Self-Reported Health in Patients on or at Risk of Sick Leave Due to Depression and Anxiety: Validity of the EQ-5D

Sandin, Kenneth; Shields, Gemma; Gjengedal, Ragne G. H.; Osnes, Kåre; Bjørndal, Marianne Tranberg; Hjemdal, Odin

doi:10.3389/fpsyg.2021.655151

Cited by 4 publications

(6 citation statements)

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“…We found no association between age and HRQoL, which is in line with some previous research [ 16 , 30 ]. However, older age has also been related to lower HRQoL in physical aspects, and lower age has been related to mental problems [ 13 , 14 ].…”

Section: Discussionsupporting

confidence: 93%

“…The second objective was to explore the relationship between different patient characteristics and HRQoL represented by EQ-5D values and VAS. Sick leave and being unemployed were associated with lower HRQoL, which is in accordance with previous findings [ 12 , 17 , 30 ]. Due to the cross-sectional data, we cannot infer any causal direction of this relationship, as being away from work may cause low HRQoL and vice versa.…”

Section: Discussionsupporting

confidence: 93%

“…The participants’ mean score on VAS was lower than the general population in Norway [ 29 ], and about the same as a Norwegian sample of mixed anxiety and depression from the specialist health services [ 30 ]. The VAS was lower compared to a British study with depressed patients and Dutch patients with personality disorders [ 28 ], but higher compared to a Spanish study with depressed patients [ 11 ].…”

Section: Resultsmentioning

confidence: 99%

“…The EuroQol five dimensions with five levels (EQ-5D-5L) [ 25 , 26 ] is a widely used generic measures of HRQoL and is validated across a range of conditions and countries [ 27 , 28 ]. The Norwegian EQ-5D-5L has been validated in the general population and for patients in specialist mental health services [ 29 , 30 ]. However, there are no studies of EQ-5D-5L on samples from community mental health services.…”

Section: Introductionmentioning

confidence: 99%

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Sociodemographic factors and use of pain medication are associated with health-related quality of life: results from an adult community mental health service in Norway

et al. 2023

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Purpose Health-related quality of life (HRQoL) is an important aspect of mental health outcomes. There are few studies on HRQoL in heterogeneous patient populations seeking help at community mental health services. The aims of the study were to compare how HRQoL, measured by the EuroQol five dimensions with five levels (EQ-5D-5L), was distributed compared to other samples from national and international studies, and to explore what factors are associated with HRQoL. Methods In a cross-sectional study, 1379 Norwegian outpatients reported their HRQoL before starting treatment. Associations with demographic variables, job status, socio-economic status, and use of pain medication were examined using multiple regression analysis. Results Most of the sample, 70% to 90%, reported problems with usual activities, pain/discomfort, and anxiety/depression; 30% to 65% reported that these problems were of a moderate to extreme degree. Forty percent reported problems with mobility, and about 20% reported problems with self-care. The sample’s HRQoL was considerably lower than the general population, and comparable to patient-groups from specialist mental health services. Originating from a developing country, lower level of education, lower yearly household income, being on sick leave or unemployed, and using pain medication were associated with lower HRQoL. Age, gender, and relationship status were not associated with HRQoL. This is the first study to simultaneously examine the unique contribution of these variables in one study. Conclusion The most impacted domains of HRQoL were pain/discomfort, anxiety/depression, and usual activities. Lower HRQoL was associated with several socio-demographic factors and use of pain medication. These findings might have clinical implications and suggest that mental health professionals should routinely measure HRQoL in addition to symptom severity, to identify areas that should be targeted to improve HRQoL.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sociodemographic factors and use of pain medication are associated with health-related quality of life: results from an adult community mental health service in Norway

et al. 2023

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“…A recent review evaluated the properties of the newer five-level version of the EQ-5D, the EQ-5D-5L, across multiple patient groups [11]. These and other studies of patients with mental health problems have shown moderate to good correlation between condition-specific measures and the EQ-5D-5L in crosssectional designs [11][12][13][14][15]. These studies did not include data on responsiveness [11].…”

