Depression, anxiety, and physical impairments and quality of life in the US noninstitutionalized population

Objective: The objective of this study was to examine health-related quality of life and health behaviors among persons reporting a primary mental health impairment compared with those reporting a primary physical health impairment and those reporting no impairment. Methods: Data were obtained from the Behavioral Risk Factor Surveillance System, an ongoing state-based, random-digit telephone survey of the noninstitutionalized U.S. population aged 18 years or older. In 2001-2002, health-related quality-of-life measures were administered in 23 states and the District of Columbia. Results: An estimated 5.1 percent of U.S. adults reporting a primary health impairment indicated that a mental health problem was the primary cause. Those with a primary mental health impairment were more likely than those with a primary physical health impairment to report infrequent vitality (less than 14 days in the previous 30 days) and frequent occurrences of mental distress, depressive symptoms, and anxiety (at least 14 days in the previous 30 days). Relative to those who reported no impairment, persons who reported a mental health impairment were more likely to indicate that they experienced frequent physical distress and frequent pain. Persons with a primary mental health impairment were more likely than those with a primary physical health impairment to smoke and drink heavily. No significant difference was found in self-reported frequent sleeplessness or fair-to-poor general health between persons with a primary mental health impairment and those with a physical health impairment. Conclusions: Mental health impairment is strongly associated with reduced health-related quality of life and health behaviors, frequently at levels equal to or exceeding those of physical health impairments.