Frequency of depression and anxiety symptoms among adults with childhood- versus adult-onset disability

Abstract

Background: Individuals with disabilities experience high rates of depression and anxiety. Potential differences between those with childhood- versus adult-onset disability have not been adequately explored.

Objective: To examine the relationship between age of disability onset and frequency of reported depression and anxiety symptoms.

Design: Secondary data analysis.

Setting: 2020-2021 National Health Interview Survey (NHIS), a nationally representative survey of adults on illness and disability in the United States.

Participants: NHIS respondents aged 22-80 years with mobility, cognitive, or mobility + cognitive disability (n = 6386).

Interventions: Age of disability onset (childhood onset, defined as onset before age 22, per NHIS question, vs. adult onset) was our independent variable.

Main outcome measures: We calculated frequency of reported current depression and anxiety symptoms among those with childhood- versus adult-onset disability. Logistic regression was used to calculate the odds ratios (OR) of frequent versus infrequent depression and anxiety symptoms for childhood- versus adult-onset disability, adjusted for demographic factors.

Results: A higher percentage of participants with childhood- compared to adult-onset disability reported frequent depression symptoms (mobility: 32.7% vs. 21.9%, p < .01; cognitive: 55.6% vs. 44.5%, p < .01; mobility + cognitive: 71.4% vs. 52.8%, p < .01) and anxiety symptoms (mobility: 44.3% vs. 35.5%, p < .01; cognitive: 83.5% vs. 63.1%, p < .01; mobility + cognitive: 82.8% vs. 70.3%, p < .01). Participants with childhood-onset disability had higher adjusted odds of frequent depression symptoms for all disability types (mobility adjusted odds ratio [aOR], 1.58 [95% confidence interval (CI), 1.15-2.16]; cognitive aOR, 1.84 [95% CI, 1.12-3.02]; mobility + cognitive aOR, 2.06 [95% CI, 1.16-3.67]), and frequent anxiety symptoms for cognitive (aOR, 3.28 [95% CI, 1.92-5.60]) and mobility + cognitive disabilities (aOR, 2.01 [95% CI, 1.07-3.75]) compared to those with adult-onset disability.

Conclusion: Individuals with childhood-onset disabilities may be at uniquely higher risk for mental health symptoms than their peers with adult-onset disabilities, warranting specific attention to their health care and outcomes.