Psychological Distress and Comorbid Physical Conditions: Disease or Disability?

Abstract

Background: The relationship between comorbidity and psychological distress is well documented, however the mechanism of this association is unclear. We aim to assess the extent to which the association between common chronic conditions and high scores on the Kessler Psychological Distress Scale (K10) measure of psychological distress vary according to comorbid conditions, disability, and sociodemographic circumstances. Methods: Analysis of self-reported cross-sectional data from the New South Wales 45 and Up Study, Australia, for 236,508 participants aged 45 years and over, using logistic regression modeling. Results: Self-reported heart attack/angina, other heart disease, stroke, and diabetes were all significantly associated with higher risk of high/very high K10 scores. These associations were attenuated, but remained statistically significant, when comorbidity, disability, and sociodemographic factors were added to the model. Men reporting needing help for daily tasks were nine times as likely to report high/very high K10 scores as those without this need, and women reporting needing help were seven times more likely to have high/very high K10 scores. Conclusions: Heart attack/angina, other heart disease, stroke, and diabetes are all significantly associated with psychological distress. However, these effects are partly explained by other comorbid conditions, limitations on physical functioning, and sociodemographic factors. These findings highlight the importance of developing public health policies that encompass psychological, physiological, and social domains, and provide crucial insights for clinicians in identifying and supporting those people at risk of psychological distress. Depression andAnxiety 31:524-532, 2014. C 2013 Wiley Periodicals, Inc.

Burnout as a risk factor for antidepressant treatment – a repeated measures time-to-event analysis of 2936 Danish human service workers

“…women, in terms of functional impairment (Byles et al, 2014;Stansfeld et al, 2011) sickness absence (Hensing et al, 2000), and suicide (Bramness et al, 2010). These findings may be related to systematic reporting differences, as previous studies show that men may report differently than women on self-rated scales measuring psychological distress (Teresi et al, 2008).…”

Psychological Distress and Emergency Department Utilization in the United States: Evidence from the Medical Expenditure Panel Survey

“…There is a high prevalence of comorbid chronic physical health conditions in individuals with high levels of psychological distress. 49,50 Although the current study adjusted for physical health comorbidities, the comorbidity index may not have fully accounted for the full spectrum of or the severity of the physical health conditions in the seriously psychologically distressed population. Physical health conditions may subsequently cause increases in psychological distress, 51 and the presence of a physical health condition affects the responses to psychological distress measures; 26 thus not all individuals with physical health conditions and concurrent serious psychological distress are mentally ill.…”

Retirement, age, gender and mental health: findings from the 45 and Up Study

“…Therefore, all analyses were performed separately for men and women by age groups separately (Byles et al, 2013a;Phongsavan et al, 2013). The distribution of five work status groups and the proportion of participants having a high level of psychological distress in each work status group were plotted by age for men and women separately.…”

“…For other people, retirement arises from external pressures including redundancy, ill health, or needing to care for a sick or disabled family member (Alavinia & Burdorf, 2008). Under these circumstances, retirement may be associated with poor mental health outcomes due to losing their work role and social networks (Van Solinge & Henkens, 2008), losing concordance with social norms for workforce participation and retirement age (Clarke, Marshall, House, & Lantz, 2011), demands of caring (Dow & Meyer, 2010), or from physical comorbidity (Byles et al, 2013a).…”

“…Internal consistency (Cronbach's alpha) was also assessed for the K10 score in this study. In keeping with the National Survey of Mental Health and Well-Being (Australian Bureau of Statistics, 2008), the National Health Survey (Australian Bureau of Statistics, 2009), and the NSW Population Health Survey (Centre for Epidemiology and Research, 2009), in the following analyses, the K10 score was categorised to create a binary outcome with two levels, low or medium level of distress (scores of 10À21) and high level of distress (scores of 22À50) (Byles et al, 2012;Byles et al, 2013a;Furukawa, Kessler, Slade, & Andrews, 2003).…”