Penner-Goeke Kirsten, Henriksen Christine A, Chateau Dan, Latimer Eric, Sareen Jitender, Katz Laurence Y
Department of Psychiatry, University of Manitoba, Winnipeg, Canada.
J Clin Psychiatry. 2015 Nov;76(11):1506-12. doi: 10.4088/JCP.14m09271.
Traditional burden-of-disease estimates often exclude personality disorders, which are associated with significant mortality and morbidity. The aim of this study was to estimate the health-related quality of life (HRQoL) and annual population-level quality-adjusted life-year (QALY) losses associated with different mental and physical health conditions. In particular, it sought to quantify the impact of personality disorders on quality of life, at an individual and population level.
This was a secondary analysis of data from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative survey of the US general population collected from 2001 to 2005 (N = 34,653). Health-related quality of life (measured using the Short-Form Health Survey-6D) was the main outcome of interest. Regression analysis assessed the impact of various mental (based on DSM-IV criteria) and physical health conditions on HRQoL scores, and this impact was combined with the prevalence of disorders to estimate the population-level burden of disease.
Mood disorders were associated with the highest decrease in HRQoL scores, followed by strokes, psychotic illness, and arthritis (P < .01). The greatest annual population QALY losses were caused by arthritis, mood disorders, and personality disorders.
Quality-adjusted life year losses associated with personality disorders ranked behind only mood disorders and arthritis. Personality disorders were associated with significant reductions in quality of life, despite the fact that they are often excluded from traditional burden of disease estimates.
传统的疾病负担估计通常不包括人格障碍，而人格障碍与显著的死亡率和发病率相关。本研究的目的是估计与不同的精神和身体健康状况相关的健康相关生活质量（HRQoL）以及年度人群水平的质量调整生命年（QALY）损失。特别是，它试图在个体和人群层面量化人格障碍对生活质量的影响。
这是对全国酒精及相关状况流行病学调查数据的二次分析，该调查是对2001年至2005年收集的美国普通人群进行的具有全国代表性的调查（N = 34,653）。健康相关生活质量（使用简短健康调查-6D进行测量）是主要关注的结果。回归分析评估了各种精神（基于《精神疾病诊断与统计手册》第四版标准）和身体健康状况对HRQoL评分的影响，并将这种影响与疾病患病率相结合，以估计人群层面的疾病负担。
情绪障碍与HRQoL评分下降幅度最大相关，其次是中风、精神病性疾病和关节炎（P <.01）。年度人群QALY损失最大的是关节炎、情绪障碍和人格障碍。
与人格障碍相关的质量调整生命年损失仅次于情绪障碍和关节炎。人格障碍与生活质量的显著降低相关，尽管它们通常被排除在传统的疾病负担估计之外。
