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Quality of life of people with schizophrenia, bipolar disorder and other psychotic disorders

  • Samuli I. Saarni (a1), Satu Viertiö (a2), Jonna Perälä (a2), Seppo Koskinen (a3), Jouko Lönnqvist (a1) and Jaana Suvisaari (a4)...
Abstract
Background

Health utility and quality of life (QoL) are increasingly important outcome measures in healthcare and health economics.

Aims

To compare the loss of subjective QoL and utility-based health-related quality of life (HRQoL) associated with psychotic disorders.

Method

A representative sample of 8028 Finns was screened for psychotic disorders and bipolar I disorder. Lifetime psychotic disorders were diagnosed using the Structured Clinical Interview for DSM–IV and/or case records. Health-related quality of life was measured with EQ–5D and 15D, and QoL was measured with a 10-point scale.

Results

Schizoaffective disorder was associated with the largest losses of QoL and HRQoL, with bipolar I disorder associated with similar or smaller losses than schizophrenia. Current depressive symptoms explained most of the losses.

Conclusions

Depressive symptoms are the strongest predictors of poor QoL/HRQoL in psychotic disorders. Subjective loss of QoL associated with psychotic disorders may be smaller than objective loss of functioning suggests. The EQ–5D is problematic as an outcome measure in psychotic disorders.

Declarations of interest

None.

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Copyright
Corresponding author
Samuli I. Saarni, MD, PhD, MSocSc, Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, PO Box 30, 00270 Helsinki, Finland. Email: samuli.saarni@helsinki.fi
Footnotes
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See pp. 348–349, this issue.

Footnotes
References
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Quality of life of people with schizophrenia, bipolar disorder and other psychotic disorders

  • Samuli I. Saarni (a1), Satu Viertiö (a2), Jonna Perälä (a2), Seppo Koskinen (a3), Jouko Lönnqvist (a1) and Jaana Suvisaari (a4)...
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eLetters

Quality of Life in Schizophrenia, Bipolar Disorder and other Psychotic Disorders

Anurag Jhanjee, Senior Resident
25 January 2011

The article entitled “Quality of Life of People with Schizophrenia, Bipolar Disorder and other Psychotic Disorders" by Saami S.I et al provides a comprehensive overview of the Quality of Life among those suffering from schizophrenia, bipolar affective disorder and other psychotic disorders. The study exhibited that schizoaffective disorder was associated with lowest wellbeing followed by schizophrenia and bipolar I disorder. Schizophrenia and bipolar affective disorder were associated with relatively larger losses of HRQoL than subjective QoL, whereas the contrary was true for delusional disorder and major depressive disorder with psychotic symptoms. This discrepancy illustrates the need for adequate management of the adverse effects of the prescribed treatment and also merits due consideration in formulation of health policies. This study deserves appreciation for taking a general population-based sample, robust methodology and high participation rate. We would like to make few suggestions which could have improved the applicability of this study:1. Instead of Using Visual Analog Scale (VAS) for assessing subjective QoL, a standardised and widely used instrument like WHO-QoL- BREF could have been better.2. Burden on caregivers of those suffering from various psychotic disorders could have been included to quantify the global impact of psychotic disorders on the life of a patient.3. Age-range should have been broader.4. Due to small sample size of patients with delusional disorders, the results cannot be generalised. ... More

Conflict of interest: None Declared

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