Impact of psychiatric disorders in the general population: satisfaction with life and the influence of comorbidity and disorder duration

Abstract

Psychiatric disorders as defined by DSM-IV are found to be highly prevalent in the general population. However, little is known about aspects defining the burden caused by different disorders. The aim of this study was to evaluate the impact of different psychiatric disorders in the community with respect to life satisfaction taking into account the effects of comorbidity and disorder duration. Psychiatric 12-month disorders and life satisfaction were assessed in a random sample of 4075 adults from the general population using the Composite International Diagnostic Interview and the Satisfaction With Life Scale (SWLS). Separate analyses were performed for comorbid and pure disorders. Disorder duration was defined by the time since disorder onset for participants fulfilling diagnostic criteria within the last year. SWLS scores were significantly lower for all diagnostic subgroups except for bipolar disorders, compared to subjects with no 12-month diagnosis. Effect sizes were medium to large. Comorbidity was significantly associated with lower satisfaction with life. Pure disorders are associated with less but still significantly reduced SWLS scores, except alcohol abuse, major depression and specific phobia. Mean duration of disorder was lowest for dysthymia (5.9 years) and highest for specific phobia (24.5 years). The only significant correlation between disorder duration and SWLS was found for major depression (r = -0.26) and no trend for the direction of the relation could be identified across disorders. The impact of mental disorders in the community was confirmed by using the subjective measure of life satisfaction. Comorbidity is a key factor in determining the extent of reduction in satisfaction with life. Measures of disorder persistence should be examined by refined research strategies. Comprehensive analyses of mental disorders--exceeding the prevalence or a single measure of burden--have to be considered to define the most urgent needs in the community.