IsHak Waguih William, Mirocha James, Dang Jonathan, Vanle Brigitte, Metrikin Benjamin, Tessema Kaleab, Danovitch Itai
Department of Psychiatry and Behavioral Neurosciences Cedars-Sinai Medical Center Los Angeles California USA.
Department of Psychiatry and Biobehavioral Sciences David Geffen School of Medicine University of California Los Angeles Los Angeles California USA.
Psychiatr Res Clin Pract. 2024 Apr 8;6(3):68-77. doi: 10.1176/appi.prcp.20230064. eCollection 2024 Fall.
Psychiatric disorders are associated with impairments in quality of life (QOL) and functioning. What remained to be investigated was the comparison of these constructs across psychiatric disorders in treatment-seeking adults. It was hypothesized that mood disorder patients would endorse worse QOL and functioning at entry into psychiatric outpatient treatment compared to patients with other disorders, and that regardless of diagnosis, severe impairments in QOL and functioning would be endorsed by the majority of the sample (>70%).
Data were collected for 2114 adults. Diagnostic and Statistical Manual of Mental Disorders diagnoses were obtained using the Mini International Neuropsychiatric Interview. Patients completed measures of QOL (Q-LES-Q), functioning (Work and Social Adjustment Scale [WSAS], Sheehan Disability Scale, Endicott Work Productivity Scale), and depression (Quick Inventory of Depressive Symptomatology-Self Report).
Overall, 70.6% of patients with psychiatric disorders reported severe impairment in QOL and 59.6% of patients reported severe impairment in functioning (per the WSAS). Patients with mood disorders were more likely to report severe impairments in QOL and functioning, compared to patients with other psychiatric disorders. Analysis of variance revealed patients with mood disorders reported significantly lower QOL, worse functioning, and greater depressive symptom severity compared to patients without mood disorders (all values <0.05).
Patients with psychiatric conditions overwhelmingly reported severely impaired QOL and functioning at entry to outpatient treatment. Patients with mood disorders were disproportionately more likely to endorse severely impaired QOL and functioning, particularly those with Major Depressive Disorder, recurrent, and Bipolar Disorder I, depressive episode. Findings suggest that future treatment efforts should focus on interventions that restore QOL and functioning in psychiatric patients, particularly among those with mood disorders.
精神疾病与生活质量(QOL)受损及功能障碍相关。有待研究的是在寻求治疗的成年人中,比较这些指标在不同精神疾病中的情况。研究假设为,与其他疾病患者相比,情绪障碍患者在进入精神科门诊治疗时会报告更差的生活质量和功能状况,且无论诊断如何,样本中的大多数(>70%)会报告生活质量和功能存在严重受损。
收集了2114名成年人的数据。使用迷你国际神经精神访谈获得《精神疾病诊断与统计手册》的诊断结果。患者完成了生活质量测量(Q-LES-Q)、功能测量(工作和社会适应量表[WSAS]、希恩残疾量表、恩迪科特工作生产力量表)以及抑郁测量(抑郁症状快速自评量表)。
总体而言,70.6%的精神疾病患者报告生活质量严重受损,59.6%的患者报告功能严重受损(根据WSAS)。与其他精神疾病患者相比,情绪障碍患者更有可能报告生活质量和功能严重受损。方差分析显示,与无情绪障碍的患者相比,情绪障碍患者报告的生活质量显著更低、功能更差且抑郁症状严重程度更高(所有P值<0.05)。
患有精神疾病的患者在进入门诊治疗时绝大多数报告生活质量和功能严重受损。情绪障碍患者尤其更有可能报告生活质量和功能严重受损,特别是那些患有复发性重度抑郁症和双相I型障碍抑郁发作的患者。研究结果表明,未来的治疗工作应侧重于恢复精神疾病患者,特别是情绪障碍患者的生活质量和功能的干预措施。