Academic journal article Hong Kong Journal of Psychiatry

Disability and Quality of Life in Schizophrenia and Obsessive Compulsive Disorder: A Cross-Sectional Comparative Study

Academic journal article Hong Kong Journal of Psychiatry

Disability and Quality of Life in Schizophrenia and Obsessive Compulsive Disorder: A Cross-Sectional Comparative Study

Article excerpt

Abstract

Objective: To assess and compare the quality of life and disability in patients with schizophrenia and obsessive compulsive disorder.

Methods: A cross-sectional study was carried out in the outpatient psychiatry clinics at Jaipur of India. Fifty patients with obsessive compulsive disorder and 47 with schizophrenia (diagnosed as per criteria of the 10th revision of the International Classification of Diseases), and with a minimum duration of 2 years on maintenance treatments, were evaluated. Evaluation was based on the World Health Organization Quality of Life Instrument, the Global Assessment of Functioning scale, and the Indian Disability Evaluation Assessment Scale. The collected data were analysed using descriptive and inferential statistics.

Results: Regarding quality of life domains, there was no statistically significant difference between the 2 groups. Obsessive compulsive disorder patients had lower scores on all domains of disability, all such differences being statistically significant.

Conclusions: The deleterious effect of illness on quality of life and functioning occur not only in schizophrenic but also in obsessive compulsive disorder patients. Thus management should be planned with this consideration to yield better outcomes in both conditions.

Key words: Disability evaluation; Obsessive-compulsive disorder; Quality of life; Schizophrenia

Introduction

Mental, behavioural, and social health problems are increasingly problematic all over the world. Yet they have received scant attention other than in wealthier, industrialised nations.1 Although the burden of illness resulting from psychiatric and behavioural disorders is enormous, it is grossly under-represented in conventional public health statistics, which tend to focus on mortality rather than morbidity or dysfunction.1

In 1990, the worldwide global burden of disease for neuropsychiatric disorders, as measured by disabilityadjusted life years (DALYs), was estimated to be 6.8%.2 Psychiatric disorders account for 5 of the 10 leading causes of disability as measured by years lived with a disability.2 The overall DALYs burden for neuropsychiatric disorders is projected to increase to 15% by the year 2020, which is proportionately larger than that for the increase in cardiovascular disease.3

The World Health Organization (WHO)'s definition of health4 emphasised the importance of well-being besides absence of disease as an essential component of health, to which not much attention has been paid for a considerable period of time. The focus has gradually shifted towards understanding the consequences of health conditions in terms of disabilities that are experienced at the level of the body, person, and society. In addition, the subjective components of health experience ('quality of life' [QOL], 'subjective well-being') have also acquired a definite place in the understanding of health and its consequences.5

There has been little examination of the extent to which presence of persistent obsessions and compulsions impacts on the QOL and disability of persons with obsessive compulsive disorder (OCD). A review of the impact of anxiety disorders on QOL enumerated the profound personal, social, and financial costs, though there was a striking dearth of studies on patients with OCD.6

Schizophrenia is a severe and debilitating disorder, which affects general health, functioning, autonomy, subjective well-being, and life satisfaction of those who suffer from it. Despite 50 years of pharmacological and psychosocial interventions, schizophrenia remains one of the top causes of disability in the world.7

We undertook this study to assess, quantify, and compare the disability and QOL in patients suffering from schizophrenia and OCD attending our psychiatric centre in Jaipur. This study has been carried out to assess the impact of mental illnesses on different domains of patient's life. …

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