Many sick days are taken for mental health

Mental disorders account for about one-third of all sick days,roughly equal to those caused by back pain, according to the mostcomprehensive report yet on the effect of illness on disability.

Adult Americans with depression, anxiety or other psychologicaldisorders annually miss 1.3 billion days of work, school or otherdaily activity, according to a report published Tuesday in theArchives of General Psychiatry. Back and neck pain cause sufferersto miss 1.2 billion days.

Mental disorders had a bigger effect than expected, researcherssaid, yet they often are left unrecognized and untreated.

"If we treated the mental disorders, we could wipe out a lot ofthe impairment," said senior author Ronald C. Kessler, a professorof health-care policy at Harvard Medical School.

Lead author Kathleen Merikangas, an epidemiologist with theNational Institute of Mental Health, said more funds should beallocated to the study and treatment of musculoskeletal conditionsand depression and psychiatric disorders.

"It is ironic we spend the least on musculoskeletal disorders anddepression when they have the most impact on people's lives anddisability," she said. The study was based on the NationalComorbidity Survey Replication, a nationwide survey of 9,282 peopleover age 18 that was sponsored by the National Institute of MentalHealth.

Participants reported the number of days they had been completelyunable to work or carry out normal activities within the previousmonth. They also said which of 30 mental and physical conditions,including such illnesses as cancer and heart disease, they had hadduring the past year.

Transient illnesses, such as influenza, were not included.

Taken together, all chronic conditions, including cancer, heartattack, ulcer and vision loss, sideline adults for a total of 3.7billion days a year, researchers said.

Researchers found that more than half of American adults havechronic health conditions. Some go to work every day, while othersare severely impaired and no longer work. The study found that thosewith chronic conditions take an average of 32 sick days a year.

Among mental disorders, depression accounted for the most sickdays, at 387 million. Others reasons included: social phobia, at 214million days; post-traumatic stress disorder, 113 million;generalized anxiety disorder, 110 million; bipolar disorder, 103million; panic disorders, 101 million; substance abuse, 93 million;agoraphobia, 37 million; and separation anxiety disorder, 20million.

Besides back and neck pain, other physical conditions that led tomissed days at work included arthritis, at 375 million days, andstroke, at 221 million days.

Cancer patients missed a total of 71.5 million days, and heartattack victims 204 million days. Although the diseases aredevastating, cancer and heart attacks accounted for a relatively lownumber of lost workdays.

Kessler explained that the diseases tend to strike older adults.In addition, cancer often does not affect the ability of people tofunction from day to day as much as back pain or depression.