Cited by 34Mental Health Treatment and AccessAging, Health, and DisabilityHealth Systems, Economic Evaluations, Quality of Life

Disability Mediates the Impact of Common Conditions on Perceived Health

Open access
Alonso, Jordi, Vilagut, Gemma, Adroher, Núria D., Chatterji, Somnath, He, Yanling, Andrade, Laura Helena, Bromet, Evelyn, Bruffaerts, Ronny +19 more·2013·PLoS ONE

Abstract

BACKGROUND: 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.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1371/journal.pone.0065858

Cites

55 of 55 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Alonso, J., Vilagut, G., Adroher, N. D., Chatterji, S., He, Y., Andrade, L. H., Bromet, E., Bruffaerts, R., Fayyad, J., Florescu, S., de Girolamo, G., Gureje, O., Haro, J. M., Hinkov, H., Hu, C., Iwata, N., Lee, S., Levinson, D., Lépine, J. P., Matschinger, H., Medina-Mora, M. E., O'Neill, S., Hormel, J., Posada-Villa, J. A., Ismet Taib, N., Xavier, M., & Kessler, R. C.
Affiliations
  • Universitat Pompeu Fabra (ES)
  • Municipal Institute for Medical Research (ES)
  • Centro de Investigación Biomédica en Red (ES)
  • World Health Organization (CH)
  • Universidade de São Paulo (BR)
  • State University of New York (US)
  • KU Leuven (BE)
  • Saint George Hospital (LB)
  • National School of Public Health, Management and Professional Development (RO)
  • University College Hospital, Ibadan (NG)
  • Centro de Investigación Biomédica en Red de Salud Mental (ES)
  • Shenzhen KangNing Hospital (CN)
  • Hiroshima International University (JP)
  • Chinese University of Hong Kong (HK)
  • Israel Ministry of Health (IL)
  • Leipzig University (DE)
  • University Medical Center Groningen (NL)
  • Universidade Nova de Lisboa (PT)
  • Harvard University (US)
Corresponding author
  • Alonso, Jordi
  • Vilagut, Gemma
  • Adroher, Núria D.
  • Chatterji, Somnath
  • He, Yanling
  • Andrade, Laura Helena
  • Bromet, Evelyn
  • Bruffaerts, Ronny
  • Fayyad, John
  • Florescu, Silvia
  • Gureje, Oye
  • Haro, Josep Maria
  • Hinkov, Hristo
  • Hu, Chiyi
  • Iwata, Noboru
  • Lee, Sing
  • Levinson, Daphna
  • Matschinger, Herbert
  • Hormel, J.
  • Xavier, Miguel
  • Kessler, Ronald C.
Venue
PLoS ONE
Published
2013-06-06
Volume
8
Issue
6
Pages
e65858
ISSN
1932-6203 (ISSN-L)
OpenAlex
W2005503424
Cited by
34
References
55
Citations by year
2026: 2 · 2025: 1 · 2023: 2 · 2022: 1 · 2021: 4 · 2020: 3 · 2019: 2 · 2018: 3 · 2017: 4 · 2016: 6 · 2015: 3 · 2014: 3
FWCI
5.93
Type
journal article
Language
en
Open access
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RECERCAT (Consorci de Serveis Universitaris de Catalunya) (publishedVersion, other-oa)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
  • Repositori digital de la UPF (Universitat Pompeu Fabra) (submittedVersion, cc-by)
  • Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
Funders
  • Robert Wood Johnson Foundation (044708, Grant 044708)
  • John D. and Catherine T. MacArthur Foundation (R01 DA016558, R13-MH066849)
  • John W. Alden Trust (R01-MH069864, R13-MH066849)
  • Bristol-Myers Squibb
  • Eli Lilly and Company
  • Pfizer
  • GlaxoSmithKline
  • World Health Organization (R03 TW006481)
  • European Commission (EAHC 20081308, 20081308, 1999-01042, QLG5–1999-01042, SANCO2004123, 2004123)
  • Public Health Agency (RES/4792/13)
  • Generalitat de Catalunya (01042, RETICS RD06/0011 REM-TAP, CB06/02/0046)
  • Bundesministerium für Gesundheit
  • National Insurance Institute of Israel (H13-SHOGAI-023, H16-KOKORO-013, H14-TOKUBETSU-026)
  • Ministry of Health, Labour and Welfare (H16-KOKORO-013, H14-TOKUBETSU-026, H13-SHOGAI-023)
  • Universidade de Lisboa
  • Regione Piemonte (00/0028)
  • Fakultet Medicinskih Nauka, Univerziteta U Kragujevcu
  • Fundação Champalimaud (R01 MH070884)
  • National Institutes of Health (5r13mh066849-04, 5r01mh069864-04, 5r01mh070884-05)
  • Substance Abuse and Mental Health Services Administration (044708)
  • Pfizer Foundation (R01‐MH069864, R01-DA016558, R13-MH066849, R03-TW006481)
  • Pan American Health Organization (FIRCA R03-TW006481)
  • Executive Agency for Health and Consumers
  • Instituto de Salud Carlos III (CB06/02/0046, CIBER CB06/02/0046, RETICS RD06/0011 REM-TAP, RETICS RD06/0011 REM-TAP, RETICS RD06/0011, RD06/0011, FIS 00/0028, CIBER CB06/02/0046)
  • Departament de Salut, Generalitat de Catalunya (CB06/02/0046, RETICS RD06/0011 REM-TAP)
  • National Institute of Mental Health (R13-MH-066849, NIMH R01MH070884, RO1-MH61905, R01‐MH070884, MH61905, R01MH061905, MH60220, MH070884, MH069864, MH066849, U01MH060220, R01‐MH069864)
  • National Institute on Drug Abuse (R01DA016558)
  • Fogarty International Center (FIRCA R03TW006481, R03TW006481)
  • Cilag
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Keywords
disability, health perception, mediation, mental illness, chronic physical illness, role functioning, stigma, family burden, mobility (physical function), WHODAS, depression, bipolar disorder, neurological disorders, health-related quality of life
MeSH terms
Activities of Daily Living, Adolescent, Adult, Aged, Aged, 80 and over, Mental Disorders, Female, Persons with Disabilities, Health Surveys, Humans, Male, Middle Aged, Quality of Life, Self-Assessment, Self Care

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review