417.
    1. Sanderson K, Andrews G. Common mental disorders in the workforce: recent findings from descriptive and social epidemiology. Can J Psychiatry. 2006;51:63–75.
    1. Polder JJ, Achterberg PW. Cost of Illness in the Netherlands. National Institute for Public Health and the Environment: Bilthoven, The Netherlands; 2004.
    1. Steenland K, Armstrong B. An overview of methods for calculating the burden of disease due to specific risk factors. Epidemiology. 2006;17:512–519.
    1. Rice DP, Miller LS. Health economics and cost implications of anxiety and other mental disorders in the United States. Br J Psychiatry Suppl. 1998;34:4–9.
    1. Smit F, Cuijpers P, Oostenbrink J, Batelaan N, de Graaf R, Beekman A. Costs of nine common mental disorders: implications for curative and preventive psychiatry. J Ment Health Policy Econ. 2006;9:193–200.
    1. Turner BJ, Hollenbeak CS, Weiner M, Ten Have T, Tang SS. Effect of unrelated comorbid conditions on hypertension management. Ann Intern Med. 2008;148:578–586.
    1. Kessler RC, Avenevoli S, Costello EJ, Green JG, Gruber M, McLaughlin KA, et al. Twelve-month prevalence and severity of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement (NCS-A)in press).

Source: PubMed

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