Quality of life and disability in patients with obsessive-compulsive disorder
Abstract
The aim of this study is to describe the situation of Spanish obsessive-compulsive disorder (OCD) patients and compare it to that of the general population and other patient groups.
Thirty-six OCD patients on maintenance treatment were evaluated using the Y-BOCS, SF-36, and DAS-S. Their SF-36 scores were compared to Spanish norms and to those obtained from U.S. OCD patients, schizophrenic outpatients, depressed outpatients, heroin dependents, patients on hemodialysis, and kidney transplant recipients.
Sixty-one percent of the patients had severe or extremely severe symptoms. Their quality of life was worse when compared with the Spanish norms in all SF-36 areas, but especially with respect to mental health. In contrast to U.S. OCD patients, social functioning is more impaired in the Spanish OCD patients. OCD patients reported the same quality of life as schizophrenics in the areas of mental health, but better in the areas of physical health. Compared with heroin dependents and depressed patients, their quality of life was worse. On mental health scales, OCD patients scored worse than somatic patients.
OCD in the Spanish population was shown to be associated with worse quality of life than for any other patient group (including physical groups), except schizophrenics.
ORIGINAL ARTICLE
Quality of life and disability in patients with obsessive-
compulsive disorder
J. Bobes
1
*, M.P. González
1
, M.T. Bascarán
1
, C. Arango
2
, P.A. Sáiz
1
, M. Bousoño
1
1
Department of Psychiatry, University of Oviedo, Julián Claveria, 6, 33006 Oviedo, Spain;
2
Hospital Gregorio
Marañón, Madrid, Spain
(Received 30 April 2000; revised 2 January 2001; accepted 9 February 2001)
Summary – The aim of this study is to describe the situation of Spanish obsessive-compulsive disorder (OCD) patients
and compare it to that of the general population and other patient groups.
Methods. Thirty-six OCD patients on maintenance treatment were evaluated using the Y-BOCS, SF-36, and DAS-S.
Their SF-36 scores were compared to Spanish norms and to those obtained from U.S. OCD patients, schizophrenic
outpatients, depressed outpatients, heroin dependents, patients on hemodialysis, and kidney transplant recipients.
Results. Sixty-one percent of the patients had severe or extremely severe symptoms. Their quality of life was worse
when compared with the Spanish norms in all SF-36 areas, but especially with respect to mental health. In contrast to
U.S. OCD patients, social functioning is more impaired in the Spanish OCD patients. OCD patients reported the same
quality of life as schizophrenics in the areas of mental health, but better in the areas of physical health. Compared with
heroin dependents and depressed patients, their quality of life was worse. On mental health scales, OCD patients scored
worse than somatic patients.
Conclusions. OCD in the Spanish population was shown to be associated with worse quality of life than for any other
patient group (including physical groups), except schizophrenics. © 2001 Éditions scientifiques et médicales Elsevier
SAS
disability / obsessive-compulsive disorder / quality of life / SF-36
INTRODUCTION
Obsessive-compulsive disorder is the fourth most com-
mon psychiatric disorder, occurring in 2–3% of the
U.S. population [14]. Furthermore, OCD is a chronic
and disabling illness that impacts negatively on the
academic, occupational, social, and family function of
patients [11, 12, 17]. This impact carries over onto
their families, friends, and society [12]. Indeed, OCD
ranks tenth in the World Bank’s and WHO’s ten
leading causes of disability and, in the case of women
aged 15–44 years, OCD occupies the fifth position
[22]. In spite of this situation, to our knowledge data on
quality of life and disability has scarcely been reported
in OCD patients.
Health-related quality of life is a multidimensional
construct reflecting an individual’s global physical and
mental well-being [19]. A more detailed definition is
that of Wenger and Furberg: “those attributes valued
by patients, including: their resultant comfort or sense
of well-being; the extent to which they were able to
maintain reasonable physical, emotional, and intellec
*Correspondence and reprints.
E-mail address: bobes@correo.uniovi.es (J. Bobes).
