Impact of Anxiety and/or Depressive Disorders and Chronic Somatic Diseases on disability and work impairment.
Anxiety and/or Depressive Disorders (ADDs) and Chronic Somatic Diseases (CSDs) are associated with substantial levels of health-related disability and work impairment. However, it is unclear whether comorbid ADDs and CSDs additively affect functional outcomes. This paper examines the impact of ADDs, CSDs, and their comorbidity on disability, work absenteeism and presenteeism.



Baseline data from the Netherlands Study of Depression and Anxiety (n=2371) were used. We assessed presence of current ADDs (using psychiatric interviews, CIDI) and presence of self-reported CSDs. Outcome measures were disability scores (WHO-DAS II questionnaire, overall and domain-specific), work absenteeism (≤2weeks and >2weeks; TiC-P) and presenteeism (reduced and impaired work performance; TiC-P). We conducted multivariate regression analyses adjusted for socio-demographics.



Both ADDs and CSDs significantly and independently impact total disability, but the impact was substantially larger for ADDs (main effect unstandardized β=20.1, p<.001) than for CSDs (main effect unstandardized β=3.88, p<.001). There was a positive interaction between ADDs and CSDs on disability (unstandardized β interaction=4.06, p=.004). Although CSDs also induce absenteeism (OR for extended absenteeism=1.42, p=.015) and presenteeism (OR for impaired work performance=1.42, p=.013), associations with ADDs were stronger (OR for extended absenteeism=6.64, p<.001; OR for impaired work performance=7.51, p<.001).



Both CSDs and ADDs cause substantial disability, work absenteeism and presenteeism, but the impact of ADDs far exceeds that of CSDs. CSDs and ADDs interact synergistically on disability, thereby bolstering the current view that patients with physical mental comorbidity (PM-comorbidity) form a severe subgroup with an unfavourable prognosis.
Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center and GGZ inGeest, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands. Electronic address: w.bokma@ggzingeest.nl.
Wicher A
WA
Bokma
Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center and GGZ inGeest, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands.
Neeltje M
NM
Batelaan
Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center and GGZ inGeest, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands.
Anton J L M
AJ
van Balkom
Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center and GGZ inGeest, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands.
Brenda W J H
BW
Penninx
D000041:Absenteeism; D000328:Adult; D001007:Anxiety; D002908:Chronic Disease / Q000523:psychology; D003866:Depressive Disorder; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D057566:Self Report; D011795:Surveys and Questionnaires
Anxiety/Anxiety Disorders; Depression; Epidemiology; Quality of life; Rehabilitation