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Non-disabled cases in a national survey
S Henderson1, A Korten, J Medway
1Centre for Mental Health Research, The Australian National University, Canberra, ACT.
Psychological Medicine
|July 19, 2001
Summary
Many individuals diagnosed with anxiety or depressive disorders in Australia do not experience disability. Current diagnostic criteria may not accurately distinguish between symptomatic and disabled individuals in the general population.
Area of Science:
- Psychiatry
- Epidemiology
- Public Health
Background:
- Large-scale mental disorder prevalence estimates face skepticism due to unverified disability.
- Assessing disability is crucial for accurate mental disorder case identification.
- This study investigated disability levels in individuals meeting anxiety/depressive disorder criteria.
Purpose of the Study:
- To determine the proportion of individuals with anxiety or depressive disorders who report no disability.
- To evaluate the discriminative validity of ICD-10 and DSM-IV criteria regarding symptom-related disability.
- To identify potential subgroups of asymptomatic yet disabled individuals.
Main Methods:
- A nationally representative Australian sample (aged 18+) was surveyed.
- The Composite International Diagnostic Interview on laptop (CIDI-A) assessed ICD-10/DSM-IV anxiety/depressive disorders.
- Self-reported disability and medical consultations were recorded for the past 4 weeks.
Main Results:
- 28% (ICD-10) and 20.4% (DSM-IV) of anxiety disorder cases reported no disability.
- 15% (ICD-10) and 13.9% (DSM-IV) of depressive disorder cases reported no disability.
- Non-disabled individuals had lower psychological distress scores and fewer doctor consultations.
Conclusions:
- ICD-10 and DSM-IV criteria, via CIDI-A, inadequately differentiate between disabled and non-disabled symptomatic individuals.
- A significant population subgroup may experience high symptom burden without functional impairment.
- Revising diagnostic criteria to include functional impairment is suggested.