Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison, 1350 University Ave, Madison, WI 53706, USA; Waisman Center, 1500 Highland Ave, Madison, WI 53705, USA.
A.J. Drexel Autism Institute, 3020 Market St #560, Philadelphia, PA 19104, USA.
Disabil Health J. 2024 Oct;17(4):101641. doi: 10.1016/j.dhjo.2024.101641. Epub 2024 May 15.
Evidence suggests that disabled people have worse mental health than non-disabled people, but the degree to which disability contributes to mental health is unclear.
This paper uses 2021 National Health Interview Survey (NHIS) data to estimate the association between disability and depression and anxiety diagnoses as well as psychological distress among adults.
We calculated disability population prevalence and mental health diagnoses and associated symptoms among 28,534 NHIS respondents. Logistic regressions estimated the odds of depression or anxiety diagnoses and recent psychological distress, controlling for disability and mental health diagnoses. We measured disability using binary and continuum measures of functional disability with the Washington Group Short Set on Functioning.
Disabled people have significantly greater odds of both depression and anxiety diagnoses compared to non-disabled people. Those with high functional disability have 552 % greater odds of an anxiety diagnosis (95 % CI: 5.61-7.58; p < 0.01) and 697 % greater odds of a depression diagnosis (95 % CI: 6.97-9.12; p < 0.01) compared to those with no functional disability. Similarly, those with any level of functional disability are more likely to have elevated psychological distress in the past 30 days compared to those with no functional disability.
Findings support the idea that mental health is worse for disabled people compared to non-disabled people, with increasing functional disability associated with worse mental health. This suggests that mental health is not being adequately addressed for those with the greatest functional disability. Future work should seek to better understand the systemic causes of disparities.
有证据表明，残疾人士的心理健康状况劣于非残疾人士，但残疾对心理健康的影响程度尚不清楚。
本文利用 2021 年全国健康访谈调查（NHIS）数据，估计残疾与成年人抑郁和焦虑诊断以及心理困扰之间的关联。
我们计算了 28534 名 NHIS 受访者中残疾人口的患病率以及心理健康诊断和相关症状。通过逻辑回归，控制残疾和心理健康诊断，估计抑郁或焦虑诊断以及近期心理困扰的可能性。我们使用华盛顿小组功能障碍短列表中的功能障碍二分类和连续测量来衡量残疾。
与非残疾人士相比，残疾人士更有可能同时患有抑郁和焦虑症。与无功能障碍的人相比，功能障碍严重的人患有焦虑症的可能性高 552%（95%CI：5.61-7.58；p<0.01），患有抑郁症的可能性高 697%（95%CI：6.97-9.12；p<0.01）。同样，与无功能障碍的人相比，任何程度功能障碍的人在过去 30 天内出现心理困扰的可能性更高。
研究结果支持这样一种观点，即与非残疾人士相比，残疾人士的心理健康状况更差，功能障碍越严重，心理健康状况越差。这表明，对于功能障碍最严重的人群，心理健康问题没有得到充分解决。未来的工作应该努力更好地理解造成差异的系统性原因。
