Psychological distress and mental health diagnoses in adults by disability and functional difficulty status: Findings from the 2021 national health interview survey.
Jamie Koenig, Kiley J McLean, Lauren Bishop
PMID 38816306WHAT IT FOUND
Adults with functional difficulty had 3.63 times greater odds of anxiety and 3.82 times greater odds of depression than those without.
Psychological distress remained significantly higher in disabled adults even after controlling for these diagnoses, suggesting unmet mental health needs beyond current treatment.
Key findings
01Disabled adults had 3.63 times greater odds of an anxiety diagnosis and 3.82 times greater odds of a depression diagnosis compared to non-disabled adults.
02Being disabled was associated with 239% greater odds of higher psychological distress severity even after controlling for anxiety and depression diagnoses.
03When using a continuum measure, adults reporting 'a lot of functional disability' had 519% greater odds of higher psychological distress severity after controlling for diagnoses.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study is cross-sectional, so it cannot determine whether disability causes mental health issues or vice versa. Mental health diagnoses were self-reported 'ever diagnosed' status, which does not account for current severity or treatment efficacy. The study used data from 2021, during the height of the pandemic, which may have inflated psychological distress levels compared to pre-pandemic norms. The disability measure was binary or continuum based on functional difficulty, not specific diagnoses, so it does not distinguish between different types of disability.
Declared interests
The authors have no conflicts of interest to declare.
The easy way to misread this
Do not assume that treating an underlying anxiety or depression diagnosis will eliminate the psychological distress associated with disability. The study found that distress remained significantly higher in disabled adults even after controlling for these diagnoses, indicating that the experience of functional limitation itself is a distinct source of distress.