Eur Psychiatry 2001 ; 16 : 239-45
© 2001 Éditions scientifiques et médicales Elsevier SAS. All rights reserved
S0924933801005715/FLA
tual function; and the degree to which they retain their
ability to participate in valued activities within the
family, in the workplace, and in the community” [21].
This concept is of special relevance in the field of
chronic disorders, since these often have a negative
effect upon health-related quality of life. In the case of
OCD the few studies that do exist indicate that these
patients have a poor quality of life.
We attempt here to describe how the patients’ health-
related quality of life and functioning are affected by
OCD and to compare their quality of life to norms for
the general Spanish population and to patients with
other psychiatric and physical disorders. Our hypoth-
eses are that 1) health-related quality of life in OCD
patients is impaired, especially in the mental health
areas; and 2) this impairment is equivalent to the impair-
ment shown by schizophrenic patients and greater than
that of depressed patients.
METHODS
Patients
Obsessive-compulsive patients
Thirty-six consecutive outpatients meeting ICD-10 cri-
teria for OCD were included in the study. Patients were
under maintenance treatment with different serotoner-
gic medications. After receiving a complete explanation
of the study, each patient gave oral consent to partici-
pate.
An experienced clinical interviewer administered an
‘ad hoc’ protocol to collect demographic information
(i.e., age, gender, civil status, educational level, and
somatic co-morbidity). To quantify the severity of the
patients’ obsessive-compulsive symptoms, we employed
the Yale-Brown Obsessive Compulsive Scale (Y-BOCS)
[9]. We used the World Health Organization Short
Disability Assessment Schedule (WHO DAS-S) [13] to
assess the disability level. The MOS 36-Item Short-
Form Health Survey (SF-36) [20] was used for evalu-
ating their health-related quality of life.
Spanish normative population
Norms for the Spanish population were obtained in a
cross-sectional study of a multi-stage, stratified random
sample of non-institutionalized individuals residing in
Spain [2]. The final sample included 9,151 individuals
(aged 18 or older) with a mean age of 45.2 years; 48.2%
were male. Personal home interviews, including the
SF-36, were performed. For most SF-36 areas, health-
related quality of life was better among men and among
younger groups (P < .01).
U.S. obsessive-compulsive patients
The data on the quality of life of 60 U.S. OCD patients
[15] were used in the analysis. The mean age of this
sample was 40.1 (10.6) years, of which 57% were male;
the mean total Y-BOCS score at baseline was 26.8
(4.2).
Schizophrenic outpatients
The sample was made up of 362 non-acute schizo-
phrenic outpatients (ICD-10 criteria) who participated
in a multi-center Spanish study on quality of life in
schizophrenia under maintenance treatment with ris-
peridone [4]. Patients were included in the study when,
having been on maintenance treatment with different
antipsychotics, their clinicians opted to switch them to
monotherapy with risperidone. This decision was made
based on intolerance or lack of efficacy of the previous
treatment. Quality of life was assessed at baseline and at
2, 4 and 8 months using the SF-36. The mean age was
34.3 (10.6) years, 72% were male, and the mean total
score on BPRS (0–4 rating) at baseline was 23.8. Data
from the SF-36 at baseline were included in this analy-
sis.
Depressed outpatients
Data on quality of life from 729 depressed patients
(ICD-10 criteria) included in a multi-center Spanish
study on depression and venlafaxine were used in this
analysis [3]. The mean age was 47.3 (13.4) years; 28%
were male. For the present analysis, we decided to
employ the data of quality of life (SF-36) at month 6,
since at that time the patients were clinically stabilized
and therefore more similar to the clinical condition of
the OCD and schizophrenic patients included in the
study.
Heroin dependents
Quality of life data for heroin dependents (ICD-10
criteria) remaining 4 years in a maintenance methadone
program (MMP) in Asturias (northern Spain) were
employed in the present study [6]. Of 132 patients who
initiated treatment in that MMP, 49 remained after 4
years. Their mean age was 32.6 (4.8) years; 89.8% were
male. Quality of life was assessed using the SF-36.
