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Generic and Illness-Specific Quality of Life in Obsessive-Compulsive Disorder

Published online by Cambridge University Press:  08 June 2010

Marit Hauschildt ,
Lena Jelinek ,
Sarah Randjbar ,
Birgit Hottenrott  and
Steffen Moritz
Marit Hauschildt*
Affiliation:
University Medical CenterHamburg-Eppendorf, Hamburg, Germany
Lena Jelinek
Affiliation:
University Medical CenterHamburg-Eppendorf, Hamburg, Germany
Sarah Randjbar
Affiliation:
University Medical CenterHamburg-Eppendorf, Hamburg, Germany
Birgit Hottenrott
Affiliation:
University Medical CenterHamburg-Eppendorf, Hamburg, Germany
Steffen Moritz
Affiliation:
University Medical CenterHamburg-Eppendorf, Hamburg, Germany
*
Reprint requests to Marit Hauschildt, University Medical Center Hamburg Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, 20246 Hamburg, Germany. E-mail: m.hauschildt@uke.de
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Abstract

Background: Obsessive compulsive disorder (OCD) is a chronic and disabling disorder. It profoundly compromises various aspects of patients’ everyday life, thus affecting their quality of life (QoL). Using generic instruments, several studies have confirmed severely impaired health-related QoL in patients diagnosed with OCD. However, there has been a dearth of research on illness-specific QoL. Aims: The present study aimed to further investigate subjective QoL in individuals with OCD with a focus on illness-specific aspects. Method: To assess subjective QoL in a broad OCD sample, an internet survey was conducted with 123 participants with obsessive-compulsive symptoms. The survey comprised both a generic (WHOQOL-BREF) and a novel self-developed OCD-specific QoL measure (QoLOC). Psychopathology was determined with diagnostic standard instruments (self-report forms of: Y-BOCS, OCI-R, BDI-SF). Results: Regression analyses confirmed depression as the best predictor for decreased QoL. In addition, participants reported high despair resulting from OCD-related problems that differed across symptom subtypes. An exploratory factor analysis suggested four domains of OCD-specific problems tapped by the QoLOC: (1) depressiveness in association with OCD; (2) constraints in activities due to OCD symptoms or avoidance; (3) problems with partner and/or family due to OCD symptoms or avoidance; (4) self-concept/coping of own illness. Conclusions: Results produced a comprehensive picture of QoL impairments and their relation to psychopathology in a representative OCD sample. Illness-specific concerns should be further addressed in QoL research in OCD because such problems are not sufficiently mirrored in generic QoL measures.

Keywords

Obsessive-compulsive disorderOCDquality of lifeinternet studyWHOQOL-BREFillness-specific problems
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 38 , Issue 4 , July 2010 , pp. 417 - 436
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2010

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References

Abbey, R. D., Clopton, J. R. and Humphreys, J. D. (2007). Obsessive-compulsive disorder and romantic functioning. Journal of Clinical Psychology, 63, 1181–1192.CrossRefGoogle ScholarPubMed
Abramowitz, J. S. and Deacon, B. J. (2006). Psychometric properties and construct validity of the Obsessive-Compulsive Inventory-Revised: replication and extension with a clinical sample. Journal of Anxiety Disorders, 20, 1016–1035.CrossRefGoogle ScholarPubMed
