Background Measurement of health-related quality of life (HRQoL) with generic preference-based instruments enables comparisons of severity across different conditions and treatments. This is necessary for rational public health policy.

Aims To measure HRQoL decrement and loss of quality-adjusted life-years (QALYs) associated with pure and comorbid forms of depressive and anxiety disorders and alcohol dependence.

Method A general population survey was conducted of Finns aged 30 years and over. Psychiatric disorders were diagnosed with the Composite International Diagnostic Interview and HRQoL was measured with the 15D and EQ–5D questionnaires.

Results Dysthymia, generalised anxiety disorder and social phobia were associated with the largest loss of HRQoL on the individual level before and after adjusting for somatic and psychiatric comorbidity. On the population level, depressive disorders accounted for 55%, anxiety disorders 30%, and alcohol dependence for 15% of QALY loss identified in this study.

Conclusions Chronic anxiety disorders and dysthymia are associated with poorer HRQoL than previously thought.

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