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Disability Mediates the Impact of Common Conditions on Perceived Health

2013-06-06Artigo científico Acesso aberto
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dc.contributor.authorAlonso, Jordi
dc.contributor.authorVilagut, Gemma
dc.contributor.authorAdroher, Núria D.
dc.contributor.authorChatterji, Somnath
dc.contributor.authorHe, Yanling
dc.contributor.authorAndrade, Laura Helena
dc.contributor.authorBromet, Evelyn
dc.contributor.authorBruffaerts, Ronny
dc.contributor.authorFayyad, John
dc.contributor.authorFlorescu, Silvia
dc.contributor.authorde Girolamo, Giovanni
dc.contributor.authorGureje, Oye
dc.contributor.authorHaro, Josep Maria
dc.contributor.authorHinkov, Hristo
dc.contributor.authorHu, Chiyi
dc.contributor.authorIwata, Noboru
dc.contributor.authorLee, Sing
dc.contributor.authorLevinson, Daphna
dc.contributor.authorLépine, Jean Pierre
dc.contributor.authorMatschinger, Herbert
dc.contributor.authorMedina-Mora, Maria Elena
dc.contributor.authorO'Neill, Siobhan
dc.contributor.authorHormel, J.
dc.contributor.authorPosada-Villa, Jose A.
dc.contributor.authorIsmet Taib, Nezar
dc.contributor.authorXavier, Miguel
dc.contributor.authorXavier, Miguel
dc.contributor.authorKessler, Ronald C.
dc.contributor.authorKessler, Ronald
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblPLOS - Public Library of Science
dc.date.accessioned2017-09-26T22:00:10Z
dc.date.available2017-09-26T22:00:10Z
dc.date.issued2013-06-06
dc.description.abstractBackground:We examined the extent to which disability mediates the observed associations of common mental and physical conditions with perceived health.Methods and Findings:WHO World Mental Health (WMH) Surveys carried out in 22 countries worldwide (n = 51,344 respondents, 72.0% response rate). We assessed nine common mental conditions with the WHO Composite International Diagnostic Interview (CIDI), and ten chronic physical with a checklist. A visual analog scale (VAS) score (0, worst to 100, best) measured perceived health in the previous 30 days. Disability was assessed using a modified WHO Disability Assessment Schedule (WHODAS), including: cognition, mobility, self-care, getting along, role functioning (life activities), family burden, stigma, and discrimination. Path analysis was used to estimate total effects of conditions on perceived health VAS and their separate direct and indirect (through the WHODAS dimensions) effects.Twelve-month prevalence was 14.4% for any mental and 51.4% for any physical condition. 31.7% of respondents reported difficulties in role functioning, 11.4% in mobility, 8.3% in stigma, 8.1% in family burden and 6.9% in cognition. Other difficulties were much less common. Mean VAS score was 81.0 (SD = 0.1). Decrements in VAS scores were highest for neurological conditions (9.8), depression (8.2) and bipolar disorder (8.1). Across conditions, 36.8% (IQR: 31.2-51.5%) of the total decrement in perceived health associated with the condition were mediated by WHODAS disabilities (significant for 17 of 19 conditions). Role functioning was the dominant mediator for both mental and physical conditions. Stigma and family burden were also important mediators for mental conditions, and mobility for physical conditions.Conclusions:More than a third of the decrement in perceived health associated with common conditions is mediated by disability. Although the decrement is similar for physical and mental conditions, the pattern of mediation is different. Research is needed on the benefits for perceived health of targeted interventions aimed at particular disability dimensions.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent1048338
dc.identifier.doi10.1371/journal.pone.0065858
dc.identifier.issn1932-6203
dc.identifier.otherPURE: 3158349
dc.identifier.otherPURE UUID: fa398ff4-c431-4a80-9925-da924c57e731
dc.identifier.otherScopus: 84878793540
dc.identifier.otherPubMed: 23762442
dc.identifier.otherWOS: 000321099000112
dc.identifier.urihttp://www.scopus.com/inward/record.url?scp=84878793540&partnerID=8YFLogxK
dc.identifier.urlhttps://www.scopus.com/pages/publications/84878793540
dc.language.isoeng
dc.peerreviewedyes
dc.subjectGeneral Medicine
dc.subjectGeneral Biochemistry,Genetics and Molecular Biology
dc.subjectGeneral Agricultural and Biological Sciences
dc.subjectSDG 3 - Good Health and Well-being
dc.titleDisability Mediates the Impact of Common Conditions on Perceived Healthen
dc.typejournal article
degois.publication.firstPage
degois.publication.issue6
degois.publication.lastPage
degois.publication.titlePLoS ONE
degois.publication.volume8
dspace.entity.typePublication
person.familyNameXavier
person.familyNameKessler
person.givenNameMiguel
person.givenNameRonald
person.identifier.ciencia-idD71F-6F62-6CFA
person.identifier.orcid0000-0003-2698-1284
person.identifier.orcid0000-0003-4831-2305
person.identifier.scopus-author-id7006066808
rcaap.rightsopenAccess
relation.isAuthorOfPublication1f1ba027-e7cf-4b4a-906b-35d61c74eb90
relation.isAuthorOfPublication6c1a1bfc-ebea-4ec9-9e0b-ee83533fa86f
relation.isAuthorOfPublication.latestForDiscovery6c1a1bfc-ebea-4ec9-9e0b-ee83533fa86f

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