Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2006 Aug;21(8):818-22.
doi: 10.1111/j.1525-1497.2006.00533.x.

Impact of health literacy on depressive symptoms and mental health-related: quality of life among adults with addiction

Alisa Lincoln  1 , Michael K Paasche-Orlow, Debbie M Cheng, Christine Lloyd-Travaglini, Christine Caruso, Richard Saitz, Jeffrey H Samet
Affiliations
Randomized Controlled Trial

Impact of health literacy on depressive symptoms and mental health-related: quality of life among adults with addiction

Alisa Lincoln et al. J Gen Intern Med. 2006 Aug.

Abstract

Background: Health literacy has been linked to health status in a variety of chronic diseases. However, evidence for a relationship between health literacy and mental health outcomes is sparse.

Objective: We hypothesized that low literacy would be associated with higher addiction severity, higher levels of depressive symptoms, and worse mental health functioning compared with those with higher literacy in adults with alcohol and drug dependence.

Methods: The association of literacy with multiple mental health outcomes was assessed using multivariable analyses. Measurement instruments included the Rapid Estimate of Adult Literacy in Medicine (REALM), the Center for Epidemiologic Studies-Depression (CES-D) scale, the Mental Component Summary scale of the Short Form Health Survey, and the Addiction Severity Index for drug and alcohol addiction. Subjects included 380 adults recruited during detoxification treatment and followed prospectively at 6-month intervals for 2 years. Based on the REALM, subjects were classified as having either low (< or = 8th grade) or higher (> or = 9th grade) literacy levels.

Results: In longitudinal analyses, low literacy was associated with more depressive symptoms. The adjusted mean difference in CES-D scores between low and high literacy levels was 4 (P<.01). Literacy was not significantly associated with mental health-related quality of life or addiction severity.

Conclusions: In people with alcohol and drug dependence, low literacy is associated with worse depressive symptoms. The mechanisms underlying the relationship between literacy and mental health outcomes should be explored to inform future intervention efforts.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Selection of study subjects.
FIGURE 2
FIGURE 2
Literacy and depressive symptoms across time.
See this image and copyright information in PMC

References

    1. Kefalides PT. Illiteracy: the silent barrier to health care. Ann Intern Med. 1999;130:333–6. - PubMed
    1. Nielsen-Bohlman LT, Panzer AM, Hamlin B, et al. Health Literacy: A Prescription to End Confusion. Committee on Health Literacy, Board on Neuroscience and Behavioral Health. Washington, DC: National Academies Press; 2004. - PubMed
    1. Paasche-Orlow MK, Parker RM, Gazmararian JA, et al. The prevalence of limited health literacy. J Gen Intern Med. 2005;20:175–84. - PMC - PubMed
    1. DeWalt DA, Berkman ND, Sheridan S, et al. Literacy and health outcomes: a systematic review of the literature. J Gen Intern Med. 2004;19:1228–39. - PMC - PubMed
    1. Baker DW, Parker RM, Williams MV, et al. Health literacy and the risk of hospital admission. J Gen Intern Med. 1998;13:791–8. - PMC - PubMed

Publication types