Behavioral and Urban Health, RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, USA.
Social Statistics, RTI International, University Center, Suite 119, 2951 Flowers Road South, Atlanta, GA, 30341-5533, USA.
Soc Psychiatry Psychiatr Epidemiol. 2018 Nov;53(11):1265-1276. doi: 10.1007/s00127-018-1554-6. Epub 2018 Jun 29.
The objective of this study is to estimate the comparative associations of mental disorders with three measures of functional impairment: the Global Assessment of Functioning (GAF); the number of days in the past 12 months of total inability to work or carry out normal activities because of emotions, nerves, or mental health (i.e., days out of role); and a modified version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0).
Secondary data analysis of the linked Mental Health Surveillance Study and the National Survey on Drug Use and Health (n = 5653), nationally representative population surveys conducted in the United States. Generalized linear models assessed the independent effects of mental disorders on each measure of functional impairment, controlling for mental disorder comorbidity, physical health disorders, and sociodemographic factors.
The results varied across measures of functional impairment. However, mood disorders generally tended to be associated with the greatest functional impairment, anxiety disorders with intermediate impairment, and substance use disorders with the least impairment. All 15 disorders were significantly associated with the GAF score in multiple regression models, eight disorders were significantly associated with the WHODAS score, and three disorders were significantly associated with days out of role.
Our results highlight the value of complementary measures of functional impairment.
本研究旨在评估精神障碍与三种功能障碍衡量指标之间的关联：总体功能评估（GAF）；过去 12 个月因情绪、神经或心理健康而完全无法工作或进行正常活动的天数（即角色缺失天数）；以及世界卫生组织残疾评估表 2.0（WHODAS 2.0）的修订版。
对美国进行的全国性代表性人群调查——心理健康监测研究和全国药物使用与健康调查（n=5653）中的链接数据进行二次数据分析。广义线性模型评估了精神障碍对每种功能障碍衡量指标的独立影响，同时控制了精神障碍共病、身体健康障碍和社会人口因素。
结果在功能障碍的衡量指标上存在差异。然而，心境障碍通常与最大程度的功能障碍相关，焦虑障碍与中度障碍相关，物质使用障碍与最小程度的障碍相关。所有 15 种疾病在多元回归模型中与 GAF 评分显著相关，8 种疾病与 WHODAS 评分显著相关，3 种疾病与角色缺失天数显著相关。
我们的结果强调了功能障碍补充衡量指标的价值。
