Background Mental disorders are related to high individual suffering and significant socio-economic burdens. However, it remains unclear to what extent self-reported mental distress is related to individuals’ days of incapacity to work and their medical costs. This study aims to investigate the impact of self-reported mental distress for specific and non-specific days of incapacity to work and specific and non-specific medical costs over a two-year span. Method Within a longitudinal research design, 2287 study participants’ mental distress was assessed using the Hospital Anxiety and Depression Scale (HADS). HADS scores were included as predictors in generalized linear models with a Tweedie distribution with log link function to predict participants’ days of incapacity to work and medical costs retrieved from their health insurance routine data during the following two-year period. Results Current mental distress was found to be significantly related to the number of specific days absent from work and medical costs. Compared to participants classified as no cases by the HADS (2.6 days), severe case participants showed 27.3-times as many specific days of incapacity to work in the first year (72 days) and 10.3-times as many days in the second year (44 days), and resulted in 11.4-times more medical costs in the first year (2272 EUR) and 6.2-times more in the second year (1319 EUR). The relationship of mental distress to non-specific days of incapacity to work and non-specific medical costs was also significant, but mainly driven from specific absent days and specific medical costs. Our results also indicate that the prevalence of presenteeism is considerably high: 42% of individuals continued to go to work despite severe mental distress. Conclusions Our results show that self-reported mental distress, assessed by the HADS, is highly related to the days of incapacity to work and medical costs in the two-year period. Reducing mental distress by improving preventive structures for at-risk populations and increasing access to evidence-based treatments for individuals with mental disorders might, therefore, pay for itself and could help to reduce public costs.
Background: Mental disorders are related to high individual suffering and significant socio-economic burdens. However, it remains unclear to what extent self-reported mental distress is related to individuals’ days of incapacity to work and their medical costs. This study aims to investigate the impact of self-reported mental distress for specific and non-specific days of incapacity to work and specific and non-specific medical costs over a two-year span.Method: Within a longitudinal research design, 2,287 study participants' mental distress was assessed using the Hospital Anxiety and Depression Scale (HADS). Days of incapacity to work and medical costs were retrieved from a German health insurance’s routine data during the following two-year period.Results: Current mental distress was found to be significantly related to the number of specific days absent from work and medical costs. Compared to participants classified as no cases by the HADS (2.6 days), severe case participants showed 27.3-times as many specific days of incapacity to work in the first year (72 days) and 10.3-times as many days in the second year (44 days), and resulted in 11.4-times more medical costs in the first year (2272 EUR) and 6.2-times more in the second year (1319 EUR). The relationship of mental distress to non-specific days of incapacity to work and non-specific medical costs is also significant, but mainly driven from specific absent days and specific medical costs. Our results also indicate that the prevalence of presenteeism is considerably high: 42% of individuals continued to go to work despite severe mental distress. Conclusions: Our results show that self-reported mental distress, assessed by the HADS, is highly related to the days of incapacity to work and medical costs in the two-year period. Reducing mental distress by improving preventive structures for at-risk populations and increasing access to evidence-based treatments for individuals with mental disorders might, therefore, pay for itself and could help to reduce public costs.
Zusammenfassung Hintergrund Gesundheit, Freude/Spaß, Figur und Gesellschaft sind Motive für sportliche Aktivitäten. Es ist unklar, welcher Zusammenhang zwischen ihrer Ausprägung, Alter, Geschlecht, Schmerzen und Trainingsumfang besteht. Material und Methoden In dieser Untersuchung wurden 792 sportlich aktive Männer und Frauen (68 % Frauen und 32 % Männer, Alter M = 53,5 Jahren, SD = 11,9, Range 24–85 Jahre) zur Ausprägung ihrer Motive für sportliche Aktivitäten, ihren Rückenschmerzen und dem Trainingsumfang ihrer sportlichen Aktivitäten befragt. Zur Überprüfung der Effekte auf den Trainingsumfang wurden Regressionsanalysen gerechnet. Ergebnisse Das Motiv Gesundheit war bei Männern und Frauen das stärkste Motiv für ihre sportlichen Aktivitäten, ohne einen signifikanten Effekt auf den Trainingsumfang zu haben. Bei Frauen hatten die Motive Freude (BFreude = 0,23, t = 3,6, p < 0,001, r = 0,25), Figur (BFigur = 0,127, t = 2,0, p = 0,05, r = 0,16) und Alter (BAlter = 0,03, t = 2,5, p = 0,01, r = 0,17) einen kleinen (Figur, Alter) bis mittleren Effekt (Freude) auf den Trainingsumfang. Bei Männern hatten nur Rückenschmerzen einen signifikanten positiven Effekt (BRückenschmerzen = 1,4, t = 4,2, p < 0,001, r = 0,35) auf den Trainingsumfang (starker Effekt). Diskussion und Schlussfolgerung Bei sportlich aktiven Frauen fördert die beim Training empfundene Freude (intrinsische Motivation) und der Wunsch nach einer besseren Figur (introjizierte Regulation = externen Anforderungen entsprechen) den Trainingsumfang. Für sportlich aktive Männer steht möglicherweise die Lösung des gesundheitlichen Problems im Vordergrund: Je größer das Problem (Rückenschmerzen) desto höher ist der Trainingsumfang. Vermutlich haben sie die Erfahrung gemacht, dass körperliches Training die Rückenschmerzen reduziert.
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