title: Low functional status as a predictor of incidence of emotional disorders in the general population.
abstract: OBJECTIVE
  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.
authors.affiliation: Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Dr. Aiguader 88, 08003, Barcelona, Spain, gbarbaglia@imim.es.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Barbaglia
authors.forename: Margreet
authors.initials: M
authors.lastname: ten Have
authors.forename: Saskia
authors.initials: S
authors.lastname: van Dorsselaer
authors.forename: Jordi
authors.initials: J
authors.lastname: Alonso
authors.forename: Gemma
authors.initials: G
authors.lastname: Vilagut
authors.forename: Ron
authors.initials: R
authors.lastname: de Graaf
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D003625:Data Collection; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D056344:Executive Function; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008019:Life Style; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology*; D009426:Netherlands; D011379:Prognosis; D011788:Quality of Life; D012307:Risk Factors; D055815:Young Adult