Validity of the EQ-5D in assessing and valuing health status in patients with schizophrenic, schizotypal or delusional disorders

Eur Psychiatry. 2007 Apr;22(3):177-87. doi: 10.1016/j.eurpsy.2006.08.004. Epub 2006 Dec 4.

Abstract

Purpose: The EQ-5D is a generic questionnaire generating a health profile and a single index score for health-related quality of life. This study aimed to analyse the discriminative ability and validity of the EQ-5D in patients with schizophrenic, schizotypal or delusional disorders.

Subjects and methods: One hundred sixty-six patients with schizophrenic, schizotypal or delusional disorders (ICD-10 F2) completed the EQ-5D. Measures of quality of life (WHOQOL-BREF), utility (TTO), subjective (SCL-90R) and objective (PANSS, CGI-S) psychopathology, and functioning (GAF, GARF, SOFAS, HoNOS) provided comparison. Discriminative ability was analysed by assessing frequency distributions of EQ-5D scores. Validity of the EQ-5D self-classifier was analysed by assessing differences in related other scores grouped by response levels of EQ-5D items. Validity of the visual analogue scale (EQ VAS) and the EQ-5D index (UK social tariff) was analysed by assessing their correlation with all other scores.

Results: Seventy-nine percent of respondents reported problems in at least one of the EQ-5D dimensions (anxiety/depression 57%, usual activities 45%, pain/discomfort 44%, self-care 29%, mobility 22%). The mean EQ VAS score/EQ-5D index was 65.7/0.71. The four most frequently reported EQ-5D health states covered 45% of all respondents. For almost all EQ-5D dimensions, different response levels were associated with significantly different scores of measures used for comparison. Correlation of EQ VAS score and EQ-5D index were largest with scores of subjective measures (SCL-90R: -0.50 and -0.73; WHOQOL mental subscore 0.62 and 0.58; always P<0.001).

Discussion and conclusion: The EQ-5D showed a moderate ceiling effect and seems to be reasonably valid in this patient group.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology
  • Comorbidity
  • Delusions / diagnosis*
  • Delusions / psychology
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology
  • Depressive Disorder / psychology
  • Disability Evaluation
  • Female
  • Health Status Indicators*
  • Humans
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Psychometrics / statistics & numerical data
  • Quality of Life / psychology*
  • Reproducibility of Results
  • Schizophrenia / diagnosis*
  • Schizophrenia / epidemiology
  • Schizophrenic Psychology*
  • Schizotypal Personality Disorder / diagnosis*
  • Schizotypal Personality Disorder / epidemiology
  • Schizotypal Personality Disorder / psychology
  • Surveys and Questionnaires*