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Quality of life in obsessive compulsive disorder

Published online by Cambridge University Press:  02 January 2013

Alexandra S. Macy ,
Jonathan N. Theo ,
Sonia C. V. Kaufmann ,
Rassil B. Ghazzaoui ,
Paul A. Pawlowski ,
Hala I. Fakhry ,
Brian J. Cassmassi  and
Waguih William IsHak
Alexandra S. Macy
Affiliation:
Department of Psychiatry at David Geffen School of Medicine at the University of California–Los Angeles, Los Angeles, California, USA
Jonathan N. Theo
Affiliation:
Department of Psychiatry at Cedars-Sinai Medical Center, and University of California–Los Angeles, Los Angeles, California, USA
Sonia C. V. Kaufmann
Affiliation:
Pacific Hospital of Long Beach, Long Beach, California, USA
Rassil B. Ghazzaoui
Affiliation:
Department of Psychology, American University in Beirut, Beirut, Lebanon, and Columbia University, New York, New York, USA
Paul A. Pawlowski
Affiliation:
Department of Psychiatry at Cedars-Sinai Medical Center, and Keck School of Medicine at University of Southern California, Los Angeles, California, USA
Hala I. Fakhry
Affiliation:
Faculty of Medicine, Cairo University, Cairo, Egypt
Brian J. Cassmassi
Affiliation:
Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
Waguih William IsHak*
Affiliation:
Department of Psychiatry at Cedars-Sinai Medical Center, and University of California–Los Angeles, Los Angeles, California, USA
*
Address for correspondence: Waguih William IsHak, MD, FAPA, Director, Psychiatry Residency Training Program; Director, Medical Student Education in Psychiatry; Consultant Psychiatrist, Consultation-Liaison Psychiatry Service at Cedars-Sinai Medical Center (CSMC); and Associate Clinical Professor of Psychiatry at UCLA and Cedars-Sinai Medical Center, 8730 Alden Drive, Thalians W-157, Los Angeles, CA 90048, USA. Email Waguih.Ishak@cshs.org
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Abstract

Obsessive-compulsive disorder (OCD) has a profound impact with a high disease burden. In order to truly understand the scope of the effect OCD has on the patient population, one must take into account not only the relentless symptoms beleaguering the patients but also examine their overall ability to enjoy their life. Quality of life (QOL) assessments/improvements are becoming an increasingly important component of healthcare, especially in the mental health field. This review examines QOL in OCD, as well as the influence of comorbidities, and the impact that OCD treatment has on QOL. We searched MEDLINE/PUBMED and PsycINFO databases from 1980–2011 using keywords “obsessive compulsive disorder” OR “OCD” AND “quality of life” OR “QOL.” Fifty-eight studies meeting specific selection criteria were ultimately included in this review. The results show that QOL in OCD is significantly impaired when compared to QOL in the general population and in patients with other psychiatric and medical disorders. Likewise, QOL in OCD also appears to be largely affected by comorbid conditions, which should be taken into account when developing a treatment plan. Furthermore, QOL in OCD has been shown to improve with medications and with both individual and group psychotherapy, albeit not to the levels enjoyed by community norms. QOL assessment in both clinical and research settings is important to examine the disease burden, to monitor treatment effectiveness, and to determine full recovery from OCD. Treatment providers should strive to not only reach symptom abatement, but also to assure that patients have regained satisfaction and functioning in their daily lives.

Keywords

Health-related quality of lifeobsessive compulsive disorderCBTpharmacotherapyquality of life

Information

Type
Review Article
Information
CNS Spectrums , Volume 18 , Issue 1 , February 2013 , pp. 21 - 33
Copyright
Copyright © Cambridge University Press 2012