End-stage renal failure patients
This sample included all patients with end-stage renal
failure who were on renal replacement therapy (hemo-
dialysis or kidney transplant recipients with a function
240
J. Bobes et al.
Eur Psychiatry 2001 ; 16 : 239–45
ing graft) in Asturias in 1996. A total of 170 patients on
hemodialysis and 210 patients with a functioning graft
were assessed using the SF-36 [16]. Mean ages were
63.7 (13.04) years (hemodialysis patients) and 49.7
(12.2) years (transplanted patients). The percentage of
males was 51.2% and 66.7% respectively.
Assessment
Measurements of health-related quality of life
As no specific instrument for assessing quality of life in
OCD patients exists, we decided to employ the SF-36,
a generic instrument, allowing us to compare the health-
related quality of life of our patients to that of the
Spanish general population and to that of other chronic
physical and mentally disordered patients.
The SF-36 is one of the most widely used health-
related quality of life instruments. It is a short question-
naire with 36 items in eight multi-item scales: physical
functioning, role-physical, bodily pain, general health,
vitality, social functioning, role-emotional, and mental
health; and two summary measures: physical health and
mental health. The physical functioning, role-physical,
and bodily pain contribute most to scoring of the
physical health summary measure while the mental
health, role-emotional, and social functioning scales
contribute most to the mental health measure. The raw
scores on the eight SF-36 scales range from 0 (worst
possible health status measured by the questionnaire) to
100 (best possible health status). In contrast, the sum-
mary measures are scored using norm-based methods.
They have a mean of 50 and a standard deviation of 10
in the general Spanish population, so scores above or
below 50 are above or below the average in the general
Spanish population. The Spanish version has demon-
strated good psychometric properties [1].
Measurements of disability
The WHO DAS-S is a semi-structured interview devel-
oped for assessing and rating the consequences of men-
tal disorders on the patient’s life. It records the clinician’s
assessment of disabilities in the following four areas:
maintenance of personal care, performance of tasks
usual in one’s occupation, functioning in relation to
family and household members, and functioning in a
broader social context. Each area is rated on a six-point
scale where 0 = no disability at any time and 5 = the
patient is severely disabled all of the time. In the assess-
ment of the disability in each area, the clinician has to
take into account both the severity of the impairment
and its duration, and to compare the patient’s function-
ing to that considered normal for a person of the same
sex, age, and sociocultural background.
Data analysis
Demographic comparisons were made using the Stu-
dent’s t-test and the Z test. Quality of life comparisons
were made using the Student t-test. The two-tailed
P-values were used for all analyses, and P-values < .05
were considered to be statistically significant.
RESULTS
Demographic and clinical characteristics
The mean age of the OCD patients was 34.08 (11.4)
years (range 13–85); 55.6% males. Marital status was
single (50%), married (44.4%), and divorced (5.6%).
Educational level was primary school (25%), high
school (36.1%), and college or university degree
(33.3%). Some 5.6% had not received any educational
training. Only 13.9% had serious somatic co-morbidity.
Compared with the other samples, our OCD patients
were significantly younger than OCD patients from the
US, Spanish normative population, depressed outpa-
tients, and somatic patients (hemodialysis and kidney-
transplanted). The percentage of women in our OCD
sample was significantly higher than in the schizo-
phrenic outpatients and heroin-dependent samples, and
was significantly lower than that of depressed outpa-
tients (table I).
Our OCD patients’ mean total score on the Y-BOCS
was 23.66 (9.03), which is consistent with moderately
severe symptoms. The mean subtotal scores were 12.11
(4.86) for obsessions and 11.56 (5.85) for compulsions.
Table I. Demographic characteristics (age and gender) across the
samples included in the health-related quality of life analysis.
