title: Functional disability and quality of life decrements in mental disorders: Results from the Mental Health Module of the German Health Interview and Examination Survey for Adults (DEGS1-MH).
abstract: BACKGROUND
  This paper provides nationally representative data on how current and past mental disorders are related to functional disability and health-related quality of life (QoL).
  
  
  METHODS
  Results are based on a nationally representative sample (DEGS1-MH; n=4483 aged 18-79). Respondents were examined by clinical interviewers with the DSM-IV Composite International Diagnostic Interview (DIA-X/M-CIDI). Functional disability, i.e. number of disability days in the past 4weeks, and QoL, i.e. mental (MCS) and physical (PCS) component scale of the SF-36V2, were examined in subjects with 12-month mental disorders (=active cases [AC]) and compared to (a) subjects who never met diagnostic criteria (=unaffected individuals [UAI]), and (b) those with a history of mental disorders but not meeting the diagnostic criteria in the past 12months (=non-active cases [NAC]; partially or fully remitted).
  
  
  RESULTS
  In comparison to UAI (mean: 1.9), AC reveals a 2-3 fold disability days/month (5.4, P<.001) and a substantially reduced MCS (UAI: 52.1; AC: 43.3, P<.001). NAC had a similar number of disability days as UAI, but significantly reduced MCS scores (49.9; P<.001). Disability days and QoL decrements were highest in internalizing disorders including somatoform disorders and most pronounced in comorbid cases.
  
  
  CONCLUSIONS
  By and large, findings of a previous study were confirmed and extended for this nationally representative German sample. 12-month mental disorders, particularly internalizing, including somatoform disorders, are associated with high levels of disability and increased health-related QoL decrements. Partial or complete remission of the mental disorders is associated with a normalization of the numbers of disability days.
authors.affiliation: Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany. Electronic address: Simon.Mack@tu-dresden.de.
authors.forename: Simon
authors.initials: S
authors.lastname: Mack
authors.affiliation: Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Jacobi
authors.affiliation: Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Beesdo-Baum
authors.affiliation: Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Gerschler
authors.affiliation: Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Strehle
authors.affiliation: Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Höfler
authors.affiliation: Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
authors.forename: Markus A
authors.initials: MA
authors.lastname: Busch
authors.affiliation: Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Maske
authors.affiliation: Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
authors.forename: Ulfert
authors.initials: U
authors.lastname: Hapke
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Gaebel
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Zielasek
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany; German Center of Neurodegenerative Diseases (DZNE), Bonn, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
authors.affiliation: Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Wittchen
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004185:Disability Evaluation; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D008603:Mental Health / Q000706:statistics & numerical data; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D013001:Somatoform Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires
keywords: Disability; Impairment; Mental disorders; Quality of life