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References

1.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, (revised 4th ed.). Washington DC: American Psychiatric Publishing; 2000.Google Scholar
2.Karno, M, Golding, JM, Sorenson, SB, Burnam, A. The epidemiology of obsessive-compulsive disorder. Am J Psychiatry. 1988; 45: 1094–1099.Google ScholarPubMed
3.World Health Organization Regional Office for the Eastern Mediterranean. The newly defined burden of mental problems. East Mediterr Health J. 1999; 5(2): 394–401.Google Scholar
4.Stein, MB, Forde, DR, Anderson, G, Walkder, JR. Obsessive-compulsive disorder in the community: An epidemiologic survey with clinical reappraisal. Am J Psychiatry. 1997; 154(8): 1120–1126.Google ScholarPubMed
5.Angst, J, Gamma, A, Endrass, J, etal. Obsessive-compulsive severity spectrum in the community: prevalence, comorbidity, and course. Eur Arch Psychiatry Clin Neurosci. 2004; 254: 156–164.CrossRefGoogle ScholarPubMed
6.IsHak, WW, Greenberg, JM, Balayan, K, etal. Quality of life: the ultimate outcome measure of interventions in major depressive disorder. Harv Rev Psychiatry. 2011; 19(5): 229–239.CrossRefGoogle ScholarPubMed
7. The WHOQOL Group. Measuring Quality of Life. 1997. Retrieved July 29, 2011. Geneva: World Health Organization(WHO/MSA/MNH/PSF/97.4). Available from http://www.who.int/mental_health/media/68.pdf.Google Scholar
8.Ware, JE. SF-36 Health Survey: Manual and Interpretation Guide. Boston: Nimrod Press; 1993.Google Scholar
9.Orley, J, Saxena, S, Herrman, H. Quality of life and mental illness: Reflections from the perspective of the WHOQOL. Br J Psychiatry. 1998; 172: 291–293.CrossRefGoogle ScholarPubMed
10.The WHOQOL Group. The World Health Organization Quality of Life Assessment (WHOQOL): development and general psychometric properties. Soc Sci Med. 1998; 46(12): 1569–1585.CrossRefGoogle Scholar
11.The WHOQOL Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med. 1998; 28(3): 551–558.CrossRefGoogle Scholar
12.Endicott, J, Nee, J, Harrison, W, Blumenthal, R. Quality of Life Enjoyment and Satisfaction Questionnaire: a new measure. Psychopharmacol Bull. 1993; 29(2): 321–326.Google ScholarPubMed
13.McHorney, CA, Ware, JE Jr, Raczek, AE. The MOS 36-Item Short-Form Health Survey (SF-36): II. psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care. 1993; 31(3): 247–263.CrossRefGoogle ScholarPubMed
14.The WHOQOL Group. The World Health Organization quality of life assessment: WHOQOL position paper from the World Health Organization. Soc Sci Med. 1995; 41(10): 1403–1409.CrossRefGoogle Scholar
15.Saxena, S, Orley, J. Quality of life assessment: the World Health Organization perspective. Eur Psychiatry. 1997; 12(S3): 263–266.CrossRefGoogle ScholarPubMed
16.Rapaport, MH, Clary, C, Fayyad, R, Endicott, J. Quality-of-life impairment in depressive and anxiety disorders. Am J Psychiatry. 2005; 162: 1171–1178.CrossRefGoogle ScholarPubMed
17.Bobes, J, Gonzalez, MP, Bascaran, MT, etal. Quality of life and disability in patients with obsessive-compulsive disorder. Eur Psychiatry. 2001; 16: 239–245.CrossRefGoogle ScholarPubMed
18.Quilty, LC, Van Ameringen, M, Mancini, C, Oakman, J, Farvolden, P. Quality of life and the anxiety disorders. J Anxiety Disord. 2003; 17: 405–426.CrossRefGoogle ScholarPubMed