Mean age Gender (% of
male)
OCD patients 34.08 55.6
Spanish normative population 45.2
b
48.2
U.S. OCD patients 40.1
b
57
Schizophrenic outpatients 34.3 72
a
Depressed outpatients 47.3
d
28.3
c
Heroin dependents 32.6 89.8
c
Hemodialysis patients 63.7
d
51.2
Kidney transplant patients 49.7
d
66.7
Statistically significant differences (Student t-test and Z test) com-
pared to OCD patients: a: P < .05; b: P = .01; c: P <.0005; d:
P .0000
QoL and disability in OCD
241
Eur Psychiatry 2001 ; 16 : 239–45
Almost two-thirds (61.1%) of the patients have total
scores on the Y-BOCS corresponding to severe or
extremely severe symptoms. The mean age at onset of
the illness was 27.5 (11.4) years. The Hamilton depres-
sion scale mean score was 14.72 (8.16), and 44.8%
obtained scores ≥ 18.
Quality of life and disability data
Mean scores obtained in the SF-36 are displayed in
table II. This table also shows the Spanish norms and
the differences between both groups expressed in stan-
dard deviation units (mean score for OCD patients
minus mean score for Spanish normative population
divided by the standard deviation of the Spanish nor-
mative population score). OCD patients mean scores
on all SF-36 scales fall below the Spanish norms. The
area with the lowest level of health-related quality of life
was social functioning (two standard deviation units
below the Spanish population) followed by role-
emotional and mental health (1.71 and 1.36 respec-
tively). These differences between the OCD patients
and the Spanish population reached statistical signifi-
cance in the general health, vitality, social functioning,
role-emotional, and mental health scales (P = .0000).
The physical health summary measure is similar to that
of the general population, while the mental health
summary measure falls two standard deviation units
below the average in the general Spanish population
(table II).
Compared to U.S. OCD patients (table III), our
patients reported significantly lower levels of quality of
life in the areas of general health (69.4 vs 51.1) and
social functioning (68.7 vs 50). Schizophrenic patients
have significantly worse levels of quality of life in areas
related to physical health: physical functioning (73.4 vs
82.3), role-physical (48.1 vs 71.5), and general health
(42.3 vs 51.1). No significant differences were found
between these two groups in the scales related to mental
health summary measures. Both depressed and heroin-
dependent patients showed significantly better levels of
quality of life than OCD patients in the following
scales: social functioning, role-emotional, and mental
health. Furthermore, depressed patients also had better
levels of quality of life in bodily pain and in vitality
scales (table III).
As expected, hemodialysis patients reported signifi-
cantly worse levels of quality of life in the physical
functioning (54.2 vs 82.3) and in the general health
(35.1 vs 51.1) scales and better levels in the social
functioning, role-emotional, and mental health scales
than our OCD patients (table III). However, scores on
the physical health scales for kidney-transplanted
patients were equal or better (general health) than those
of OCD patients (table III).
Table IV reflects the ratings given by clinicians in the
DAS-S scale. The areas considered as most disabled
were social and occupational. Compared to the ratings
of schizophrenic patients, OCD patients were signifi-
cantly more disabled in these two areas (3.21 vs 2.61
and 3.18 vs 2.64 respectively).
DISCUSSION
Our results demonstrate that OCD patients, along
with the schizophrenics, had the lowest health-related
quality of life across the eight groups analyzed, espe-
cially in mental health areas, as evidenced by the lowest
Table II. Comparison between SF-36 mean scores from OCD patients and Spanish population norms.
OCD Spanish population norms
(N = 9,151)
Difference in standard deviation
units
(N = 36)
Physical functioning (PF) 82.36 (24.21) 84.70 –.09
Role-physical (RP) 71.52 (36.91) 83.20 –.33
Bodily pain (BP) 72.80 (29.43) 79.00 –.22
General health (GH)
a
51.11 (22.58) 68.30 –.77
Vitality (VT)
a
45.27 (19.81) 66.90 –.97
Social functioning (SF)
a
50.00 (31.48) 90.10 –2
Role-emotional (RE)
a
37.03 (41.99) 88.60 –1.71
Mental health (MH)
a
45.88 (21.77) 73.30 –1.36
Physical health 51.96 .19
Mental health 29.21 –2.07
Student t-test: a: P = .0000
242 J. Bobes et al.
Eur Psychiatry 2001 ; 16 : 239–45
mean SF-36 subscale scores. The areas showing the
greatest impairment were social functioning, role-
emotional and mental health, so our first hypothesis
concerning the greater impairment of the areas related
to the mental health summary measure was confirmed.
