Depression: The Strongest Predictor of Impairment of Work, Social Life, and Family Life

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Investigators note that there is substantial evidence indicating depression, anxiety, and somatization are associated with impairment of function.
Investigators note that there is substantial evidence indicating depression, anxiety, and somatization are associated with impairment of function.

In the primary care setting, depression is the most common symptom associated with increased disability in the domains of work, social life, and family life, according to a study published in Psychiatry Research.

Researchers analyzed the association of depression, anxiety, and somatization on functional disability in the domains of work, social life, and family life in patients seeking mental health care at primary care facilities. The study included 1241 patients from 28 primary care centers. All patients completed computerized questionnaires, which included the Sheehan Disability Scale, the depression module, the Generalized Anxiety Disorder Scale, and the somatic symptom severity scale of the Patient Health Questionnaire.

Of the cross-sectional study population, 77% were women, 47.5% had secondary education, 51.1% were employed, and the average age was 43.2. Based on the Sheehan Disability Scale, 56.4% scored ≥5 in at least one domain, and 80.8% had a total impairment score of ≥5. Depression was the main predictor for both total impairment level and impairment in each of the 3 domains (P <.001, for all). Anxiety was significantly associated with functional disability in the family life domain, and somatization was significantly associated with functional disability in the work domain (P <.01, for both).

Future studies need to broaden the sample population to include more diversity in demographics and mental health severity as well as analyze the causation of this association between functional impairment and severity of mental health symptoms.

The study researchers concluded that depression is associated with reduced function across all domains, including work, family life, and social life, while anxiety is associated with reduced function in family life and somatization is associated with reduced function at work. The researchers hope that earlier detection in the primary care setting might reduce the burden of the mental disorder.

Reference

González-Blanch C, Hernández-de-Hita F, Muñoz-Navarro R, et al. Domain-specific associations between disability and depression, anxiety, and somatization in primary care patients [published online Sept. 5, 2018]. Psychiatry Res. doi: 10.1016/j.psychres.2018.09.007

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