Section: Introductionmentioning

confidence: 99%

Responsiveness to change in health status of the EQ-5D in patients treated for depression and anxiety

Sandin

Shields

Gjengedal

et al. 2023

Health Qual Life Outcomes

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Background The EQ-5D is a commonly used generic measure of health but evidence on its responsiveness to change in mental health is limited. This study aimed to explore the responsiveness of the five-level version of the instrument, the EQ-5D-5 L, in patients receiving treatment for depression and anxiety. Methods Patient data (N = 416) were collected at baseline and at end of treatment in an observational study in a Norwegian outpatient clinic. Patients were adults of working age (18–69 years) and received protocol-based metacognitive or cognitive therapy for depression or anxiety according to diagnosis. Responsiveness in the EQ-5D was compared to change in the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI). Effect sizes (Cohen’s d), Standardised response mean (SRM), and Pearson’s correlation were calculated. Patients were classified as “Recovered”, “Improved”, or “Unchanged” during treatment using the BDI-II and the BAI. ROC analyses determined whether the EQ-5D could correctly classify patient outcomes. Results Effect sizes were large for the BAI, the BDI-II, the EQ-5D value and the EQ VAS, ranging from d = 1.07 to d = 1.84. SRM were also large (0.93-1.67). Pearson’s correlation showed strong agreement between change scores of the EQ-5D value and the BDI-II (rs -0.54) and moderate between the EQ-5D value and the BAI (rs -0.43). The EQ-5D consistently identified “Recovered” patients versus “Improved” or “Unchanged” in the ROC analyses with AUROC ranging from 0.72 to 0.84. Conclusion The EQ-5D showed good agreement with self-reported symptom change in depression and anxiety, and correctly identified recovered patients. These findings indicate that the EQ-5D may be appropriately responsive to change in patients with depression and anxiety disorders, although replication in other clinical samples is needed.

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Health-related quality of life in psychiatric outpatients: a cross-sectional study of associations with symptoms, diagnoses, and employment status

Havnen,

Lindberg,

Lundqvist

et al. 2024

Qual Life Res

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Background This cross-sectional study aimed to explore health-related quality of life (HRQoL) in a large heterogeneous patient sample seeking outpatient treatment at a specialist mental health clinic. Method A sample of 1947 patients with common mental disorders, including depressive-, anxiety-, personality-, hyperkinetic- and trauma-related disorders, completed the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) to assess HRQoL. We investigated clinical and sociodemographic factors associated with the EQ-5D index and the EQ Visual Analogue Scale (VAS) using regression analyses. Results The sample reported lower HRQoL compared with the general population and primary mental health care patients. Sick leave, disability pension, work assessment allowance, and more symptoms of anxiety and depression were associated with lower EQ-5D index and EQ VAS scores. Furthermore, being male, use of pain medication and having disorders related to trauma were associated with reduced EQ-5D index scores, while hyperkinetic disorders were associated with higher EQ-5D index scores. Conclusion HRQoL of psychiatric outpatients is clearly impaired. This study indicated a significant association between employment status, symptom severity, and HRQoL in treatment-seeking outpatients. The findings highlight the importance of assessing HRQoL as part of routine clinical assessment.

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Self-Reported Health in Patients on or at Risk of Sick Leave Due to Depression and Anxiety: Validity of the EQ-5D

Cited by 4 publications

References 52 publications

Sociodemographic factors and use of pain medication are associated with health-related quality of life: results from an adult community mental health service in Norway

Sociodemographic factors and use of pain medication are associated with health-related quality of life: results from an adult community mental health service in Norway

Responsiveness to change in health status of the EQ-5D in patients treated for depression and anxiety

Health-related quality of life in psychiatric outpatients: a cross-sectional study of associations with symptoms, diagnoses, and employment status

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