Koran et al. [15] also reported more impairment in the
mental health domains; they found vitality to be the
area most impaired, followed by the mental health and
role-emotional areas. The greatest level of disability in
our OCD patients corresponded to social and occupa-
tional areas. These results are consistent with several
studies [7, 10, 12, 17], which have reported that the
greatest impact of OCD on the patients’ lives was
disruption of their careers and their relationships with
family and friends. Up to 60–70% reported ‘much’ or
‘very much’ interference with their school, work, social
and family lives [10]. Stein et al. [17] found that
socializing and family relationships were the areas
reported as moderately or severely dysfunctional for the
majority of patients (60.5% and 59% respectively).
Severe or moderate interference with work was reported
by 40% and with academic achievement by 54.5%. In
our study clinicians rated work and social life as the
areas with the greatest disability followed by family life.
The mean level of disability in these areas (between
50% and 60%) is consistent with the levels reported by
Steketee [18] in her review.
The poorer quality of life of the OCD patients com-
pared to the Spanish general population cannot be
attributed to differences in age or gender. Young people
and males, who in Spain report better quality of life,
were over-represented in the OCD patient group.
Health-related quality of life was found to be quite
similar in OCD and in schizophrenic patients, as in the
case of Calvocoressi et al. [5]. This is particularly rel-
evant because schizophrenia has traditionally been con-
sidered the most devastating psychiatric illness.
However, our results suggest that in the areas related to
the mental health summary measure, the quality of life
of OCD patients is exactly as poor as that of schizo-
phrenic patients. The lack of statistically significant
differences between both groups can scarcely be
imputed to clinical or demographic factors. Clinically,
both samples were similar as evidenced by their scores
on the severity instruments. Demographically, mean
ages were identical, but the higher proportion of males
in the schizophrenic group may have contributed to
this group’s higher quality of life scores. The differences
found in the areas related to the physical health sum-
mary can be, to some extent, surprising. They would
seem to point out that schizophrenia would affect the
lives of their sufferers more widely than OCD. But,
upon closer examination as to the exact meaning of the
physical areas, we think that there may be other inter-
pretations. Taking into account the fact that the role-
Table III. Comparison between SF-36 mean scores from OCD patients and other psychiatric and somatic patients.
PF RP BP GH VT SF RE MH
OCD (N = 36) 82.36 71.52 72.80 51.11 45.27 50.00 37.03 45.88
U.S. OCD (N = 60) 88.80 77.50 79.40 69.40
c
44.30 68.70
b
52.80 51.70
Schizophrenics
(N = 346)
73.4
a
48.1
b
71.6 42.3
a
38.7 46.5 35.4 47.3
Depressed (N = 729) 85.46 74.58 81.16
a
56.62 55.01
a
78.76
d
77.10
d
68.79
d
Heroin dependents
(N = 49)
86.53 82.65 80.85 52.40 46.42 80.93
d
68.44
c
58.61
b
Hemodialysis patients
(N = 170)
54.20
d
64.00 65.60 35.10
c
51.60 80.90
d
72.40
d
67.70
d
Kidney transplant reci-
pients (N = 210)
83.30 87.40
a
80.20 65.30
b
73.60
d
93.50
d
87.50
d
79.60
d
PF: Physical functioning; RP: Role-physical; BP: Bodily pain; GH: General health; VT: Vitality; SF: Social functioning; RE: Role-emotional;
MH: Mental health. Statistically significant differences (Student t-test) compared to OCD patients’ mean scores: a: P < .05; b: P <.005; c:
P < .0005; d: P = .0000
Table IV. Scores on the World Health Organization Short Disability
Assessment Schedule (WHO DAS-S): OCD patients vs schizophrenic
patients.
