Which mental disorders are associated with the greatest impairment in functioning?

Edlund, Mark J.; Wang, Jiantong; Brown, Kristen; Forman‐Hoffman, Valerie L.; Calvin, Sara; Hedden, Sarra L.; Bose, Jonaki

doi:10.1007/s00127-018-1554-6

Cited by 28 publications

(32 citation statements)

References 31 publications

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“…Impairments were most consistently associated with major depression, panic disorder, and ADHD after adjusting for class membership. This association is consistent with evidence for the special importance of these disorders in previous surveys among students (Verger et al, ) as well as in the general population (Comer et al, ; Edlund et al, ). However, the LCA showed that substantial proportions of the students with these disorders also had other diagnoses, making it important to consider the use of trans‐diagnostic approaches in treating these students (Barlow et al, ).…”

Section: Discussionsupporting

confidence: 91%

The role impairment associated with mental disorder risk profiles in the WHO World Mental Health International College Student Initiative

Alonso

Vilagut

Mortier

et al. 2018

Int J Methods Psych Res

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Objective The objective of this study is to assess the contribution of mental comorbidity to role impairment among college students. Methods Web‐based self‐report surveys from 14,348 first‐year college students (Response Rate [RR] = 45.5%): 19 universities, eight countries of the World Mental Health International College Student Initiative. We assessed impairment (Sheehan Disability Scales and number of days out of role [DOR] in the past 30 days) and seven 12‐month DSM‐IV disorders. We defined six multivariate mental disorder classes using latent class analysis (LCA). We simulated population attributable risk proportions (PARPs) of impairment. Results Highest prevalence of role impairment was highest among the 1.9% of students in the LCA class with very high comorbidity and bipolar disorder (C1): 78.3% of them had severe role impairment (vs. 20.8%, total sample). Impairment was lower in two other comorbid classes (C2 and C3) and successively lower in the rest. A similar monotonic pattern was found for DOR. Both LCA classes and some mental disorders (major depression and panic, in particular) were significant predictors of role impairment. PARP analyses suggest that eliminating all mental disorders might reduce severe role impairment by 64.6% and DOR by 44.3%. Conclusions Comorbid mental disorders account for a substantial part of role impairment in college students.

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Section: Discussionsupporting

confidence: 91%

The role impairment associated with mental disorder risk profiles in the WHO World Mental Health International College Student Initiative

Alonso

Vilagut

Mortier

et al. 2018

Int J Methods Psych Res

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“…Together these findings, evidentially, suggest a significant and chronic burden in refugees due to poor mental health, impeding their functioning and possibilities to adapt. 1,98 When method of assessment is considered, the results reported here are largely in line with the results reported in earlier meta-analyses. [14][15][16] This could suggest that prevalence rates of anxiety, depression and PTSD in refugee populations do not change over time.…”

Section: Discussionsupporting

confidence: 90%

“…Together these findings, evidentially, suggest a significant and chronic burden in refugees due to poor mental health, impeding their functioning and possibilities to adapt. 1,98…”

Section: Discussionmentioning

confidence: 99%

Anxiety, depression and post-traumatic stress disorder in refugees resettling in high-income countries: systematic review and meta-analysis

et al. 2020

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Background The number of refugees is at its highest since the Second World War and on the rise. Many refugees suffer from anxiety, depression and post-traumatic stress disorder (PTSD), but exact and up-to-date prevalence estimates are not available. Aims To report the pooled prevalence of anxiety and mood disorders and PTSD in general refugee populations residing in high-income countries and to detect sources of heterogeneity therein. Method Systematic review with meta-analyses and meta-regression. Results Systematic searches (final search date 3 August 2019) yielded 66 eligible publications that reported 150 prevalence estimates (total sample N = 14 882). Prevalence rates were 13 and 42% (95% CI 8–52%) for diagnosed and self-reported anxiety, 30 and 40% (95% CI 23–48%) for diagnosed and self-reported depression, and 29 and 37% (95% CI 22–45%) for diagnosed and self-reported PTSD. These estimates are substantially higher relative to those reported in non-refugee populations over the globe and to populations living in conflict or war settings, both for child/adolescent and adult refugees. Estimates were similar over different home and resettlement areas and independent of length of residence. Conclusions Our data indicate a challenging and persisting disease burden in refugees due to anxiety, mood disorders and PTSD. Knowing this is relevant for the development of public health policies of host countries. Scalable interventions, tailored for refugees, should become more readily available.

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“…Despite the fact that DSM-5 has been introduced in 2013, the WHODAS 2.0 has not so far been widely adopted in mental health research and practice. Although Edlund et al [ 28 ] indicated that eating disorders ‘might be highly disabling’, in their nationally representative population surveys using the WHODAS 2.0, the authors did not include eating disorders because of their relatively low prevalence. The two studies that did assess a patient-reported version of the WHODAS in patients with an eating disorder either did not have a noneating disorder control group [ 29 ] or did not report separately on patients with an eating disorder [ 30 ].…”

Section: Global Burden Of Disease Studymentioning

confidence: 99%

Review of the burden of eating disorders: mortality, disability, costs, quality of life, and family burden

Hoeken

Hoek

2020

Current Opinion in Psychiatry

399

241

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Purpose of review To review the recent literature on the burden of eating disorders in terms of mortality, disability, quality of life, economic cost, and family burden, compared with people without an eating disorder. Recent findings Estimates are that yearly over 3.3 million healthy life years worldwide are lost because of eating disorders. In contrast to other mental disorders, in anorexia nervosa and bulimia nervosa years lived with disability (YLDs) have increased. Despite treatment advances, mortality rates of anorexia nervosa and bulimia nervosa remain very high: those who have received inpatient treatment for anorexia nervosa still have a more than five times increased mortality risk. Mortality risks for bulimia nervosa, and for anorexia nervosa treated outside the hospital, are lower but still about twice those of controls. In people with an eating disorder, quality of life is reduced, yearly healthcare costs are 48% higher than in the general population, the presence of mental health comorbidity is associated with 48% lower yearly earnings, the number of offspring is reduced, and risks for adverse pregnancy and neonatal outcomes are increased. Summary People with a current or former eating disorder are at risk of increased mortality, high YLD rates, a reduced quality of life, increased costs, and problems with childbearing.

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Which mental disorders are associated with the greatest impairment in functioning?

Abstract: Our results highlight the value of complementary measures of functional impairment.

Cited by 28 publications

References 31 publications

The role impairment associated with mental disorder risk profiles in the WHO World Mental Health International College Student Initiative

The role impairment associated with mental disorder risk profiles in the WHO World Mental Health International College Student Initiative

Anxiety, depression and post-traumatic stress disorder in refugees resettling in high-income countries: systematic review and meta-analysis

Review of the burden of eating disorders: mortality, disability, costs, quality of life, and family burden

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