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Days out of role due to common physical and mental health problems: results from the São Paulo Megacity Mental Health Survey

Abstract

To investigate the relative importance of common physical and mental disorders in affecting days out-of-role (number of days totally unable to work or carry out normal activities because of health problems), in a population-based sample of adults in São Paulo Metropolitan Area, Brazil. The São Paulo Megacity Mental Health Survey administered face-to-face interviews with 2,942 adult household residents. Presence of eight chronic physical disorders and three classes of mental disorders (mood, anxiety, and substance use disorders) was assessed in the previous year along with the number of days in the previous month each respondent was totally unable to work or carry out normal daily activities due to health problems. Multiple regression analysis examined associations of disorders and their comorbidities with days out-of-role controlled socio-demographics variables. Both individual-level and population-level associations were estimated. 13.1% of respondents reported one or more days out-of-role in the previous month. The annualized median was 41.4 days out-of-role. The disorders considered here accounted for 71.7% of all days out-of-role, with highest annualized individual-level effects of digestive (22.6), mood (19.9), substance use (15.0), chronic pain (16.5), and anxiety (14.0) disorders. The disorders associated with highest population-attributable risk proportions of day out-of-role were chronic pain (35.2%), mood (16.5%) and anxiety (15.0%) disorders. As pain, anxiety, and mood disorders have high effects at both the individual and societal levels, targeted interventions to reduce the impairments associated with these disorders have the highest potential to reduce the societal burdens of chronic illness in the São Paulo Metropolitan area. (AU)

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