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

Br J Psychiatry. 2010 Nov;197(5):386-94. doi: 10.1192/bjp.bp.109.076489.


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.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Bipolar Disorder / epidemiology
  • Bipolar Disorder / psychology*
  • Cost of Illness*
  • Depression / epidemiology
  • Depression / psychology
  • Epidemiologic Methods
  • Female
  • Finland / epidemiology
  • Health Status*
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care / methods
  • Outcome Assessment, Health Care / statistics & numerical data
  • Psychiatric Status Rating Scales
  • Psychotic Disorders / epidemiology
  • Psychotic Disorders / psychology*
  • Quality of Life / psychology*
  • Review Literature as Topic
  • Schizophrenia / epidemiology
  • Schizophrenic Psychology*
  • Self-Assessment
  • Socioeconomic Factors