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The British Journal of Psychiatry (2003) 183: 299-303
© 2003 The Royal College of Psychiatrists

Functional health status, chronic medical conditions and disorders of mood

PAUL G. SURTEES, PhD and NICHOLAS W. J. WAINWRIGHT, PhD

Strangeways Research Laboratory, Institute of Public Health, University of Cambridge

KAY-TEE KHAW, MD

Clinical Gerontology Unit, University of Cambridge School of Clinical Medicine, Addenbrooke’s Hospital, Cambridge

NICHOLAS E. DAY, PhD

Strangeways Research Laboratory, Institute of Public Health, University of Cambridge, UK

Correspondence: Dr Paul Surtees, Strangeways Research Laboratory, Worts Causeway, Cambridge CB1 8RN, UK. Tel: +44 (0) 1223 74065; fax: +44 (0) 1223 411609; e-mail: paul.surtees{at}srl.cam.ac.uk

Declaration of interest None. Funding detailed in Acknowledgements.

Background Understanding of the impact of depressive and anxiety disorders on functional health status in the context of chronic medical illness has been gained almost exclusively from the study of patient populations.

Aims To compare the impact of major depressive and generalised anxiety disorder with that of chronic medical conditions on functional health in a UK resident population.

Method The functional health of 20 921 study participants was assessed using the Medical Outcomes Study Short Form 36 questionnaire. Depressive and anxiety disorder episode histories and chronic medical conditions were assessed using independent self-completed questionnaires.

Results The degree of physical functional impairment associated with mood disorders was of equivalent magnitude to that associated with the presence of chronic medical conditions or with being some 12 years older.

Conclusions Depressive and anxiety disorders have a profound impact on functional health that is independent of chronic medical illness. Chronic anxiety is associated with physical health limitations in excess of those associated with chronic depression or any of the physical health conditions considered, except for stroke.


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