Abramowitz, J. S., Wheaton, M. G. and Storch, E. A. (2008). The status of hoarding as a symptom of obsessive-compulsive disorder. Behaviour Research and Therapy, 46, 1026–1033.CrossRefGoogle ScholarPubMed
Akdede, B., Alptekin, K., Akvardar, Y. and Kitis, A. (2005). Quality of life in patients with obsessive-compulsive disorder: relations with cognitive functions and clinical symptoms. Turkish Journal of Psychiatry, 16, 1–7.Google Scholar
Aksaray, G., Yelken, B., Kaptanoglu, C., Oflu, S. and Ozaltin, M. (2001). Sexuality in women with obsessive compulsive disorder. Journal of Sex and Marital Therapy, 27, 273–277.Google ScholarPubMed
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th edn, DSM-IV). Washington, DC: American Psychiatric Association.Google Scholar
Angermeyer, M. C., Kilian, R. and Matschinger, H. (2000). WHOQOL-100 und WHOQOL-BREF. Göttingen: Hogrefe.Google Scholar
Angst, J., Gamma, A., Endrass, J., Goodwin, R., Ajdacic, V., Eich, D. and Rossler, W. (2004). Obsessive-compulsive severity spectrum in the community: prevalence, comorbidity, and course. European Archives of Psychiatry and Clinical Neuroscience, 254, 156–164.CrossRefGoogle ScholarPubMed
Beck, A. T. and Steer, R. A. (1993). Beck Depression Inventory Manual. San Antonio: Psychological Corporation.Google Scholar
Besiroglu, L., Cilli, A. S. and Askin, R. (2004). The predictors of health care seeking behavior in obsessive-compulsive disorder. Comprehensive Psychiatry, 45, 99–108.CrossRefGoogle ScholarPubMed
Bobes, J., Gonzalez, M. P., Bascaran, M. T., Arango, C., Saiz, P. A. and Bousono, M. (2001). Quality of life and disability in patients with obsessive-compulsive disorder. European Psychiatry, 16, 239–245.CrossRefGoogle ScholarPubMed
Bystritsky, A., Liberman, R. P., Hwang, S., Wallace, C. J., Vapnik, T., Maindment, K. and Saxena, S. (2001). Social functioning and quality of life comparisons between obsessive-compulsive and schizophrenic disorders. Depression and Anxiety, 14, 214–218.CrossRefGoogle ScholarPubMed
Bystritsky, A., Saxena, S., Maidment, K., Vapnik, T., Tarlow, G. and Rosen, R. (1999). Quality-of-life changes among patients with obsessive-compulsive disorder in a partial hospitalization program. Psychiatric Services, 50, 412–414.CrossRefGoogle Scholar
Cattell, R. B. (1987). The Scientific Use of Factor Analysis. New York: Plenum.Google Scholar
Chinman, M., Young, A. S., Schell, T., Hassell, J. and Mintz, J. (2004). Computer-assisted self-assessment in persons with severe mental illness. The Journal of Clinical Psychiatry, 65, 1343–1351.CrossRefGoogle ScholarPubMed
Coles, M. E., Cook, L. M. and Blake, T. R. (2007). Assessing obsessive compulsive symptoms and cognitions on the internet: evidence for the comparability of paper and internet administration. Behaviour Research and Therapy, 45, 2232–2240.CrossRefGoogle ScholarPubMed
Cordiolia, A. V., Heldt, E., Bochia, D. B., Margisb, R., de Sousab, M. B., Tonellob, J. F., Manfrob, G. G. and Kapczinskia, F. (2003). Cognitive-behavioral group therapy in obsessive-compulsive disorder: a randomized clinical trial. Psychotherapy and Psychosomatics, 72, 211–216.Google Scholar
Deacon, B. J. and Abramowitz, J. S. (2005). The Yale-Brown Obsessive Compulsive Scale: factor analysis, construct validity, and suggestions for refinement. Journal of Anxiety Disorders, 19, 573–585.CrossRefGoogle ScholarPubMed
Demal, U., Lenz, G., Mayrhofer, A., Zapotoczky, H. G. and Zitterl, W. (1993). Obsessive-compulsive disorder and depression: a retrospective study on course and interaction. Psychopathology, 26, 145–150.CrossRefGoogle ScholarPubMed
