Four-year course of quality of life and obsessive\u2013compulsive disorder

Karin C P Remmerswaal,Nic J A Van Der Wee,Patricia Van Oppen,Adriaan W Hoogendoorn,Anton J L M Van Balkom,Neeltje M Batelaan

doi:10.1007/s00127-019-01779-7

Abstract

ObjectivePatients with obsessive compulsive disorder (OCD) have high disease burden. It is important to restore quality of life (QoL) in treatment, so that patients become able to live a fulfilling life. Little is known about the longitudinal course of QoL in patients with OCD, its association with remission from OCD, and about factors that contribute to an unfavourable course of QoL in remitting patients.MethodsStudy on the 4-year course of QoL of patients with chronic (n = 144), intermittent (n = 22), and remitting OCD (n = 73) using longitudinal data of the Netherlands Obsessive Compulsive Disorder Association (NOCDA; complete data: n = 239; imputed data n = 382). The EuroQol five-dimensional questionnaire (EQ-5D) utility score was used to assess QoL. In patients with remitting OCD, we examined patient characteristics that contributed to an unfavourable course of QoL, including sociodemographics, OCD characteristics, psychiatric comorbidity, and personality traits.ResultsCourse of QoL was associated with course of OCD. QoL improved in those who remitted from OCD; however, even in these patients, QoL remained significantly below the population norms. The correlation between QoL and severity of OCD was only moderate: r = − 0.40 indicating that other factors besides OCD severity contribute to QoL. In remitters, more severe anxiety and depression symptoms were related to a lower QoL. Results were similar in complete and imputed data sets.ConclusionsRemission from OCD is associated with improvement of QoL, but comorbid anxiety and depression symptoms hamper the improvement of QoL. QoL could be improved by reducing OCD symptoms in patients with OCD and by treating comorbid anxiety and depression symptoms in remitting patients.

Highlights

Patients with mental disorders like schizophrenia, major depressive disorder, anxiety disorders, and obsessive compulsive disorder (OCD) experience an impaired Quality of Life (QoL) compared with the general population
The present study underlines the importance of assessing QoL in patients with OCD
We have investigated the 4-year course of QoL, its association with remission from OCD and the factors that contribute to an unfavourable course of QoL in remitting OCD patients

Summary

Introduction

Patients with mental disorders like schizophrenia, major depressive disorder, anxiety disorders, and obsessive compulsive disorder (OCD) experience an impaired Quality of Life (QoL) compared with the general population. In particular following successful treatment of the index mental disorder, QoL is often not restored to the level of the general population, which implies that remitted patients still may experience problems in their daily physical, psychological, and social functioning [2, 3]. In patients with major depressive disorder and anxiety disorders, QoL improved after treatment, but levels of QoL remained below population norms, even when patients were remitted [3, 10,11,12,13]

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Results

Conclusion