Physical disability and mental health: An epidemiology of psychiatric and substance disorders.

Objective: To estimate the lifetime and 1-year prevalence of psychiatric and substance disorders as they vary by the presence of physical disability and across gender, race– ethnicity, and age. Study Design: Community screening provided a sampling frame from which stratified random samples were drawn. Participants: Half were men, half were screened as having activity limitation, and African Americans, non-Hispanic Whites, persons of Cuban heritage, and other Hispanics each composed 25% of the sample. Interviews were completed with 1,986 individuals using the Composite International Diagnostic Interview. Outcome Measures: The authors provide the lifetime and past-year occurrence of both psychiatric and substance disorders. Results: A compelling relationship is observed between physical disability and risk for the lifetime occurrence of both psychiatric and substance disorders and for the past-year occurrence of psychiatric disorders. Elevations in risk are greater for men than for women, for the young than for the old, and for persons of Hispanic heritage compared with African Americans and nonHispanic Whites. Conclusions: Physical disability appears to represent a dimension of stress that increases risk for the occurrence of psychiatric or substance disorders.

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