Costs to Quality of Life Associated with Common Mental Disorders: Results from a Nationally Representative Sample
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Objective: Traditional burden of disease estimates often exclude personality disorders, which are associated with significant mortality and morbidity. This paper aimed to estimate the health related quality of life and annual population level quality-adjusted life years (QALY) losses associated with different mental and physical health conditions. In particular, it sought to quantify the impact of personality disorders on quality of life, at an individual and population level. Method: This secondary analysis of study used data from the National Epidemiologic Survey on Alcohol and Related Conditions (n=34,533), a nationally representative survey of the United States general population collected from 2001-2005. Health related quality of life (measured using the SF-6D) was the main outcome of interest. Regression analysis assessed the impact of various mental (based on DSM-IV criteria) and physical health conditions on HRQOL scores, and this impact was combined with prevalence of disorders to estimate the population level burden of disease. Results: Mood disorders were associated with the highest decrease in HRQOL scores, followed by psychotic illness, stroke and arthritis (P<0.01 ). The greatest annual population QALY losses were caused by arthritis, mood disorders, and personality disorders. Conclusion: QALY losses associated with personality disorders ranked behind only mood disorders and arthritis. Personality disorders were associated with significant reductions in quality of life, despite the fact that they are often excluded from traditional burden of disease estimates.