Diefenbach, G. J., Abramowitz, J. S., Norberg, M. M. and Tolin, D. F. (2007). Changes in quality of life following cognitive-behavioral therapy for obsessive-compulsive disorder. Behaviour Research and Therapy, 45, 3060–3068.CrossRefGoogle ScholarPubMed
Eisen, J. L., Mancebo, M. A., Pinto, A., Coles, M. E., Pagano, M. E., Stout, R. and Rasmussen, S. A. (2006). Impact of obsessive-compulsive disorder on quality of life. Comprehensive Psychiatry, 47, 270–275.Google Scholar
Foa, E. B., Huppert, J. D., Leiberg, S., Langner, R., Kichic, R., Hajcak, G. and Salkovskis, P. M. (2002). The Obsessive-Compulsive Inventory: development and validation of a short version. Psychological Assessment, 14, 485–496.CrossRefGoogle ScholarPubMed
Frost, R. O., Steketee, G., Williams, L. F. and Warren, R. (2000). Mood, personality disorder symptoms and disability in obsessive compulsive hoarders: a comparison with clinical and nonclinical controls. Behaviour Research and Therapy, 38, 1071–1081.CrossRefGoogle ScholarPubMed
Furlanetto, L. M., Mendlowicz, M. V. and Romildo Bueno, J. (2005). The validity of the Beck Depression Inventory-Short Form as a screening and diagnostic instrument for moderate and severe depression in medical inpatients. Journal of Affective Disorders, 86, 87–91.CrossRefGoogle ScholarPubMed
Gönner, S., Leonhart, R. and Ecker, W. (2007). The Obsessive-Compulsive Inventory-Revised (OCI-R): validation of the German version in a sample of patients with OCD, anxiety disorders, and depressive disorders. Journal of Anxiety Disorders, 22, 734–749.CrossRefGoogle Scholar
Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Delgado, P., Heninger, G. R. and Charney, D. S. (1989). The Yale-Brown Obsessive Compulsive Scale. II. Validity. Archives of General Psychiatry, 46, 1012–1016.CrossRefGoogle ScholarPubMed
Gorsuch, R. L. (1983). Factor Analysis (2nd ed.). Hillsdale, NJ: Erlbaum.Google Scholar
Grabe, H.-J. and Ettelt, S. (2006). Diagnosis and therapy of obsessive-compulsive disorder. Psychotherapeut, 51, 311–320.CrossRefGoogle Scholar
Grisham, J. R. and Williams, A. D. (2009). Cognitive control of obsessional thoughts. Behaviour Research and Therapy, 47, 395–402.CrossRefGoogle ScholarPubMed
Guadagnoli, E. and Velicer, W. F. (1988). Relation of sample size to the stability of component patterns. Psychological Bulletin, 103, 265–275.CrossRefGoogle Scholar
Hannan, S. E. and Tolin, D. F. (2005). Mindfulness and acceptance based behavior therapy for obsessive-compulsive disorder. In Orsillo, S. M. and Roemer, L. (Eds.), Acceptance and Mindfulness-Based Approaches to Anxiety: conceptualization and treatment (pp. 271–299). New York: Springer.CrossRefGoogle Scholar
Hollander, E. (1997). Obsessive-compulsive disorder: the hidden epidemic. The Journal of Clinical Psychiatry, 58 Suppl 12, 3–6.Google Scholar
Hollander, E. (1998). Treatment of obsessive-compulsive spectrum disorders with SSRIs. The British Journal of Psychiatry, 35, 7–12.CrossRefGoogle Scholar
Hollander, E., Kwon, J. H., Stein, D. J., Broatch, J., Rowland, C. T. and Himelein, C. A. (1996). Obsessive-compulsive and spectrum disorders: overview and quality of life issues. The Journal of Clinical Psychiatry, 57 Suppl 8, 3–6.Google Scholar
Holmes, E. A., Lang, T. J., Moulds, M. L. and Steele, A. M. (2008). Prospective and positive mental imagery deficits in dysphoria. Behaviour Research and Therapy, 46, 976–981.CrossRefGoogle ScholarPubMed