OCD
(N = 34)
Schizophrenics
(N = 365)
Personal care 1.35 (1.35) 1.60
Occupation
a
3.18 (3.34) 2.64
Family and household 2.41 (2.12) 2.16
Broader social context
a
3.21 (3.40) 2.61
Student t-test: a: P < .05
QoL and disability in OCD
243
Eur Psychiatry 2001 ; 16 : 239–45
physical area refers to role limitations due to physical
problems, it could be that schizophrenic patients were
less able to differentiate if their role limitations are due
to physical or to emotional problems. Another factor
that could contribute to this difference is the medica-
tion. When the baseline SF-36 was administered, all
schizophrenics were on neuroleptic depot medication.
This type of medication is known to have secondary
effects that could influence the impairment on the
physical scales. Finally, the clinicians’ disability ratings
support our hypothesis that OCD is as devastating as
schizophrenia. Clinicians rated the social and occupa-
tional lives of the OCD patients as significantly more
disabled than those of schizophrenic patients.
Spanish OCD patients reported worse levels of health-
related quality of life than U.S. OCD patients in the
areas of general health and social functioning. Social
functioning was the area most affected by the OCD in
the Spanish sampling, while in the U.S. sample it ranks
fourth. This difference may be interpreted in the con-
text of cultural differences between both populations,
in that the social component of a Spaniard’s life tends
to be more important to him.
With respect to the rest of the psychiatric disorders
included in the analysis, no doubts exist. The quality of
life of the OCD patients was worse than that of the
depressed or heroin-dependent patients. However,
Koran et al. [15] reported better quality of life in all
SF-36 areas except in role-emotional for OCD than for
depressed patients. It is necessary to point out, how-
ever, that these authors used the median and not the
mean scores to compare the quality of life across the
groups.
Patients with OCD showed lower levels of health-
related quality of life in the areas corresponding to the
mental health domain and equal or higher levels in the
areas of physical health domain than patients on hemo-
dialysis. These findings are consistent with expected
differences in the effects of mental and physical disorder
on health-related quality of life. The fact that kidney
transplant recipients reported equal or better quality of
life than OCD patients highlights the success that
kidney transplantation has achieved, not only in the
clinical field but in the patients’ daily lives [8].
Methodological limitations necessitate viewing our
results with caution. First, there is the cross-sectional
nature of our study. Second, our private outpatients are
unlikely to be a representative sample of OCD patients
in Spain. Third, the small size of the sample limited the
ability to control for gender and co-morbid disorders.
And finally, we have only used a generic health-related
quality of life instrument with no specific instrument
for psychiatric patients, since no such instrument for
OCD exists. Nevertheless, the results of this study are
consistent with clinical experience and with similar
studies carried out in other countries.
REFERENCES
1 Alonso J, Prieto L, Antó JM. La versión española del SF-36
Health Survey (Cuestionario de Salud SF-36): un instrumento
para la medida de los resultados clínicos. Med Clin (Barcelona)
1995 ; 104 : 771-6.
2 Alonso J, Regidor E, Barrio G, Prieto L, Rodríguez C, de la
Fuente L. Valores poblacionales de referencia de la versión
española del Cuestionario de Salud SF-36. Med Clin (Barce-
lona) 1998 ; 111 : 410-6.
3 Bobes J, Baca E, Casais L, Roca M, González MP. Quality of life
in depressed Spanish patients after six-months of treatment with
venlafaxine. American Psychiatric Association Annual Meeting-
New Research Abstracts. Washington DC: APA; 1998. p. 135.
4 Bobes J, Gutiérrez M, Gibert J, González MP, Herraiz L,
Fernández A. Quality of life in schizophrenia: long-term
follow-up in 362 chronic Spanish schizophrenic outpatients
undergoing risperidone maintenance treatment. Eur Psychiatry
1998 ; 13 : 158-63.
5 Calvocoressi L, Libman D, Vegso SJ, McDougle CJ, Price LH.
Global functioning of inpatients with obsessive-compulsive dis-
order, schizophrenia, and major depression. Psychiatr Serv
1998 ; 49 : 379-81.
