Common mental disorders and physical diseases account for a large proportion of the number of days out of role, with depressive disorder and chronic pain being the main mental disorder and physical disease associated with role impairment, respectively.
Key Findings
Results
The weighted rate of role impairment was 3.68% in patients with any mental disorders and 8.75% in those with any physical diseases.
Data came from the China Mental Health Survey (CMHS), a cross-sectional nationally representative study conducted from 2012 to 2015.
28,140 respondents participated in face-to-face interviews using the Composite International Diagnostic Interview-3.0 (CIDI-3.0).
Role impairment was defined as days in the past month being totally or partially unable to work or carry out normal daily activities due to mental disorders or physical diseases.
The rate of role impairment was more than twice as high among those with physical diseases (8.75%) compared to those with mental disorders (3.68%).
Results
Depressive disorder was the main mental disorder associated with role impairment.
Depressive disorder showed a statistically significant association with role impairment (β = 0.12, P <0.001).
This was the strongest association among mental disorders examined in the study.
Associations were analyzed using multiple regression controlling for other conditions.
Results
Chronic pain was the main physical disease associated with role impairment.
Chronic pain showed a statistically significant association with role impairment (β = 0.07, P <0.001).
This was the strongest association among physical diseases examined in the study.
Chronic pain's association with role impairment was identified after multiple regression analysis.
Results
Patients with more mental disorders or physical diseases experienced more days with role impairment.
A dose-response relationship was observed between the number of conditions (mental or physical) and days of role impairment.
This pattern held for both mental disorders and physical diseases separately.
The finding suggests cumulative burden of comorbid conditions on functional capacity.
Conclusions
Common mental disorders and physical diseases account for a large proportion of the number of days out of role in China.
The study used a large-scale nationally representative sample of 28,140 respondents across China.
Both mental and physical health conditions contributed substantially to days lost from normal functioning.
The authors concluded that the level of mental health in China should be substantially increased to address this burden.
The study design was cross-sectional, limiting causal inference.
What This Means
This research used data from a large national survey of over 28,000 people across China (collected 2012–2015) to examine how mental disorders and physical diseases affect people's ability to carry out their normal daily activities, including work. The researchers found that about 3.7% of people with any mental disorder and about 8.8% of people with any physical disease reported being unable to fully participate in their normal roles during the past month. Depression was the mental health condition most strongly linked to this kind of impairment, while chronic pain was the physical condition most strongly linked to it. People with multiple mental or physical health conditions tended to lose more days of normal functioning than those with just one condition.
This research suggests that both mental and physical health conditions impose a significant burden on people's daily functioning in China, and that depression and chronic pain deserve particular attention as major contributors to lost productivity and activity. The more conditions a person has, the worse the impact appears to be, highlighting the importance of addressing comorbid (co-occurring) health problems. The authors emphasize that there is a need to substantially improve mental health care and awareness in China to reduce this societal burden.
It is important to note that because this was a cross-sectional study (a snapshot in time), it cannot establish whether the health conditions directly caused the role impairment or whether other factors may be involved. Nevertheless, the findings provide valuable population-level evidence about the scope of functional disability associated with common mental and physical health conditions in China.
Muhai J, Liu Z, Zhang T, Ding R, Li T, Xu G, et al.. (2026). Role impairment of patients with mental disorders and physical diseases in China: Results from the China Mental Health Survey.. Chinese medical journal. https://doi.org/10.1097/CM9.0000000000004060