Huppert, J. D., Simpson, H. B., Nissenson, K. J., Liebowitz, M. R. and Foa, E. B. (2009). Quality of life and functional impairment in obsessive-compulsive disorder: a comparison of patients with and without comorbidity, patients in remission, and healthy controls. Depression and Anxiety, 26, 39–45.CrossRefGoogle ScholarPubMed
Jelinek, L., Hottenrott, B. and Moritz, S. (2009). When cancer stands for illness but no longer for an animal or zodiac sign: investigation of biased associative networks in obsessive compulsive disorder (OCD). Journal of Anxiety Disorders, 8, 1031–1036.CrossRefGoogle Scholar
Jones, S. R., Fernyhough, C., de-Wit, L. and Meins, E. (2008). A message in the medium? Assessing the reliability of psychopathology e-questionnaires. Personality and Individual Differences, 44, 349–359.CrossRefGoogle Scholar
Katschnig, H. (2006). Quality of life in mental disorders: challenges for research and clinical practice. World Psychiatry, 5, 139–145.Google ScholarPubMed
Kohn, R., Saxena, S., Levav, I. and Saraceno, B. (2004). The treatment gap in mental health care. Bulletin of the World Health Organization, 82, 858–866.Google ScholarPubMed
Koran, L. M. (2000). Quality of life in obsessive-compulsive disorder. The Psychiatric Clinics of North America, 23, 509–517.CrossRefGoogle ScholarPubMed
Koran, L. M., Thienemann, M. L. and Davenport, R. (1996). Quality of life for patients with obsessive-compulsive disorder. The American Journal of Psychiatry, 153, 783–788.Google ScholarPubMed
Lange, A., van de Ven, J. P. and Schrieken, B. (2003). Interapy: treatment of post-traumatic stress via the internet. Cognitive Behaviour Therapy, 32, 110–124.CrossRefGoogle ScholarPubMed
Lochner, C., Kinnear, C. J., Hemmings, S. M., Seller, C., Niehaus, D. J., Knowles, J. A., Daniels, W., Moolman-Smook, J. C., Seedat, S. and Stein, D. J. (2005). Hoarding in obsessive-compulsive disorder: clinical and genetic correlates. The Journal of Clinical Psychiatry, 66, 1155–1160.CrossRefGoogle ScholarPubMed
Lochner, C., Mogotsi, M., du Toit, P. L., Kaminer, D., Niehaus, D. J. and Stein, D. J. (2003). Quality of life in anxiety disorders: a comparison of obsessive-compulsive disorder, social anxiety disorder, and panic disorder. Psychopathology, 36, 255–262.CrossRefGoogle ScholarPubMed
Lopez, A. D. and Murray, C. C. (1998). The global burden of disease, 1990–2020. Nature Medicine, 4, 1241–1243.CrossRefGoogle ScholarPubMed
MacCallum, R. C., Widaman, K. F., Zhang, S. and Hong, S. (1999). Sample size in factor analysis. Psychological Methods, 4, 84–99.CrossRefGoogle Scholar
Masellis, M., Rector, N. A. and Richter, M. A. (2003). Quality of life in OCD: differential impact of obsessions, compulsions, and depression comorbidity. Canadian Journal of Psychiatry, 48, 72–77.CrossRefGoogle ScholarPubMed
Mataix-Cols, D., Rosario-Campos, M. C. and Leckman, J. F. (2005). A multidimensional model of obsessive-compulsive disorder. The American Journal of Psychiatry, 162, 228–238.CrossRefGoogle ScholarPubMed
Mendlowicz, M. V. and Stein, M. B. (2000). Quality of life in individuals with anxiety disorders. The American Journal of Psychiatry, 157, 669–682.CrossRefGoogle ScholarPubMed
Meyerson, P. and Tryon, W. W. (2003). Validating internet research: a test of the psychometric equivalence of internet and in-person samples. Behavior Research Methods, Instruments, and Computers, 35, 614–620.CrossRefGoogle ScholarPubMed
