Meta-Analysis: The Effects of Depression and Anxiety on the Quality of Life of People with Disability

Iffah Nurhayati, Bhisma Murti, Hanung Prasetya


Background: A person with a disability is a person who has (suffers) a disability/ limitations in the structure and function of the body which can cause problems in their life. Environmental conditions (physical, biological and social) that are not disability-friendly will have an impact on mental problems and the most common are depression and anxiety. Depression and anxiety have an important influence on the health conditions and quality of life of persons with disabilities. The purpose of this study was to analyze the effect of depression on the quality of life of persons with disabilities and to analyze the effect of anxiety on the quality of life of persons with disabilities.

Subjects and Method: The meta-analysis was carried out by systematically reviewing the same number of articles from PubMed, Science Direct, and Google Scholar. This is done using the search keywords “anxiety” AND “depression” AND “quality of life” AND “disability” AND “multivariate analysis”. The population in this study were persons with disabilities. The interventions given were anxiety and depression, while the comparison was not anxious and not depressed. The outcome of the study was quality of life. The article used is a full text article with an observational study design that reports the value of the Adjusted Odds Ratio (aOR). Articles were collected using PRISMA flowcharts and analyzed using the Review Manager 5.3 application with random effect models.

Results: Meta-analysis in 8 cross-sectional studies of depression can reduce 0.79 times the quality of life of persons with disabilities (aOR= 0.79; 95% CI= 0.69-0.92; p= 0.002) and in 3 cohort studies depression decreased 0.61 times the quality of life of persons with disabilities (aOR= 0.61; 95% CI= 0.30-1.22; p= 0.16). Meta-ana¬lysis in 8 cross-sectional studies, anxiety decreased 0.70 times the quality of life of persons with disabilities (aOR= 0.70; 95% CI= 0.60; p<0.001) and in 5 cohort studies anxiety decreased 0.84 times (aOR= 0.84; 95% CI= 0.68-1.04; p= 0.12).

Conclusion: Depression and anxiety have an effect on decreasing the quality of life of persons with disabilities.

Keywords: Anxiety, depression, quality of life, disability, multivariate analysis

Correspondence: Iffah Nurhayati, Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: Mobile-phone: 085742202990.

Journal of Maternal and Child Health (2021), 06(03): 267-284

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Bagshaw SM, Stelfox T, Johnson JA, McDermid RC, Rolfson DB, PhamD T, Ibrahim Q, Majumdar SR (2015). Longterm association between frailty and health-related quality of life among survivors of critical illness: a prospective multicenter cohort study. Crit Care Med, 43 (5): 973-983. DOI: 10.1097/CCM.0000000000000860.

Cahyono SAT (2017). Penyandang disabilitas: menelisik layanan rehabilitasi sosial difabel pada keluarga miskin (Persons with disabilities: researching disabled social rehabilitation services for poor families). Media Informasi Penelitian Kesejahteraan Sosial, 41 (3): 239–254. DOI: 10.31105/mipks.v41i3.2257.

Davillas A, Pudney S (2019). Biomarkers as precursors of disability. Econ Hum Biol, 36: 10. DOI: 10.1016/j.ehb.2019.100814.

Economic and Social Commission for Asia and the Pacific (ESCAP) United Nati-ons Building (2016). Disability at a glance 2015 strengthening employment prospects for persons with disabilities in Asia and the Pacific. ESCAP United Nations Publication. Thailand.

Effendi AB, Yunianto R (2017). Implementasi diversity program bagi tenaga kerja penyandang disabilitas pada PT. Wangta Agung Kota Surabaya (Implementation of the diversity program for workers with disabilities at PT. Wangta Agung City of Surabaya). Indones J Disabil Stud, 4(2): 6–103. DOI: 10.21776/ub.ijds.2017.004.02.2.

Halimi L, Marin G, Molinari N, Gamez AS, Boissin C, Suehs CM, Vachier I, Bour-din A (2018). J Psychosom Res, 105: 45-51. DOI: 10.1016/j.jpsychores.201-7.12.003.

Hanjarwati A, Suprihatiningrum J, Aminah S (2019). Persepsi penyandang disabilitas dan stakeholder untuk mempromosikan dan mengembangkan komunitas inklusif di DIY Dan Asia Tenggara (Perceptions of persons with disabilities and stakeholders to promote and develop inclusive communities in DIY And Southeast Asia). J Sos Ref, 13(2): 379. DOI: 10.14421/jsr.v13i12.1625.

Lee MK (2016). Disability and quality of life in community-dwelling elderly cancer survivors: Case-control study in the Korean population. Eur J Oncol Nurs, 24, 22-28. DOI: 10.1016/j.ejon.2016.08.003.

Lenze EJ, Rogers JC, Martire LM, Mulsant BH, Rollman BL, Dew MA, Schulz R, Reynolds CF (2001). The association of late-life depression and anxiety with physical disability: A review of the literature and prospectus for future research. Am J Geriatr Psychiatry, 9(2): 113–135. DOI: 10.1097/-00019442-200105000-00004

Lim NCS, Fan CHJ, Yong MKH, Wong EPY, Yip LWY (2016). Assessment of depression, anxiety, and quality of life in Singaporean patients with glaucoma. J Glaucoma, 25(7): 605-612. DOI: 10.1097/IJG.0000000000000-393.

