Abstract
BackgroundPeople with eating disorders (ED) often report poor health-related quality of life (HRQoL), which is explicitly correlated to illness’ severity and its effects on cognitive performance. We aimed to analyze health-related quality of life (HRQoL) in subgroups of eating disorder (ED) patients by using the brief version of WHOQoL questionnaire (WHOQoL-BREF) before treatment administration. Moreover, in order to compare our findings with other published data, we carried out a comprehensive review of the literature on HRQoL in ED patients.MethodsOur review was carried out by means of an accurate data mining of PsychInfo and Medline databases and other available sources. In our cross-sectional study, eighty female ED patients (26 with bulimia nervosa, 33 with anorexia nervosa, 7 with binge eating disorder and 14 with ED not otherwise specified) completed the WHOQoL-BREF. HRQoL scores were compared among ED subgroups and clinical information (presence of previous contacts, length of illness, psychiatric comorbidity) was considered in the analysis.ResultsOur review shows that with few exceptions ED patients have a poorer HRQoL than the healthy population of control and sometimes the mental component of HRQoL is the most involved dimension. Moreover, there are no differences in the HRQoL among ED groups, even if AN patients in some studies have a lower HRQoL scores. Furthermore, BED patients have a poorer HRQoL than obese patients who do not have binge episodes. Finally, all treatments were positively correlated with an improvement on general and specific QoL dimensions. In our sample, ED subgroups differed only for Psychological Health HRQoL scores (F = 4.072, df = 3; p = 0.01). No differences were found between inpatients and outpatients, treatment naïve and previously treated patients and patients with or without psychiatric comorbidity. Moreover, HRQoL scores were not correlated to length of illness within each ED subgroup.ConclusionsThe analysis of the literature adds some relevant information on HRQoL in ED and may address the future research toward the exploration of specific questions. One of these may be the prominent role of Psychological Health domain in HRQoL, since our study confirms that this component is able to differentiate eating disorders.
Highlights
People with eating disorders (ED) often report poor health-related quality of life (HRQoL), which is explicitly correlated to illness’ severity and its effects on cognitive performance
The third review was carried out by Jenkins et al using a narrative approach [15]. This is a comprehensive review, which allows to enter into the details of the papers and to analyze specific issues such as the HRQoL associated with subclinical ED pathology, body mass index (BMI), or purging and other compensatory behaviors
A second type of design is the cross-sectional analysis of samples of subjects attending outpatients ED centers or of patients waiting for a gastric by-pass surgery
Summary
People with eating disorders (ED) often report poor health-related quality of life (HRQoL), which is explicitly correlated to illness’ severity and its effects on cognitive performance. We aimed to analyze health-related quality of life (HRQoL) in subgroups of eating disorder (ED) patients by using the brief version of WHOQoL questionnaire (WHOQoL-BREF) before treatment administration. As reviewed by Engel and colleagues [3], most of studies investigating the HRQoL in eating disorder (ED) patients measured the effects of abnormal eating behavior on health status but not on HRQoL. People with ED often report poor HRQoL [6], which is explicitly correlated to illness’ severity and its effects on cognitive performance [7,8]. ED are frequently associated with comorbid psychiatric disorders, especially anxiety, somatoform and depressive disorders, which further prevent recovery and increase the probability of resistance to treatment efforts [10,11]
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