McCallum Sonia M, Batterham Philip J, Calear Alison L, Sunderland Matthew, Carragher Natacha
Centre for Mental Health Research, Research School of Population Health, 63 Eggleston Road, The Australian National University, Acton, ACT 2601, Australia. Email:.
Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Randwick Campus, 22-32 King Street, Randwick, NSW 2031, Australia. Email:.
Aust Health Rev. 2019 Jan;43(6):644-652. doi: 10.1071/AH16276.
Objective The aim of this study was to determine the effect of a broad range of common mental disorders and their comorbidity on health-related quality of life and functional disability. Methods In all, 2734 Australians aged ≥18 years, recruited from the general community via Facebook during August-December 2014, completed an online survey assessing demographic characteristics, nine mental disorders, suicidal ideation and attempt. Outcome measures were health-related quality of life (assessed using the Assessment of Quality of Life (AQoL)-4D measure and functional disability (days out of role). Results Overall, 53.1% of the sample met criteria for at least one mental disorder. Participants with each of the 11 mental health problems had significantly lower mean AQoL-4D scores and significantly greater functional disability compared with not having the disorder (P<0.001). A monotonic decrease in quality of life and an increase in functional disability were observed with an increased total number of comorbid disorders (P<0.001). Accounting for disorder prevalence, annual economic burden for each mental disorder was estimated to be in the range of A$870 million-A$17 billion. Conclusions Mental disorders negatively affect health-related quality of life and functional disability, exacerbated by increased comorbidity. The economic burden to participants and employers estimated in this study is of concern, and highlights the importance of evidence-based treatment and prevention approaches. What is known about the topic? Mental disorders are associated with poorer health-related quality of life, increased functional disability and increased economic costs. What does this paper add? This paper furthers our understanding of the associations of nine mental disorders, suicidal ideation and suicide attempts with quality of life in an Australian setting, highlighting the considerable economic implications of these associations. Further, it reveals that comorbidity of mental disorders exacerbates reductions in quality of life and increased functional disability. What are the implications for practitioners? The economic burden associated with lost productivity and quality of life for individuals with mental disorders is considerable. Therefore, prioritising funding to prevention and treatment using evidence-based approaches will have significant effect in terms of economic productivity and personal well-being for individuals.
目的 本研究旨在确定一系列常见精神障碍及其共病对健康相关生活质量和功能残疾的影响。方法 2014年8月至12月期间，通过脸书从普通社区招募了2734名年龄≥18岁的澳大利亚人，他们完成了一项在线调查，评估人口统计学特征、九种精神障碍、自杀意念和自杀未遂情况。结局指标为健康相关生活质量（使用生活质量评估（AQoL）-4D量表进行评估）和功能残疾（失能天数）。结果 总体而言，53.1%的样本符合至少一种精神障碍的标准。与未患该障碍的参与者相比，患有11种心理健康问题中任何一种的参与者的平均AQoL-4D得分显著更低，功能残疾也显著更严重（P<0.001）。随着共病障碍总数的增加，生活质量呈单调下降，功能残疾增加（P<0.001）。考虑到疾病患病率，估计每种精神障碍的年度经济负担在8.7亿澳元至170亿澳元之间。结论 精神障碍对健康相关生活质量和功能残疾有负面影响，共病增加会加剧这种影响。本研究估计的参与者和雇主的经济负担令人担忧，并凸显了循证治疗和预防方法的重要性。关于该主题已知的情况是什么？精神障碍与较差的健康相关生活质量、功能残疾增加和经济成本增加有关。本文补充了什么？本文进一步加深了我们对澳大利亚背景下九种精神障碍、自杀意念和自杀未遂与生活质量之间关联的理解，突出了这些关联的重大经济影响。此外，它揭示了精神障碍的共病会加剧生活质量的下降和功能残疾的增加。对从业者有何启示？精神障碍患者因生产力和生活质量丧失而产生的经济负担相当大。因此，优先为循证方法的预防和治疗提供资金，将对个人的经济生产力和个人福祉产生重大影响。