6 Fernández Miranda JJ, González G, Portilla MP, Sáiz Mar-
tínez PA, Gutiérrez Cienfuegos E, Bobes García J. Calidad de
vida y severidad de la adicción en heroinómanos en manten-
imiento prolongado con metadona. Adicciones 1999 ; 11 :
43-52.
7 Gallup Organization. A Gallup study of obsessive-compulsive
disorder sufferers. Princeton, NJ: Gallup Organization; 1990.
8 González MP, Sudilovsky A, Bobes J, DiMartini A. Quality of
life of geriatric patients following transplantation: short- and
long-term outcomes. In: Trzepac PT, DiMartini A, Eds. Trans-
plantation psychiatry. New York: Cambridge University Press;
in press.
9 Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleis-
chmann RL, Hill CL, et al. The Yale-Brown Obsessive Com-
pulsive Scale. I. Development, use, and reliability. Arch Gen
Psychiatry 1989 ; 46 : 1006-11.
10 Hollander E. Obsessive-compulsive disorder: the hidden epi-
demic. J Clin Psychiatry 1997 ; 58 (Suppl 12) : 3-6.
11 Hollander E. Treatment of obsessive-compulsive spectrum dis-
orders with SSRIs. Br J Psychiatry 1998 ; 173 (Suppl 35) : 7-12.
12 Hollander E, Kwon JH, Stein DJ, Broatch J, Rowland CT,
Himelein CA. Obsessive-compulsive and spectrum disorders:
overview and quality of life issues. J Clin Psychiatry 1996 ; 57
(Suppl 8) : 3-6.
13 Janca A, Kastrup M, Katschnig H, López-Ibor JJ, Mezzich JE,
Sartorius N. The World Health Organization Short Disability
Assessment Schedule (WHO DAS-S): a tool for the assessment
of difficulties in selected areas of functioning of patients with
mental disorders. Soc Psychiatr Epidemiol 1996 ; 31 : 349-54.
14 Karno M, Golding JM, Sorenson SB, Burnam A. The epidemi-
ology of obsessive-compulsive disorder in five US communities.
Arch Gen Psychiatry 1988 ; 45 : 1094-9.
244 J. Bobes et al.
Eur Psychiatry 2001 ; 16 : 239–45
15 Koran LM, Thienemann ML, Davenport R. Quality of life for
patients with obsessive-compulsive disorder. Am J Psychiatry
1996 ; 153 : 783-8.
16 Rebollo P, Bobes J, González MP, Sáiz PA, Ortega F. Factores
que influyen en la calidad de vida relacionada con la salud de los
pacientes en terapia renal sustitutiva. Nefrología in press.
17 Stein DJ, Roberts M, Hollander E, Rowland C, Serebro P.
Quality of life and pharmaco-economic aspects of obsessive-
compulsive disorder. S Afr Med J 1996 ; 36 : 1579-85.
18 Steketee G. Disability and family burden in obsessive-
compulsive disorder. Can J Psychiatry 1997 ; 42 : 919-28.
19 Ware JE. SF-36 Health Survey: manual and interpretation
guide. Boston: Health Institute, New England Medical Center;
1993.
20 Ware JE, Sherbourne CD. The MOS 36-Item Short-Form
Health Survey (SF-36). I. Conceptual framework and item
selection. Med Care 1992 ; 30 : 473-83.
21 Wenger NK, Furberg CD. Cardiovascular disorders. In:
Spilker B, Ed. Quality of life assessment in clinical trials. New
York: Raven Press; 1990. p. 335-45.
22 World Health Organization. The “newly defined” burden of
mental problems. Fact Sheets nº 217. Geneva: WHO; 1999.
