Assessment of quality of life in people with severe and enduring anorexia nervosa: a comparison of generic and specific instruments

Mitchison, Deborah, Hay, Phillipa, Engel, Scott, Crosby, Ross, Le Grange, Daniel, Lacey, Hubert, Mond, Jonathan, Slewa-Younan, Shameran, and Touyz, Stephen (2013) Assessment of quality of life in people with severe and enduring anorexia nervosa: a comparison of generic and specific instruments. BMC Psychiatry, 13 (284). pp. 1-9.

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Abstract

Background: Criticisms that generic measures of health-related quality of life (HRQoL) are not sensitive to impairment in anorexia nervosa (AN) has spurred the development of disease-specific measures. This study aimed to compare the psychometric properties of a generic to a disease-specific measure of HRQoL.

Methods: 63 participants with AN completed measures of a generic HRQoL (SF-12), disease-specific HRQoL (Eating Disorders Quality of Life Questionnaire; EDQOL), functional impairment (days out of role; DOR; Work and Social Adjustment Scale; WSAS), and eating disorder severity (Eating Disorder Examination; EDE) at baseline, post-treatment, and 6- and 12-months follow-up. Cronbach's a was computed for the SF-12 and EDQOL (internal consistency). Correlations were assessed between SF-12/EDQOL scores and DOR, WSAS, and EDE scores (convergence validity). Three sets of three multiple linear regressions were performed using SF-12 and EDQOL scores as predictors and change in DOR, WSAS, and EDE global scores from baseline to (i) post-treatment, (ii) 6-month follow-up, (iii) and 12-month follow-up as dependent variables (predictive validity and sensitivity).

Results: The EDQOL displayed stronger internal consistency (alpha = 0.92) than the SF-12 (alpha = 0.80). The SF-12 converged more strongly with DOR and the WSAS (r(p) = -0.31 to -0.63 vs. 0.06 to 0.70), while the EDQOL converged more strongly with the EDE (r(p) = -0.01 to 0.48 vs. -0.01 to -0.37). The SF-12 demonstrated stronger predictive validity (beta = -0.55 to 0.29) and sensitivity to changes in ED severity (beta = -0.47 to 0.32).

Conclusions: The SF-12 is a valid and sensitive measure of HRQoL impairment in patients with AN. While the SF-12 may be preferred in research comparing EDs to other populations, and in research and practice as an indicator of functional impairment; the EDQOL may be preferred by clinicians and researchers interested in HRQoL impairment specifically associated with an ED and as an additional indicator of ED severity.

Item ID: 32976
Item Type: Article (Refereed Research - C1)
Keywords: quality of life, anorexia nervosa, questionnaires, psychometric, eating disorder, measurement, burden, treatment
Additional Information:

© 2013 Mitchison et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

ISSN: 1471-244X
Funders: National Health and Medical Research Council (NHMRC)
Projects and Grants: NHMRC 457419
Date Deposited: 30 Apr 2014 09:52
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110319 Psychiatry (incl Psychotherapy) @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920199 Clinical Health (Organs, Diseases and Abnormal Conditions) not elsewhere classified @ 100%
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