Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, PO Box 30, 00270 Helsinki, Finland.
Br J Psychiatry. 2010 Nov;197(5):386-94. doi: 10.1192/bjp.bp.109.076489.
Health utility and quality of life (QoL) are increasingly important outcome measures in healthcare and health economics.
To compare the loss of subjective QoL and utility-based health-related quality of life (HRQoL) associated with psychotic disorders.
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.
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.
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.
健康效用和生活质量（QoL）在医疗保健和健康经济学中越来越重要的结果衡量标准。
比较与精神障碍相关的主观生活质量和基于效用的健康相关生活质量（HRQoL）的损失。
使用 DSM-IV 结构临床访谈和/或病例记录对 8028 名芬兰人进行了精神障碍和双相 I 障碍的代表性样本筛查。使用终生精神障碍进行诊断。使用 EQ-5D 和 15D 测量与健康相关的生活质量，并使用 10 分制测量生活质量。
情感分裂障碍与 QoL 和 HRQoL 的最大损失相关，而双相 I 障碍与精神分裂症相关的损失相似或更小。当前的抑郁症状解释了大部分损失。
抑郁症状是精神障碍中 QoL/HRQoL 较差的最强预测因素。与精神障碍相关的主观 QoL 损失可能比功能丧失所表明的要小。EQ-5D 在精神障碍中作为结果衡量标准存在问题。
