Risk of depressive and anxiety disorders in young adults with disabilities: a nationwide cohort study in South Korea.

BACKGROUND

Although often associated with ageing, disability is becoming increasingly prevalent among young adults. While disability can pose a substantial psychological burden for young adults on critical pathways to establish the foundations for their future, the mental health risks faced by this population remain underexplored.

AIMS: This study aimed to (1) assess the association between disability - including its presence, severity and type - and the risk of depressive and anxiety disorders, and (2) examine whether this association varies across sociodemographic factors, health behaviours and comorbidities in a young adult population.

METHODS

We conducted a population-based cohort study using linked data from the National Disability Registry and the National Health Insurance Database of South Korea. A total of 6,058,290 individuals aged 20-39 years who underwent health check-ups between 2009 and 2012 were followed through 2022. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for depressive and anxiety disorders.

RESULTS

Individuals with disabilities had significantly higher risks of depressive (aHR: 1.58, 95% CI: 1.55-1.60) and anxiety disorders (aHR: 1.50, 95% CI: 1.42-1.59). Increased risks were consistently observed across various disability types with the highest risk observed for mental health-related disabilities in depression (aHR: 4.98, 95% CI 4.62-5.37) and epilepsy-related disabilities in anxiety disorders (aHR: 12.05, 95% CI 8.73-16.63). Subgroup analyses revealed stronger associations among individuals in their 20s, low-income groups, non-smokers and those abstaining from alcohol, compared to their respective counterparts.

CONCLUSIONS

Young adults with disabilities, a population that has been relatively overlooked in policy discussions, warrant greater policy attention in relation to their mental health.