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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2004

Open Access 01-12-2004 | Research

Sad, blue, or depressed days, health behaviors and health-related quality of life, Behavioral Risk Factor Surveillance System, 1995–2000

Authors: Rosemarie Kobau, Marc A Safran, Matthew M Zack, David G Moriarty, Daniel Chapman

Published in: Health and Quality of Life Outcomes | Issue 1/2004

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Abstract

Background

Mood disorders are a major public health problem in the United States as well as globally. Less information exists however, about the health burden resulting from subsyndromal levels of depressive symptomatology, such as feeling sad, blue or depressed, among the general U.S. population.

Methods

As part of an optional Quality of Life survey module added to the U.S. Behavioral Risk Factor Surveillance System, between 1995–2000 a total of 166,564 BRFSS respondents answered the question, "During the past 30 days, for about how many days have you felt sad, blue, or depressed?" Means and 95% confidence intervals for sad, blue, depressed days (SBDD) and other health-related quality of life (HRQOL) measures were calculated using SUDAAN to account for the BRFSS's complex sample survey design.

Results

Respondents reported a mean of 3.0 (95% CI = 2.9–3.1) SBDD in the previous 30 days. Women (M = 3.5, 95% CI = 3.4–3.6) reported a higher number of SBDD than did men (M = 2.4, 95% CI = 2.2–2.5). Young adults aged 18–24 years reported the highest number of SBDD, whereas older adults aged 60–84 reported the fewest number. The gap in mean SBDD between men and women decreased with increasing age. SBDD was associated with an increased prevalence of behaviors risky to health, extremes of body mass index, less access to health care, and worse self-rated health status. Mean SBDD increased with progressively higher levels of physically unhealthy days, mentally unhealthy days, unhealthy days, activity limitation days, anxiety days, pain days, and sleepless days.

