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Quality of Life Following Remission of Mental Disorders: Findings From the National Epidemiologic Survey on Alcohol and Related Conditions

J Clin Psychiatry 2013;74(5):e445-e450
10.4088/JCP.12m08269

Objective: Although psychiatric disorders are associated with decreased health-related quality of life, it is unknown whether symptom remission is associated with its improvement or normalization.

Method: Data were derived from the National Epidemiologic Survey on Alcohol and Related Conditions, a large national sample of the United States population. A total of 34,653 adults 18 years and older residing in households completed 2 waves (2001–2002 and 2004–2005) of face-to-face surveys. DSM-IV psychiatric diagnoses of mood, anxiety, and substance use disorders were based on the Alcohol Use Disorder and Associated Disabilities Interview Schedule–DSM-IV Version. Health-related quality of life was assessed with the Short Form-12 Health Survey, Version 2 (SF-12).

Results: Remission from alcohol dependence, major depressive disorder, bipolar disorder, dysthymia, social anxiety disorder, and generalized anxiety disorder was associated with significant improvement in SF-12 scores compared to nonremission (ranging from β = 7.28 in dysthymia to β = 3.16 in social anxiety disorder, all P < .05). However, with the exception of alcohol abuse, individuals who had remitted from all other disorders had lower SF-12 scores than individuals without lifetime history of the disorder. Furthermore, remission of alcohol abuse, cannabis use disorder, nicotine dependence, panic disorder, and specific phobia was not associated with significant improvement in SF-12 scores.

Conclusions: The relationship between psychiatric disorders and health-related quality of life is complex and differs across disorders. Although remission of several psychiatric disorders was associated with significant improvements, remission was generally not associated with full restoration of health-related quality of life, even among those without comorbid disorders.

J Clin Psychiatry 2013;74(5):e445–e450

Submitted: November 5, 2012; accepted February 25, 2013 (doi:10.4088/JCP.12m08269).

Corresponding author: Jose M. Rubio, MD, New York State Psychiatric Institute, 1051 Riverside Dr, Box 69, New York, NY 10032 (lorente01@gmail.com).