Quality of life of people with schizophrenia, bipolar disorder and other psychotic disorders.

BACKGROUND: Health utility and quality of life (QoL) are increasingly important outcome measures in healthcare and health economics.

AIMS: To compare the loss of subjective QoL and utility-based health-related quality of life (HRQoL) associated with psychotic disorders.

METHOD: A representative sample of 8028 Finns was screened for psychotic disorders and bipolar I disorder. Lifetime psychotic disorders were diagnosed using the Structured Clinical Interview for DSM-IV and/or case records. Health-related quality of life was measured with EQ-5D and 15D, and QoL was measured with a 10-point scale.

RESULTS: Schizoaffective disorder was associated with the largest losses of QoL and HRQoL, with bipolar I disorder associated with similar or smaller losses than schizophrenia. Current depressive symptoms explained most of the losses.

CONCLUSIONS: Depressive symptoms are the strongest predictors of poor QoL/HRQoL in psychotic disorders. Subjective loss of QoL associated with psychotic disorders may be smaller than objective loss of functioning suggests. The EQ-5D is problematic as an outcome measure in psychotic disorders.