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      The comparative importance of mental and physical disorders for health-related days out of role in the general population of Saudi Arabia

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          Abstract

          Background

          A major component of illness burden is role impairment. As part of the recently-completed Saudi National Mental Health Survey (SNMHS), we compare the number of days out of role in the Saudi population associated with ten core mental disorders assessed in the survey to those associated with ten commonly occurring chronic physical disorders.

          Methods

          The SNMHS was a household survey that assessed prevalence of ten common anxiety, mood, disruptive behavior, and eating disorders in a nationally representative sample of n = 1981 citizens of the Kingdom of Saudi Arabia (KSA) ages 15–65. Comparison information was obtained on prevalence of ten common chronic physical disorders and number of health-related days out of role (DOR) in the 30 days before interview. Generalized linear models were used to examine univariate and multivariable associations of disorders with DOR and to calculate population attributable risk (PAR) separately and overall for the disorders controlling for socio-demographics.

          Results

          19.9% of respondents had one or more of the selected mental disorders and 47.1% had one or more of the selected physical disorders. Nine mental disorders and two physical disorders were associated with increased DOR. PAR was 32.9% for mental disorders, 27.0% for physical disorders, and 59.9% for both combined.

          Conclusions

          Mental disorders are associated with a substantial proportion of all health-related DOR in the Kingdom of Saudi Arabia. Programs to detect and treat mental disorders might lead to substantially decreased role impairment in the Kingdom.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12889-022-12721-z.

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          Most cited references65

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              Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health Surveys

              The DSM‐IV diagnoses generated by the fully structured lay‐administered Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) in the WHO World Mental Health (WMH) surveys were compared to diagnoses based on follow‐up interviews with the clinician‐administered non‐patient edition of the Structured Clinical Interview for DSM‐IV (SCID) in probability subsamples of the WMH surveys in France, Italy, Spain, and the US. CIDI cases were oversampled. The clinical reappraisal samples were weighted to adjust for this oversampling. Separate samples were assessed for lifetime and 12‐month prevalence. Moderate to good individual‐level CIDI‐SCID concordance was found for lifetime prevalence estimates of most disorders. The area under the ROC curve (AUC, a measure of classification accuracy that is not influenced by disorder prevalence) was 0.76 for the dichotomous classification of having any of the lifetime DSM‐IV anxiety, mood and substance disorders assessed in the surveys and in the range 0.62–0.93 for individual disorders, with an inter‐quartile range (IQR) of 0.71–0.86. Concordance increased when CIDI symptom‐level data were added to predict SCID diagnoses in logistic regression equations. AUC for individual disorders in these equations was in the range 0.74–0.99, with an IQR of 0.87–0.96. CIDI lifetime prevalence estimates were generally conservative relative to SCID estimates. CIDI‐SCID concordance for 12‐month prevalence estimates could be studied powerfully only for two disorder classes, any anxiety disorder (AUC = 0.88) and any mood disorder (AUC = 0.83). As with lifetime prevalence, 12‐month concordance improved when CIDI symptom‐level data were added to predict SCID diagnoses. CIDI 12‐month prevalence estimates were unbiased relative to SCID estimates. The validity of the CIDI is likely to be under‐estimated in these comparisons due to the fact that the reliability of the SCID diagnoses, which is presumably less than perfect, sets a ceiling on maximum CIDI‐SCID concordance. Copyright © 2006 John Wiley & Sons, Ltd.
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                Author and article information

                Contributors
                kessler@hcp.med.harvard.edu
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                12 February 2022
                12 February 2022
                2022
                : 22
                : 289
                Affiliations
                [1 ]GRID grid.415310.2, ISNI 0000 0001 2191 4301, Biostatistics, Epidemiology and Scientific Computing Department, , King Faisal Specialist Hospital and Research Centre, ; Riyadh, Saudi Arabia
                [2 ]GRID grid.512466.2, ISNI 0000 0005 0272 3787, King Salman Center for Disability Research, ; Riyadh, Saudi Arabia
                [3 ]GRID grid.56302.32, ISNI 0000 0004 1773 5396, SABIC Psychological Health Research & Applications Chair (SPHRAC), , College of Medicine, King Saud University, ; Riyadh, Saudi Arabia
                [4 ]GRID grid.38142.3c, ISNI 000000041936754X, Department of Health Care Policy, , Harvard Medical School, ; 180 Longwood Avenue, Boston, MA 02115 USA
                [5 ]Edrak Medical Center, Riyadh, Saudi Arabia
                [6 ]GRID grid.415280.a, ISNI 0000 0004 0402 3867, Mental Health Department, , King Fahad Specialist Hospital-Dammam, ; Dammam, Saudi Arabia
                [7 ]GRID grid.415696.9, ISNI 0000 0004 0573 9824, Vision Realization Office, , Ministry of Health, ; Riyadh, Saudi Arabia
                [8 ]GRID grid.415696.9, ISNI 0000 0004 0573 9824, National Center for Mental Health Promotion, , Ministry of Health, ; Riyadh, Saudi Arabia
                [9 ]GRID grid.3575.4, ISNI 0000000121633745, Department of Information, Evidence, and Research, , World Health Organization, ; Geneva, Switzerland
                Article
                12721
                10.1186/s12889-022-12721-z
                8840674
                35151288
                2a22a763-b3be-4d23-821d-17d43823de02
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 8 July 2021
                : 3 February 2022
                Categories
                Research
                Custom metadata
                © The Author(s) 2022

                Public health
                saudi arabia,mental disorder,physical disorders,days out of role,impairment,saudi national mental health survey (snmhs)

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