19.Moritz, G, Rufer, M, Fricke, S, etal. Quality of life in obsessive-compulsive disorder before and after treatment. Compr Psychiatry. 2005; 46(6): 453–459.CrossRefGoogle ScholarPubMed
20.Stengler-Wenze, K, Kroll, M, Riedel-Heller, S, Matschinger, H, Angermeyer, MC. Quality of life in obsessive-compulsive disorder: the different impact of obsessions and compulsions. Psychopathology. 2007; 40: 282–289.CrossRefGoogle Scholar
21.Gururaj, G, Math, S, Reddy, JYC, Chandrashekar, C. Family burden, quality of life and disability in obsessive compulsive disorder: an Indian perspective. J Postgrad Med. 2008; 54(2): 91–96.Google ScholarPubMed
22.Eisen, JL, Mancebo, MA, Pinto, A, etal. Impact of obsessive-compulsive disorder on quality of life. Compr Psychiatry. 2006; 47: 270–275.CrossRefGoogle ScholarPubMed
23.Markarian, Y, Larson, MJ, Aldea, MA, etal. Multiple pathways to functional impairment in obsessive-compulsive disorder. Clin Psychol Rev. 2010; 30(1): 78–88.CrossRefGoogle ScholarPubMed
24.Moritz, S, Meier, B, Hand, I, Schick, M, Jahn, H. Dimensional structure of the Hamilton Depression Rating Scale in patients with obsessive-compulsive disorder. Psychiatry Res. 2004; 125: 71–180.CrossRefGoogle ScholarPubMed
25.Huppert, JD, Simpson, HB, Nissenson, KJ, Liebowitz, MR, Foa, EB. Quality of life and functional impairment in obsessive-compulsive disorder: a comparison of patients with and without co-morbidity, patients in remission and healthy controls. Depress Anxiety. 2009; 26: 39–45.CrossRefGoogle ScholarPubMed
26.Cassin, SE, Richter, MA, Zhang, KA, Rector, NA. Quality of life in treatment-seeking patients with obsessive-compulsive disorder with and without major depressive disorder. Can J Psychiatry. 2009; 54(7): 460–467.CrossRefGoogle ScholarPubMed
27.Fontenelle, IS, Fontenelle, LF, Borges, MC, etal. Quality of life and symptom dimensions of patients with obsessive-compulsive disorder. Psychiatry Res. 2010; 179(2): 198–203.CrossRefGoogle ScholarPubMed
28.Didie, ER, Pinto, A, Mancebo, M, etal. A comparison of quality of life and psychosocial functioning in obsessive-compulsive disorder and body dysmorphic disorder. Ann Clin Psychiatry. 2007; 19(3): 181–186.CrossRefGoogle ScholarPubMed
29.Grant, JE, Mancebo, MC, Pinto, A, Eisen, JL, Rasmussen, SA. Impulse control disorders in adults with obsessive compulsive disorder. J Psychiatr Res. 2006; 40: 494–501.CrossRefGoogle ScholarPubMed
30.Besiroglu, L, Uguz, F, Saglam, M, Agargun, MY, Cilli, AS. Factors associated with major depressive disorder occurring after the onset of obsessive-compulsive disorder. J Affect Disord. 2007; 102: 73–79.CrossRefGoogle ScholarPubMed
31.Rodriguez-Salgado, B, Dolengevich-Segal, H, Arrojo-Romero, M, etal. Perceived quality of life in obsessive-compulsive disorder: related factors. BMC Psychiatry. 2006; 6(20). doi:10.1186/1471-244X-6-20.CrossRefGoogle ScholarPubMed
32.Koran, LM, Thienemann, ML, Davenport, R. Quality of life for patients with obsessive-compulsive disorder. Am J Psychiatry. 1996; 153: 783–788.Google ScholarPubMed
33.Greist, JH, Bandelow, B, Hollander, E, etal. WCA recommendations for the long-term treatment of obsessive-compulsive disorder in adults. CNS Spectrums. 2003; 8(supp 1): 7–16.CrossRefGoogle ScholarPubMed
34.Ferrao, YA, Shavitt, RG, Bedin, NR, etal. Clinical features associated to refractory obsessive-compulsive disorder. J Affect Disord. 2006; 94: 199–209.CrossRefGoogle ScholarPubMed
