The British Journal of Psychiatry
Quality of life of people with schizophrenia, bipolar disorder and other psychotic disorders
Samuli I. Saarni, Satu Viertiö, Jonna Perälä, Seppo Koskinen, Jouko Lönnqvist, Jaana Suvisaari

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.

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