Institute of Psychiatry, Benazir Bhutto hospital, Rawalpindi, Pakistan.
PLoS One. 2023 Aug 3;18(8):e0289080. doi: 10.1371/journal.pone.0289080. eCollection 2023.
Severe mental illnesses have huge impact on health-related quality of life. They contribute to significant morbidity in terms of number of number of years of life lost in form DALYS (disability adjusted life years) and shorter life expectancy and early mortality. There is limited evidence on their burden in low- and middle-income countries like Pakistan.
To determine the health-related quality of life in patients suffering from severe mental illness (schizophrenia, depression, and bipolar affective disorder) and demographic factors associated with poor health related quality of life in these patients.
This was descriptive cross sectional, using retrospective record view of data. Study was done under IMPACT (Improving Mental And Physical health Together) Program, which conducted a multi-morbidity survey conducted at institute of psychiatry, Benazir Bhutto hospital, Rawalpindi, using EQ 5d 5l (EURO QOL 5D5L) questionnaire having both subjective (EQVAS) and objective domains.
The study included 922 SMI patients, of whom 555 participants (60.2%) were males and 367(39.69%) were females. The participants suffered from major depressive disorder (422;45.8%), followed by bipolar affective disorder (392; 42.51%) and schizophrenia (108;11.7%). Most participants were in a younger age group with (80%) of population being below 50 years old and had education level below secondary education (57.4%). In the analysis of association between EQ-VAS (subjective quality of life scale) and demographic factors, a significant association was found for marital status(p<0.001), gender (p< 0.001) and education (p< 0.001). Women had lower EQ-VAS scores (M = 49.43±SD = 27.72) as compared to males (M = 58.81±SD = 27.1) and individuals with lower educational status also had lower mean scores. Additionally, participants who were single, divorced or widowed also had lower mean EQVAS scores. When health related quality of life was analyzed across SMI, it was lower in all SMI, but was significantly lower for depression in both subjective and objective domains of health related of quality-of-life instrument.
Health related quality of life is an important outcome measure and regular assessment of both subjective and objective aspects should be incorporated in management plans of patients suffering from severe mental illnesses.
严重精神疾病对健康相关生活质量有巨大影响。它们导致大量残疾，表现在丧失的伤残调整生命年（DALYS）数量和预期寿命缩短和早逝方面。在巴基斯坦等中低收入国家，它们的负担证据有限。
确定患有严重精神疾病（精神分裂症、抑郁症和双相情感障碍）患者的健康相关生活质量，并确定与这些患者健康相关生活质量差相关的人口统计学因素。
这是一项描述性的横断面研究，使用回顾性记录数据。该研究是在 IMPACT（共同改善精神和身体健康）计划下进行的，该计划在白沙瓦贝娜齐尔·布托医院的精神病学研究所进行了一项多疾病调查，使用 EQ 5d 5l（EUROQOL 5D5L）问卷，该问卷既有主观（EQVAS）又有客观领域。
该研究纳入了 922 名 SMI 患者，其中 555 名参与者（60.2%）为男性，367 名（39.69%）为女性。参与者患有重度抑郁症（422 例；45.8%），其次是双相情感障碍（392 例；42.51%）和精神分裂症（108 例；11.7%）。大多数参与者年龄在 50 岁以下，教育水平低于中学（57.4%）。在 EQ-VAS（主观生活质量量表）与人口统计学因素之间的关联分析中，婚姻状况（p<0.001）、性别（p<0.001）和教育程度（p<0.001）存在显著关联。女性的 EQ-VAS 评分较低（M=49.43±SD=27.72），而男性（M=58.81±SD=27.1）和教育程度较低的个体的平均得分也较低。此外，单身、离婚或丧偶的参与者的平均 EQVAS 评分也较低。当分析 SMI 患者的健康相关生活质量时，所有 SMI 患者的健康相关生活质量都较低，但在健康相关生活质量量表的主观和客观领域，抑郁症患者的健康相关生活质量显著较低。
健康相关生活质量是一个重要的结果衡量标准，应将主观和客观方面的定期评估纳入严重精神疾病患者的管理计划中。
