ArticleFrontiers in rehabilitation sciences2026
Associations between self-reported depression and functioning across ICF domains: a Danish population-based study.
Article in Frontiers in rehabilitation sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Depression is a major contributor to disability, yet clinical assessment and research have primarily focused on symptom severity. This study aims to examine associations between self-reported depression and functioning across the International Classification of Functioning, Disability and Health (ICF), while accounting for environmental and personal factors. Methods: The study analyzed self-reported data from the 2021 Danish "How are you?" survey. Guided by the ICF framework, associations between self-reported depression and functioning were analyzed using logistic regression in a stratified random sample of 48,936 adults aged 25 years and older. Results: Of the 28,101 respondents included, 3,060 (13%) reported symptoms indicative of depression. Across all ICF components, individuals with self-reported depression reported substantially more disability than those without depression. After adjustment for personal and environmental factors, depression (reference: no depression) remained strongly associated with impairments in body functions and structures, including poor sleep quality (OR 2.94, 95% CI 2.44-3.54), atypical sleep duration (OR 1.27, 95% CI 1.18-1.37), perceived stress (OR 9.75, 95% CI 8.12-11.72), life strain (OR 1.97, 95% CI 1.67-2.33), and loneliness (OR 2.93, 95% CI 2.43-3.52). Depression was also associated with activity limitations and participation restrictions, including requiring assistance with activities of daily living (OR 1.39, 95% CI 1.10-1.74), difficulty engaging with healthcare providers (OR 1.83, 95% CI 1.44-2.32), non-engagement in work or education (OR 1.40, 95% CI 1.10-1.79), and lack of community involvement (1.19, 95% CI 1.03-1.39). Conclusions: Self-reported depression was associated with widespread disability across psychological, social, and physical domains, underscoring its relevance as a condition with substantial disability. The findings support the utility of ICF for systematically capturing the multidimensional impact of depression at the population level, informing comprehensive assessment and rehabilitation-practice and research.
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