35.Besiroglu, L, Cilli, AS, Askin, R. The predictors of health care seeking behavior in obsessive-compulsive disorder. Compr Psychiatry. 2004; 45(2): 99–108.CrossRefGoogle ScholarPubMed
36.Koran, LM, Bormberg, D, Hornfeldt, CS, etal. Extended-release fluvoxamine and improvements in quality of life in patients with obsessive-compulsive disorder. Compr Psychiatry. 2010; 51(4): 373–379.CrossRefGoogle ScholarPubMed
37.Dougherty, DD, Jameson, M, Decersbach, T, etal. Open-label study of high (30 mg) and moderate (20 mg) dose escitalopram for the treatment of obsessive-compulsive disorder. Int Clin Psychopharmacol. 2009; 24(6): 306–311.CrossRefGoogle ScholarPubMed
38.Hollander, E, Stein, DJ, Fineberg, NS, Marteau, F, Legault, M. Quality of life outcomes in patients with obsessive-compulsive disorder: relationship to treatment response and symptom relapse. J Clin Psychiatry. 2010; 71(6): 784–792.CrossRefGoogle ScholarPubMed
39.Koran, JM, Hackett, E, Rubin, A, Wolkow, R, Robinson, D. Efficacy of sertraline in the long-term treatment of obsessive-compulsive disorder. Am J Psychiatry. 2002; 159: 88–95.CrossRefGoogle ScholarPubMed
40.Pallanti, S, Quercioli, L, Koran, L. Citalopram intravenous infusion in resistant obsessive-compulsive disorder: an open trial. J Clin Psychiatry. 2002; 63: 796–801.CrossRefGoogle ScholarPubMed
41.Ross, S, Fallon, BA, Petkova, E, Feinstein, S, Liebowitz, MR. Long-term follow-up study of patients with refractory obsessive-compulsive disorder. J Neuropsychiatry Clin Neurosci. 2008; 20: 450–457.CrossRefGoogle ScholarPubMed
42.Fallon, B, Liebowitz, MR, Campeas, R, etal. Intravenous clomipramine for obsessive-compulsive disorder refractory to oral clomipramine: a placebo-controlled study. Arch Gen Psychiatry. 1989; 55(10): 918–924.CrossRefGoogle Scholar
43.Hou, SY, Yen, CF, Huang, MF, Wang, PW, Yeh, YC. Quality of life and its correlates in patients with obsessive-compulsive disorder. Kaohsiung J Med Sci. 2010; 26(8): 397–407.CrossRefGoogle ScholarPubMed
44.Reddy, YC, Alur, AM, Mandjunath, S, Kandavel, T, Math, SB. Long-term follow-up study of patients with serotonin reuptake inhibitor-nonresponsive obsessive-compulsive disorder. J Clin Psychopharmacol. 2010; 30(3): 267–272.CrossRefGoogle ScholarPubMed
45.Shetti, CN, Reddy, YCJ, Kandavel, T, etal. Clinical predictors of drug nonresponse in obsessive-compulsive disorder. J Clin Psychiatry. 2005; 66: 1517–1523.CrossRefGoogle ScholarPubMed
46.Lindsay, M, Crino, R, Andrews, G. Controlled trial of exposure and response prevention in obsessive-compulsive disorder. Br J Psychiatry. 1997; 171: 135–139.CrossRefGoogle ScholarPubMed
47.Simpson, HB, Zuckoff, AM, Maher, MJ, etal. Challenges using motivational interviewing as an adjunct to exposure therapy for obsessive-compulsive disorder. Behav Res Ther. 2010; 48(10): 941–948.CrossRefGoogle ScholarPubMed
48.Maltby, N, Tolin, DF. A brief motivational intervention for treatment-refusing OCD patients. Cogn Behav Ther. 2005; 34(3): 176e184.CrossRefGoogle ScholarPubMed
49.Merlo, LJ, Storch, EA, Lehmkuhl, HD, etal. Cognitive behavioral therapy plus motivational interviewing improves outcome for pediatric obsessive-compulsive disorder: a preliminary study. Cogn Behav Ther. 2010; 39(1): 24–27.CrossRefGoogle ScholarPubMed
50.Maher, MJ, Huppert, JD, Chen, H, etal. Moderators and predictors of response to cognitive-behavioral therapy augmentation of pharmacotherapy in obsessive-compulsive disorder. Psychol Med. 2010; 40(12): 2013–2023.CrossRefGoogle ScholarPubMed
