The mental health of Australians 2

4.3 Impact of affective disorders

Page last updated: May 2009

In general, people with affective disorders were more likely than people with anxiety or substance use disorders to experience greater levels of impairment due to their mental disorders. Impairment can be measured in a number of ways, some of which are outlined below.

4.3.1 Days out of role
4.3.2 Interference with life
4.3.3 Psychological distress

4.3.1 Days out of role

People with affective disorders reported 6.2 days out of role in the previous 30 days. The average number of days that people were not able to carry out their normal activities for each type of affective disorder is presented in Table 4-3.

Dysthymia was associated with the highest number of days out of role with an average of 9.7 days out of role in the previous 30 days.

Table 4-3: Days out of role by type of 12-month affective disorder

Disorder

Days out of role in previous 30 days (mean)

Depressive episode
6.4
Dysthymia
9.7
Bipolar affective disorder
5.3
Any affective disorder
6.2

Note: Total is lower than the sum of disorders as people may have had more than one type of affective disorder.

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4.3.2 Interference with life

Mental disorders can impact on all aspects of people's lives. The Sheehan Disability Scales included in the survey assessed interference with life across four domains, namely home responsibilities, work or study, close relationships and social life. Table 4-4 shows the proportion of people with each type of affective disorder who reported severe or very severe interference in each of these four domains.

People with depressive episode and dysthymia experienced the highest levels of interference across all domains of life (71.8% and 71.1%). Social life was most affected, with over half of people with depressive episode and with dysthymia experiencing severe or very severe interference in this domain (54.2% and 54.0% respectively). Interference with home life was also very high for those with dysthymia (51.3%).

Table 4-4: Proportion of people with severe or very severe interference across different life domains by type of 12-month affective disorder

Disorder

Home
(%)

Work or study
(%)

Close relationships (%)

Social life
(%)

Any domain
(%)

Depressive episode
37.4
40.3
39.9
54.2
71.8
Dysthymia
51.3
33.2
42.7
54.0
71.1
Bipolar affective disorder
28.0
23.2
27.5
29.4
41.4

Note: Any domain is lower than the sum of individual domains as people may have experienced severe or very severe interference in more than one life domain.

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4.3.3 Psychological distress

Psychological distress was measured using the Kessler 10 scale (K10). The proportion of people with each type of affective disorder reporting each of the four levels of psychological distress, as scored on the K10, is presented in Table 4-5.

High to very high levels of psychological distress were reported by two thirds (66.5%) of people with dysthymia. Levels of psychological distress were very similar for people with depressive episode and bipolar affective disorder, with high to very high levels reported by 52.1% and 51.9% of people with these mental disorders respectively.

Table 4-5: Proportion of people with each psychological distress (K10) level by type of 12-month affective disorder

Disorder

Low (%)

Moderate (%)

High (%)

Very high (%)

Depressive episode
19.7
28.2
29.8
22.3
Dysthymia
9.8
23.7
39.5
27.0
Bipolar affective disorder
17.1
31.0
29.7
22.2
Any affective disorder
19.3
28.6
29.9
22.2
Note: Totals are lower than the sum of disorders as people may have had more than one type of affective disorder.