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- CitationsCitations138
- ReferencesReferences25
- "La mayoría presentan otros trastornos de ansiedad, depresivos, trastorno bipolar o abuso de sustancias, por lo que este trastorno, es uno de los que mayor comorbilidad presenta. Así mismo, la OMS califica el trastorno como uno de los top 10 enfermedades incapacitantes, por pérdida de ingresos y disminución de calidad de vida (Bobes et al., 2001). Aunque la inclusión del trastorno en el nuevo DSM-V (2015) está presentado en una categoría aparte y supuestamente diferente de los trastornos de ansiedad su abordaje terapéutico se basa principalmente en el alivio de la ansiedad independientemente de sus peculiares manifestaciones que pueda presentar cada uno y los tipos (Miró & Pastor, 2012). "
[Show description] [Hide description] DESCRIPTION: Descripcion y divulgación general de estudios en el abordaje del TOC desde la perspectiva del mindfulness.- "While OCD causes significant distress to the person experiencing its symptoms, it is also associated with reduced quality-of-life as well as high levels of social and occupational impairment. It has been identified by the World Health Organization (WHO) as one of the world's top 10 disabling illnesses by lost income and decreased quality-of-life (Bobes, Gonzalez, Bascaran, Arango, Saiz, & Bousono, 2001). Current standard pharmacotherapy has reasonable efficacy in OCD, but has several limitations. "
[Show abstract] [Hide abstract] ABSTRACT: Some yoga-based practices have been found to be useful for patients with obsessive compulsive disorder (OCD). The authors could not find a validated yoga therapy module available for OCD. This study attempted to formulate a generic yoga-based intervention module for OCD. A yoga module was designed based on traditional and contemporary yoga literature. The module was sent to 10 yoga experts for content validation. The experts rated the usefulness of the practices on a scale of 1-5 (5 = extremely useful). The final version of the module was pilot-tested on patients with OCD (n = 17) for both feasibility and effect on symptoms. Eighty-eight per cent (22 out of 25) of the items in the initial module were retained, with modifications in the module as suggested by the experts along with patients' inputs and authors' experience. The module was found to be feasible and showed an improvement in symptoms of OCD on total Yale-Brown Obsessive-Compulsive Scale (YBOCS) score (p = 0.001). A generic yoga therapy module for OCD was validated by experts in the field and found feasible to practice in patients. A decrease in the symptom scores was also found following yoga practice of 2 weeks. Further clinical validation is warranted to confirm efficacy.- "With special reference to patients with OCD, QoL domains in terms of social relationships, work role functioning, and mental health perspectives are all decreased in patients with acute and chronic OCD but physical health is relatively less affected negatively by this disorder [3,17,18]. However, severe compulsions related to obsession of contamination result in multiple skin problems among patients with OCD [19,20]. "
[Show abstract] [Hide abstract] ABSTRACT: Background: Obsessive Compulsive Disorder (OCD) is a chronic and disabling condition that negatively affects quality of life (QoL) of patients with this disorder attributable to sociodemographic, clinical and illness-specific factors. However, findings vary across studies that have explored sociodemographic and QoL of patients with OCD compared to control group or patients with other mental disorders. Objective: This cross-sectional study aimed to analyze the sociodemographic and comparatively assess QoL of patients with OCD and community dwellers with no diagnosis of OCD. Method: Sixty patients with diagnosed OCD and seventy six people without OCD were selected from different clinical and community settings, respectively. A semi-structured proforma was used for the collection of sociodemographic variables and World Health Organization QOL-BREF (WHOQOL-BREF) scale for the assessment of the subjective QoL of both groups. Results: Male gender, lower education and unemployment were significantly associated with OCD and scores related to physical, psychological, social and environmental domains of WHOQOL-Original Research Article Alghamdi and Awadalla; INDJ, 6(3): 1-15, 2016; Article no.INDJ.21469 2 BREF were significantly lower in OCD group compared to control population. All grades of satisfaction levels differ significantly between sub-items of 3 domains of QoL of OCD group when compared to community dwellers but environmental domain sub-items did not differ between the two groups. The OCD group was not significantly dissatisfied across all four QoL domains when compared to control group. Conclusion: The preliminary results of this study are partially comparable to international data on QoL of patients with OCD and call for a research with a larger sample in Saudi Arabia's community setting.
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