Moritz, S. (2008). A review on quality of life and depression in obsessive-compulsive disorder. CNS Spectrums, 13, 16–22.CrossRefGoogle ScholarPubMed
Moritz, S. and Jelinek, L. (2009). Inversion of the “unrealistic optimism” bias contributes to overestimation of threat in obsessive-compulsive disorder. Behavioural and Cognitive Psychotherapy, 37, 179–193.Google Scholar
Moritz, S., Jelinek, L., Hauschildt, M. and Naber, D. (in press). How to treat the untreated: effectiveness of a self-help metacognitive training program (myMCT) for obsessive-compulsive disorder (OCD). Dialogues in Clinical Neuroscience.Google Scholar
Moritz, S., Meier, B., Kloss, M., Jacobsen, D., Wein, C., Fricke, S. and Hand, I. (2002). Dimensional structure of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Psychiatry Research, 109, 193–199.CrossRefGoogle ScholarPubMed
Moritz, S. and Pohl, R. (2009). Biased processing of threat-related information rather than knowledge deficits contributes to overestimation of threat in obsessive-compulsive disorder. Behavior Modification, 33, 763–777.CrossRefGoogle ScholarPubMed
Moritz, S., Rufer, M., Fricke, S., Karow, A., Morfeld, M., Jelinek, L., and Jacobsen, D. (2005). Quality of life in obsessive-compulsive disorder before and after treatment. Comprehensive Psychiatry, 46, 453–459.CrossRefGoogle ScholarPubMed
Moritz, S., Wahl, K., Ertle, A., Jelinek, L., Hauschildt, M., Klinge, R. and Hand, I. (2009). Neither saints nor wolves in disguise: ambivalent interpersonal attitudes and behaviors in obsessive-compulsive disorder. Behavior Modification, 33, 274–292.CrossRefGoogle ScholarPubMed
Newth, S. and Rachman, S. (2001). The concealment of obsessions. Behaviour Research and Therapy, 39, 457–464.CrossRefGoogle ScholarPubMed
Nieuwenhuizen, C. (2006). Instruments for measuring quality of life in mental disorders II. Some new developments. In Katschnig, H., Freeman, H. and Sartorius, N. (Eds.), Quality of Life in Mental Disorders (2nd ed.). Chichester: Wiley.Google Scholar
Priebe, S. (1999). Research in quality of life in mental health care: aims and strategies. In Priebe, S., Oliver, J. P. J. and Kaiser, W. (Eds.), Quality of Life and Mental Health Care. Petersfield: Wrightson Biomedical.Google Scholar
Rachman, S. (1997). A cognitive theory of obsessions. Behaviour Research and Therapy, 35, 793–802.Google Scholar
Rachman, S. (1998). A cognitive theory of obsessions: elaborations. Behaviour Research and Therapy, 36, 385–401.CrossRefGoogle ScholarPubMed
Rachman, S., Elliott, C. M., Shafran, R. and Radomsky, A. S. (2009). Separating hoarding from OCD. Behaviour Research and Therapy, 47, 520–522.Google Scholar
Ritter, P., Lorig, K., Laurent, D. and Matthews, K. (2004). Internet versus mailed questionnaires: a randomized comparison. Journal of Medical Internet Research, 6, e29.CrossRefGoogle ScholarPubMed
Riva, G., Teruzzi, T. and Anolli, L. (2003). The use of the internet in psychological research: comparison of online and offline questionnaires. Cyberpsychology and Behavior, 6, 73–80.CrossRefGoogle ScholarPubMed
Rodriguez-Salgado, B., Dolengevich-Segal, H., Arrojo-Romero, M., Castelli-Candia, P., Navio-Acosta, M., Perez-Rodriguez, M. M., et al. (2006). Perceived quality of life in obsessive-compulsive disorder: related factors. BMC Psychiatry, 6, 20.Google Scholar
Salkovskis, P. M. (1999). Understanding and treating obsessive-compulsive disorder. Behaviour Research and Therapy, 37 Suppl 1, S29–52.CrossRefGoogle Scholar
