Four-year course of quality of life and obsessive–compulsive disorder

Abstract

Objective Patients with obsessive compulsive disorder (OCD) have high disease burden. It is important to restore quality of life (QoL) in treatment, so that patients become able to live a fulfilling life. Little is known about the longitudinal course of QoL in patients with OCD, its association with remission from OCD, and about factors that contribute to an unfavourable course of QoL in remitting patients. Methods Study on the 4-year course of QoL of patients with chronic (n = 144), intermittent (n = 22), and remitting OCD (n = 73) using longitudinal data of the Netherlands Obsessive Compulsive Disorder Association (NOCDA; complete data: n = 239; imputed data n = 382). The EuroQol five-dimensional questionnaire (EQ-5D) utility score was used to assess QoL. In patients with remitting OCD, we examined patient characteristics that contributed to an unfavourable course of QoL, including sociodemographics, OCD characteristics, psychiatric comorbidity, and personality traits. Results Course of QoL was associated with course of OCD. QoL improved in those who remitted from OCD; however, even in these patients, QoL remained significantly below the population norms. The correlation between QoL and severity of OCD was only moderate: r = − 0.40 indicating that other factors besides OCD severity contribute to QoL. In remitters, more severe anxiety and depression symptoms were related to a lower QoL. Results were similar in complete and imputed data sets. Conclusions Remission from OCD is associated with improvement of QoL, but comorbid anxiety and depression symptoms hamper the improvement of QoL. QoL could be improved by reducing OCD symptoms in patients with OCD and by treating comorbid anxiety and depression symptoms in remitting patients.

Ventral Capsule/Ventral Striatum Stimulation in Obsessive-Compulsive Disorder: Toward a Unified Connectomic Target for Deep Brain Stimulation?

“…The mean EQ‐5D health index is within the confidence interval the EQ‐5D (0.67, 95% CI = 0.64–0.70) of large cohort of chronic and demographically comparable OCD patients (40). We did not observe an improvement in quality of life as observed in Ménchon et al This may indicate that other factors than OCD severity contributed to the quality of life outcome, or reflect the lower sensitivity and precision of the EQ‐5D‐3L in our study compared to the EQ‐5D‐5L used by Menechon et al (41) Mood improved in both responders and nonresponders, without significant between‐group differences, showing that effects of mood may be independent of effects on OCD symptoms.…”

Deep Brain Stimulation for Obsessive-Compulsive Disorder: Real World Experience Post-FDA-Humanitarian Use Device Approval

“…Here we report the results of VC/VS DBS in five patients whose comorbidities include substance use disorders, MDD, autism spectrum disorder, psychosis, anorexia nervosa, and tic disorder. A recent study of quality of life QOL in OCD demonstrated that QOL in OCD is often as dependent on the comorbid psychiatric disease as the OCD itself ( 26 ). This underscores the fact that “success” from DBS in these patients is heavily dependent on their comorbidities in addition to their OCD.…”

Characteristic and Early Discontinuation of Obsessive-Compulsive Disorder Trials Registered on ClinicalTrials.gov

“…Compulsions are defined as repeated behaviors or mental acts that patients wish to perform in response to obsessions ( 2 ). The prevalence of OCD throughout the lifetime of an individual is 1.6% and varies significantly with age ( 3 ).…”

“…The currently available literature suggests that the mean QoL of patients with OCD is lower than that of the healthy population. Thus, OCD has a marked impact on QoL ( 3 ).…”