Marthoenis, Syukri M, Abdullah, Tandi TMR, Putra N, Laura H, Setiawan A, Sofyam H, Schouler-Ocak M (2021). Quality of life, depression, and anxiety of patients undergoing hemodialysis: Significant role of acceptance of the illness. Int J Psychiatr Med, 56(1): 40-50. DOI: 10.1177/0091217420913382.

Mehbub AAHM, Astell-Burt T, Feng X (2019). Does social capital and a healthier lifestyle increase mental health resilience to disability acquisition? Groupbased discrete trajectory mixture models of pre-post longitudinal data. Soc Sci Med, 235. DOI: 10.1016/j.socscimed.2019.01.045

Moon YS, Kim SJ, Kim HC, Won MH, Kim DH. (2004). Correlates of quality of life after stroke. J Neurosci, 224 (1-2): 37-41. DOI: 10.1016/j.jns.2004.05.0-18.

Murti B (2020). Prinsip Meta-Analisis. Workshop Online Program Magister Ilmu Kesehatan Masyarakat, Program Pascasarjana, Universitas Sebelas Maret (Principles of Meta-Analysis. Online Workshop for Masters Program in Public Health Sciences, Post-graduate Program, Universitas Sebelas Maret).

Nas K, Sarac AJ, Gur A, Cevik R, Altay Z, Erdal A, Ersoy Y, et al. (2011). Psychological status is associated with health-related quality of life in patients with rheumatoid arthritis. J Back and Musculoskelet Rehabil, 24 (2): 95–100. DOI: 10.3233/BMR-2011-0281.

Nguyen C, Ranque B, Baubet T, Bérezné A, Mestre-Stanislas C, Rannou F, Papelard A, et al. (2014). Clinical, functional and health-related quality of life correlates of clinically significant symptoms of anxiety and depression in patients with systemic sclerosis: A cross-sectional survey. PLoS ONE, 9(2). DOI: 10.1371/journal.pone.009-0484.

O’Donnell ML, Creamer MC, Mc Farlane M, Silove D, Bryant R (2010). Does access to compensation have an impact on recovery outcomes after injury?. Med J Aust, 192 (6): 328-333. DOI: 10.5694/j.1326-5377.2010.tb03532.x.

Pan JH, Song XY, Lee SY, Kwok T. (2008). Longitudinal analysis of quality of life for stroke survivors using latent curve models. J Stroke, 39 (10): 2795-2802. DOI: 10.1161/STROKEAHA.108.515-460.

Raju RS, Sarma PS, Pandian JD (2010). Psychosocial problems, quality of life, and functional independence among Indian stroke survivors. J Stroke, 41 (12): 2932–2937. DOI: 10.1161/STR-OKEAHA.110.596817

Risal A, Manandhar K, Linde M, Steiner TJ, Holen A (2016). Anxiety and depression in Nepal: Prevalence, comorbidity and associations. BMC Psychiatry, 16 (1): 1-9. DOI: 0.1186/s12888-016-0810-0.

Saboya PMHP, Zimmermann PR, Bodanes LC (2010). Association between anxiety or depressive symptoms and arterial hypertension, and their impact on the quality of life. Int J Psychiatr Med, 40 (3): 307-320. DOI: 10.2190/PM.40.3.f.

Scalone L, Mantovani LG, Mannucci PM, Gringeri A. (2006). Quality of life is associated to the orthopaedic status in haemophilic patients with inhibitors. Haemophilia, 12 (2), 154-162. DOI: 10.1111/j.1365-2516.2006.01204.x.

Solomon R, Kirwin P, Van Ness PH, O’Leary J, Fried TR (2010). Trajecto-ries of quality of life in older persons with advanced illness. J Am Geriatr Soc, 58 (5): 837-843. DOI: 10.1111/j.1532-5415.2010.02817.x.

Ulusoy EK, Bolattürk ÖF (2020). The effect of greater occipital nerve blockade on the quality of life, disability and co-morbid depression, anxiety, and sleep disturbance in patients with chronic migraine. Neurol Sci, 41 (7): 1829–1835. DOI: 10.1007/s10072-020-042-86-9.

Woon LSC, Sidi HB, Ravindran A, Gosse PJ, Mainland RL, Kaunisman ES, Hatta NH, Zulkifli AY, Mustafa N (2020). Depression, anxiety, and associated factors in patients with diabetes: Evidence from the anxiety, depression, and personality traits in diabetes mellitus (ADAPT-DM) study. BMC Psychiatry, 20(1): 1-14. DOI: 10.1186/s12888-020-02615-y.

World Health Organization (2011). World Report on Disability. DOI:, accessed October 2020.

Zakiei A, Kiani N, Morovati F, Komasi S (2018). Classification of various types of disability and determining their predictive causes in western Iran. Clin Epidemiol Glob Health, S2213-3984 (18): 30276-8. DOI: 10.1016/j.cegh.2018.11.003.


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