Conclusion

Use of this measure of sad, blue or depressed days along with other valid mental health measures and community indicators can help to assess the burden of mental distress among the U.S. population, identify subgroups with unmet mental health needs, inform the development of targeted interventions, and monitor changes in population levels of mental distress over time.
Literature
1.
2.
Jonas BS, Brody D, Roper M, Narrow WE: Prevalence of mood disorders in a national sample of young American adults. Soc Psychiatry Psychiatr Epidemiol 2003, 38: 618–624. 10.1007/s00127-003-0682-8PubMedCrossRef
3.
4.
Center for Mental Health Services: Mental Health, United States, 2002. DHHS Pub No. (SMA) 3938. Rockville, MD: Substance Abuse and Mental Health Services Administration (Edited by: Manderscheid RW, Henderson MJ). 2004, 92–104.
5.
Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen HU, Kendler KS: Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Arch Gen Psychiatry 1994, 51: 8–19.PubMedCrossRef
6.
7.
Robins L, Helzer JE, Croghan J, Williams JBW, Spitzer RL: NIMH Diagnostic Interview Schedule. Version III. Rockville, MD: National Institute of Mental Health 1981.
8.
American Psychiatric Association: Diagnostic and Statistical Manual, Third edition, revised. (DSM-III-R) Washington, DC: APA 1987.
9.
American Psychiatric Association: Diagnostic and Statistical Manual, Fourth edition, revised. (DSM-IV) Washington, DC: APA 1994.
10.
Roberts RE, Kaplan GA, Shema SJ, Strawbridge WJ: Prevalence and correlates of depression in an aging cohort: the Alameda County Study. J Gerontol B Psychol Sci Soc Sci 1997, 52B: S252-S258.CrossRef
11.
Murray JL, Lopez AD, Eds: Summary: The Global Burden of Disease. Boston: Harvard School of Public Health 1996.
12.
13.
Gaynes BN, Burns BJ, Tweed DL, Erickson P: Depression and health-related quality of life. J Nerv Ment Dis 2002, 190: 799–806. 10.1097/00005053-200212000-00001PubMedCrossRef
14.
Hybels CF, Blazer DG, Pieper CF: Toward a threshold for subthreshold depression: an analysis of correlates of depression by severity of symptoms using data from an elderly community sample. Gerontologist 2001, 41: 357–65.PubMedCrossRef
15.
Solomon A, Haaga DA, Arnow BA: Is clinical depression distinct from subthreshold depressive symptoms?: A review of the continuity issue in depression research. J Nerv Ment Dis 2001, 189: 498–506. 10.1097/00005053-200108000-00002PubMedCrossRef
16.
Weissman MM, Bruce ML, Leaf PJ, Florio LP, Holzer C: Affective Disorders. In Psychiatric Disorders in America: The Epidemiologic Catchment Area Study (Edited by: Robins LE, Regier DA). New York: The Free Press 1991, 53–80.
17.
Mechanic D: Is the prevalence of mental disorders a good measure of the need for services? Health Affairs 2003, 22: 8–20. 10.1377/hlthaff.22.5.8PubMedCrossRef
18.
19.
Cassano P, Fava M: Depression and public health: an overview. J of Psychosom Res 2002, 53: 849–57. 10.1016/S0022-3999(02)00304-5CrossRef
20.
Judd LL, Schettler PJ, Akiskal HS: The prevalence, clinical relevance, and public health significance of subthreshold depressions. Psychiatr Clin North Am 2002, 25: 685098.CrossRef
21.
22.
23.
Radloff L: The CES-D Scale: a self-report depression scale for research in the general population. Appl Psychol Measurement 1977, 1: 385–401.CrossRef
24.
Albert SM: Validation of BRFSS QOL Items: Harlem Prostate Screening Project. Atlanta: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion 1997.
25.
26.
National Heart, Lung and Blood Institute: Clinical Guidelines on the identification, evaluation, and treatment of obesity in adults Bethesda, MD: National Heart Lung, and Blood Institute 1998.
27.
Turner RJ, Wheaton B, Lloyd DA: The epidemiology of social stress. Am Socid Rev 1995, 60: 104–125.CrossRef
28.
Kuehner C: Gender differences in unipolar depression: an update of epidemiological findings and possible explanations. Acta Psychiatrica Scandinavica 2003, 108: 163–74. 10.1034/j.1600-0447.2003.00204.xPubMedCrossRef
29.
Blehar MC: Public health context of women's mental health research. Psychiatr Clin North Am 2003, 26: 781–799.PubMedCrossRef
30.
Sloan DM, Kornstein SG: Gender differences in depression and response to antidepressant treatment. Psychiatr Clin North Am 2003, 26: 581–594.PubMedCrossRef
31.
Steiner M, Dunn E, Born L: Hormones and mood: from menarche to menopause and beyond. J Affect Disord 2003, 74: 67–83. 10.1016/S0165-0327(02)00432-9PubMedCrossRef
32.
33.
Lorant V, Deliege D, Eaton W, Robert A, Philippot P, Ansseau M: Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol 2003, 157: 98–112. 10.1093/aje/kwf182PubMed
34.
Link BG, Lennon MC, Dohrenwen BP: Socioeconomic status and depression: The role of occupations involving direction, control, and planning. AJS 1993, 98: 1351–1387. 10.1086/230192
35.
Brown DW, Balluz LS, Ford ES, Giles WH, Strine TW, Moriarty DG, Croft JB, Mokdad AH: Associations between Short- and Long-Term Unemployment and Frequent Mental Distress among a National Sample of Men and Women. J Occup Environ Med 2003, 45: 1159–1166. 10.1097/01.jom.0000094994.09655.0fPubMedCrossRef
36.
Brown SL: The effect of union type on psychological well-being: Depression among cohabitors versus marrieds. J Health Soc Behav 2000, 41: 241–255.PubMedCrossRef
37.
Dunlop DD, Song J, Lyons JS, Manheim LM, Chang RW: Racial/ethnic differences in rates of depression among preretirement adults. Am J Public Health 2003, 93: 1945–1952.PubMedCentralPubMedCrossRef
38.
39.
Strine TW, Balluz LI, Chapman DP, Moriarty DG, Owens MG, Mokdad AH: Risk behaviors and health care coverage among adults by frequent mental distress status, 2001. Am J Prev Med 2004, 26: 213–216. 10.1016/j.amepre.2003.11.002PubMedCrossRef
40.
O'Koro CA, Mokdad AH, Brewer RD, Naimi TS, Moriarty DG, Giles WH: Binge drinking and health-related quality of life: Do popular perceptions match reality? Am J Prev Med 2004, 26: 230–232. 10.1016/j.amepre.2003.10.022CrossRef
41.
Ford ES, Moriarty DG, Zack MM, Mokdad AH, Chapman D: Self-reported body mass index and health-related quality of life: findings from the Behavioral Risk Factor Surveillance System. Obes Res 2001, 9: 21–31.PubMedCrossRef
42.
Brown DW, Balluz LS, Heath GW, Moriarty DG, Ford ES, Giles WH, Mokdad AH: Associations between recommended levels of physical activity and health-related quality of life–Findings from the 2001 Behavioral Risk Factor Surveillance System. Prev Med 2003, 37: 520–528. 10.1016/S0091-7435(03)00179-8PubMedCrossRef
43.
Stroebe W: Changing conceptions of health and illness: Social psychology and health Buckingham, Philadelphia: Open University Press 2000, 1–9.
44.
Murphy JM, Horton NJ, Monson RR, Laird NM, Sobol AM, Leighton AH: Cigarette smoking in relation to depression: Historical trends from the Stirling County study. Am J Psychiatry 2003, 160: 1663–1669. 10.1176/appi.ajp.160.9.1663PubMedCrossRef
45.
Bandura A: Perceived self-efficacy in health-promoting behavior. In Self-efficacy: The Exercise of Control 4 Edition New York: W.H. Freeman and Company 1997, 279–318.
Metadata
Title
Sad, blue, or depressed days, health behaviors and health-related quality of life, Behavioral Risk Factor Surveillance System, 1995–2000
Authors
Rosemarie Kobau
Marc A Safran
Matthew M Zack
David G Moriarty
Daniel Chapman
Publication date
01-12-2004
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2004
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-2-40

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