Social Role Disability and Mental-Physical Co-Morbidity

描述（由申请人提供）：世界人口正在发生历史性转变，进入慢性身体疾病、精神障碍和残疾患病率增加的年龄组。慢性身体状况和精神障碍都是导致残疾的主要原因。可治疗的精神障碍和慢性身体疾病经常同时发生，但没有关于它们同时发病的国家数据。在一般人群中，患有特殊精神障碍并患有主要慢性身体疾病的人的残疾程度和性质在很大程度上是未知的。越来越多的证据表明，治疗共病性精神障碍可改善慢性躯体疾病患者的功能结局。不幸的是，应对慢性病、精神障碍和相关残疾日益流行的努力并没有以可靠的人口数据为指导。迫切需要流行病学数据来指导研究、临床实践、卫生保健组织和公共政策应对这一挑战。

DESCRIPTION (provided by applicant): An historic shift of the world population into age groups with increased prevalence of chronic physical diseases, mental disorders and disability is taking place. Chronic physical conditions and mental disorders are both leading causes of disability. Treatable mental disorders and chronic physical conditions often co-occur, but national data concerning their co-morbidity are not available. The extent and nature of disability among persons with specific mental disorders co-morbid with major chronic physical conditions is largely unknown in the population-at-large. There is growing evidence that treating co-morbid mental disorders improves functional outcomes among persons with chronic physical diseases. Unfortunately, efforts to respond to the growing epidemic of chronic disease, mental disorders and related disability are not guided by reliable population-based data. Epidemiological data are urgently needed to guide research, clinical practice, health care organization and public policy in responding to this challenge. In response to PA-02-047 (Research on Co-morbid Mental and Other Physical Disorders), our goal is to address this knowledge gap by determining the extent and nature of disability among persons with mental disorders that are co-morbid with major chronic physical conditions. We will employ data from 28 coordinated national population surveys (N=196,000) participating in the WHO World Mental Health (WMH) initiative. We will study how mood, anxiety, substance use and impulse control disorders influence disability among persons with cardiovascular disease, diabetes, respiratory disorders, arthritis,and chronic pain conditions. The specific aims of this program of research are: Aim 1: Estimate prevalence rates of treatable mental disorders among representative cases with major chronic physical disorders that are leading causes of disability; Aim 2: Advance disability research methods by calibrating WMH disability measures for use in national and international health surveys and health outcomes research; Aim3: Establish the specific contributions of mental disorders to global and specific role disabilities (including work role disability) among persons with major chronic physical disorders; and Aim 4: Determine the effects of physical-mental co-morbidity and social role disability on broader measures of disease burden including health utilities, family burden and stigma.