51.Cordioli, AV, Heidt, E, Bochi, DB, etal. Cognitive-behavioral group therapy in obsessive-compulsive disorder: a randomized clinical trial. Psychother Psychosom. 2003; 72: 211–216.CrossRefGoogle Scholar
52.Sousa, MB, Isolan, LR, Oliveira, RR, Manfro, GG, Cordioli, AV. A randomized clinical trial of cognitive-behavioral group therapy and sertraline in the treatment of obsessive-compulsive disorders. J Clin Psychiatry. 2006; 67(7): 1133–1139.CrossRefGoogle Scholar
53.Brown, RA, Abrantes, AM, Strong, DR, etal. A pilot study of moderate-intensity aerobic exercise for obsessive compulsive disorder. J Nerv Ment Dis. 2007; 195(6): 514–520.CrossRefGoogle ScholarPubMed
54.Saxena, S, Ayers, CR, Maidment, KM, etal. Quality of life and functional impairment in compulsive hoarding. J Psychiatr Res. 2011; 45: 475–480.CrossRefGoogle ScholarPubMed
55.Albert, U, Maina, G, Bogetto, F, Chiarie, A, Mataix-Cols, D. Clinical predictors of health-related quality of life in obsessive-compulsive disorder. Compr Psychiatry. 2010; 51(2): 193–200.CrossRefGoogle ScholarPubMed
56.Hauschildt, M, Jelinek, L, Randjbar, S, Hottenrott, B, Moritz, S. Generic and illness-specific quality of life in obsessive-compulsive disorder. Behav Cogn Psychother. 2010; 38(4): 417–436.CrossRefGoogle ScholarPubMed
57.Meltzer-Brody, S, Davidson, JRT. Completeness of response and quality of life in mood and anxiety disorders. Depress Anxiety. 2000; 12(supp 1): 95–101.3.0.CO;2-U>CrossRefGoogle ScholarPubMed
58.Raffin, AL, Fachel, JMG, Ferrao, YA, de Souza, FP, Cordioli, AV. Predictors of response to group cognitive-behavioral therapy in the treatment of obsessive-compulsive disorder. Eur Psychiatry. 2009; 24: 297–306.CrossRefGoogle ScholarPubMed
59.IsHak, WW, Greenberg, JM, Saah, T, etal. Development and validation of the Individual Burden of Illness Index for Major Depressive Disorder (IBI-D). Adm Policy Ment Health. 2011 Oct 4. [Epub ahead of print].Google Scholar
60.Larun, L, Nordheim, LV, Ekeland, E, Hagen, KB, Heian, F. Exercise in prevention and treatment of anxiety and depression among children and young people. Cochrane Database Syst Rev. 2006; 3: CD004691.Google Scholar
61.Ruano, C, Henriquez, P, Bes-Rastrollo, M, etal. Dietary fat intake and quality of life: the SUN project. Nutr J. 2011; 10: 121. doi:10.1186/1475-2891-10-121.CrossRefGoogle ScholarPubMed
62.Vilhauer, JS, Young, S, Kealoha, C, etal.: Treating major depression by creating positive expectations for the future: a pilot study for the effectiveness of future-directed therapy (FDT) on symptom severity and quality of life. CNS Neurosci Ther. 2012; 8: 102–109.CrossRefGoogle Scholar
63.Nyklicek, I, Kuijpers, KF. Effects of mindfulness-based stress reduction intervention on psychological well-being and quality of life: is increased mindfulness indeed the mechanism? Ann Behav Med. 2008; 35: 331–340.CrossRefGoogle ScholarPubMed
64.Hamre, HJ, Witt, CM, Glockmann, A, etal. Rhythmical massage therapy in chronic disease: a 4-year prospective cohort study. J Altern Complement Med. 2007; 13: 635–642.CrossRefGoogle ScholarPubMed
65.Maratos, A, Gold, C, Wang, X, Crawford, M. Music therapy for depression. Cochrane Database Syst Rev. 2008; 23(1): CD004517.Google Scholar
66.Strean, W. Laughter prescription. Can Fam Physician. 2009; 55(10): 965–967.Google ScholarPubMed