Samuels, J., Shugart, Y. Y., Grados, M. A., Willour, V. L., Bienvenu, O. J., Greenberg, B. D., Knowles, J. A., McCracken, J. T., Rauch, S. L., Murphy, D. L., Wang, Y., Pinto, A., Fyer, A. J., Piacentini, J., Pauls, D. L., Cullen, B., Rasmussen, S. A., Hoehn-Saric, R., Valle, D., Liang, K. Y., Riddle, M. A. and Nestadt, G. (2007). Significant linkage to compulsive hoarding on chromosome 14 in families with obsessive-compulsive disorder: results from the OCD Collaborative Genetics Study. American Journal of Psychiatry, 164, 493–499.CrossRefGoogle ScholarPubMed
Sasson, Y., Zohar, J., Chopra, M., Lustig, M., Iancu, I. and Hendler, T. (1997). Epidemiology of obsessive-compulsive disorder: a world view. The Journal of Clinical Psychiatry, 58 Suppl 12, 7–10.Google Scholar
Schulenberg, S. E. and Yutrzenka, B. A. (2001). Equivalence of computerized and conventional versions of the Beck Depression Inventory-II (BDI-II). Current Psychology, 20, 216–230.Google Scholar
Shusterman, A., Feld, L., Baer, L. and Keuthen, N. (2009). Affective regulation in trichotillomania: evidence from a large-scale internet survey. Behaviour Research and Therapy, 47, 637–644.CrossRefGoogle ScholarPubMed
Skevington, S. M., Lotfy, M. and O'Connell, K. A. (2004). The World Health Organization's WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A Report from the WHOQOL Group. Quality of Life Research, 13, 299–310.CrossRefGoogle Scholar
Sorensen, C. B., Kirkeby, L. and Thomsen, P. H. (2004). Quality of life with OCD: a self-reported survey among members of the Danish OCD Association. Nordic Journal of Psychiatry, 58, 231–236.CrossRefGoogle ScholarPubMed
Stein, D. J., Roberts, M., Hollander, E., Rowland, C. and Serebro, P. (1996). Quality of life and pharmaco-economic aspects of obsessive-compulsive disorder: a South African survey. South African Medical Journal, 86, 1582–1575.Google ScholarPubMed
Steketee, G., Frost, R. and Bogart, K. (1996). The Yale-Brown Obsessive Compulsive Scale: interview versus self-report. Behaviour Research and Therapy, 34, 675–684.CrossRefGoogle ScholarPubMed
Stengler-Wenzke, K., Kroll, M., Matschinger, H. and Angermeyer, M. C. (2006). Subjective quality of life of patients with obsessive-compulsive disorder. Social Psychiatry and Psychiatric Epidemiology, 41, 662–668.CrossRefGoogle ScholarPubMed
Stengler-Wenzke, K., Kroll, M., Riedel-Heller, S., Matschinger, H. and Angermeyer, M. C. (2007). Quality of life in obsessive-compulsive disorder: the different impact of obsessions and compulsions. Psychopathology, 40, 282–289.Google Scholar
Tenney, N. H., Denys, D. A., van Megen, H. J., Glas, G. and Westenberg, H. G. (2003). Effect of a pharmacological intervention on quality of life in patients with obsessive-compulsive disorder. International Clinical Psychopharmacology, 18, 29–33.Google Scholar
The WHOQOL Group (1996). What quality of life? The WHOQOL Group. World Health Organization Quality of Life Assessment. World Health Forum, 17, 354–356.Google Scholar
Tolin, D. F., Frost, R. O., Steketee, G. and Fitch, K. E. (2008). Family burden of compulsive hoarding: results of an internet survey. Behaviour Research and Therapy, 46, 334–344.Google Scholar
Ware, J. E. Jr., and Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30, 473–483.Google Scholar
Welkowitz, L. A., Struening, E. L., Pittman, J., Guardino, M. and Welkowitz, J. (2000). Obsessive-compulsive disorder and comorbid anxiety problems in a national anxiety screening sample. Journal of Anxiety Disorders, 14, 471–482.CrossRefGoogle Scholar
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