Health-Related Quality of Life in Primary Care Patients With Mental Disorders

Results From the PRIME-MD 1000 Study

Robert L. Spitzer, Kurt Kroenke, Mark Linzer, Steven R. Hahn, Janet B W Williams, Frank Verloin Degruy, David Brody, Mark Davies

Research output: Contribution to journalArticle

664 Citations (Scopus)

Abstract

To determine if different mental disorders commonly seen in primary care are uniquely associated with distinctive patterns of impairment in the components of health-related quality of life (HRQL) and how this compares with the impairment seen in common medical disorders. —Survey. —Four primary care clinics. —A total of 1000 adult patients (369 selected by convenience and 631 selected by site-specific methods to avoid sampling bias) assessed by 31 primary care physicians using PRIME-MD (Primary Care Evaluation of Mental Disorders) to make diagnoses of mood, anxiety, alcohol, somatoform, and eating disorders. —The six scales of the Short-Form General Health Survey and self-reported disability days, adjusting for demographic variables as well as psychiatric and medical comorbidity. —Mood, anxiety, somatoform, and eating disorders were associated with substantial impairment in HRQL. Impairment was also present in patients who only had subthreshold mental disorder diagnoses, such as minor depression and anxiety disorder not otherwise specified. Mental disorders, particularly mood disorders, accounted for considerably more of the impairment on all domains of HRQL than did common medical disorders. Finally, we found marked differences in the pattern of impairment among different groups of mental disorders just as others have reported unique patterns associated with different medical disorders. Whereas mood disorders had a pervasive effect on all domains of HRQL, anxiety, somatoform, and eating disorders affected only selected domains. —Mental disorders commonly seen in primary care are not only associated with more impairment in HRQL than common medical disorders, but also have distinct patterns of impairment. Primary care directed at improving HRQL needs to focus on the recognition and treatment of common mental disorders. Outcomes studies of mental disorders in both primary care and psychiatric settings should include multidimensional measures of HRQL. (JAMA. 1995;274:1511-1517).

Original languageEnglish (US)
Pages (from-to)1511-1517
Number of pages7
JournalJournal of the American Medical Association
Volume274
Issue number19
DOIs
StatePublished - 1995
Externally publishedYes

Fingerprint

Mental Disorders
Primary Health Care
Quality of Life
Anxiety Disorders
Somatoform Disorders
Mood Disorders
Psychiatry
Selection Bias
Primary Care Physicians
Health Surveys
Comorbidity
Alcohols
Demography
Outcome Assessment (Health Care)
Depression
Feeding and Eating Disorders

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Health-Related Quality of Life in Primary Care Patients With Mental Disorders : Results From the PRIME-MD 1000 Study. / Spitzer, Robert L.; Kroenke, Kurt; Linzer, Mark; Hahn, Steven R.; Williams, Janet B W; Degruy, Frank Verloin; Brody, David; Davies, Mark.

In: Journal of the American Medical Association, Vol. 274, No. 19, 1995, p. 1511-1517.

Research output: Contribution to journalArticle

Spitzer, Robert L. ; Kroenke, Kurt ; Linzer, Mark ; Hahn, Steven R. ; Williams, Janet B W ; Degruy, Frank Verloin ; Brody, David ; Davies, Mark. / Health-Related Quality of Life in Primary Care Patients With Mental Disorders : Results From the PRIME-MD 1000 Study. In: Journal of the American Medical Association. 1995 ; Vol. 274, No. 19. pp. 1511-1517.
@article{1f0c9da4c568418798509af986ebb000,
title = "Health-Related Quality of Life in Primary Care Patients With Mental Disorders: Results From the PRIME-MD 1000 Study",
abstract = "To determine if different mental disorders commonly seen in primary care are uniquely associated with distinctive patterns of impairment in the components of health-related quality of life (HRQL) and how this compares with the impairment seen in common medical disorders. —Survey. —Four primary care clinics. —A total of 1000 adult patients (369 selected by convenience and 631 selected by site-specific methods to avoid sampling bias) assessed by 31 primary care physicians using PRIME-MD (Primary Care Evaluation of Mental Disorders) to make diagnoses of mood, anxiety, alcohol, somatoform, and eating disorders. —The six scales of the Short-Form General Health Survey and self-reported disability days, adjusting for demographic variables as well as psychiatric and medical comorbidity. —Mood, anxiety, somatoform, and eating disorders were associated with substantial impairment in HRQL. Impairment was also present in patients who only had subthreshold mental disorder diagnoses, such as minor depression and anxiety disorder not otherwise specified. Mental disorders, particularly mood disorders, accounted for considerably more of the impairment on all domains of HRQL than did common medical disorders. Finally, we found marked differences in the pattern of impairment among different groups of mental disorders just as others have reported unique patterns associated with different medical disorders. Whereas mood disorders had a pervasive effect on all domains of HRQL, anxiety, somatoform, and eating disorders affected only selected domains. —Mental disorders commonly seen in primary care are not only associated with more impairment in HRQL than common medical disorders, but also have distinct patterns of impairment. Primary care directed at improving HRQL needs to focus on the recognition and treatment of common mental disorders. Outcomes studies of mental disorders in both primary care and psychiatric settings should include multidimensional measures of HRQL. (JAMA. 1995;274:1511-1517).",
author = "Spitzer, {Robert L.} and Kurt Kroenke and Mark Linzer and Hahn, {Steven R.} and Williams, {Janet B W} and Degruy, {Frank Verloin} and David Brody and Mark Davies",
year = "1995",
doi = "10.1001/jama.1995.03530190025030",
language = "English (US)",
volume = "274",
pages = "1511--1517",
journal = "JAMA - Journal of the American Medical Association",
issn = "0002-9955",
publisher = "American Medical Association",
number = "19",

}

TY - JOUR

T1 - Health-Related Quality of Life in Primary Care Patients With Mental Disorders

T2 - Results From the PRIME-MD 1000 Study

AU - Spitzer, Robert L.

AU - Kroenke, Kurt

AU - Linzer, Mark

AU - Hahn, Steven R.

AU - Williams, Janet B W

AU - Degruy, Frank Verloin

AU - Brody, David

AU - Davies, Mark

PY - 1995

Y1 - 1995

N2 - To determine if different mental disorders commonly seen in primary care are uniquely associated with distinctive patterns of impairment in the components of health-related quality of life (HRQL) and how this compares with the impairment seen in common medical disorders. —Survey. —Four primary care clinics. —A total of 1000 adult patients (369 selected by convenience and 631 selected by site-specific methods to avoid sampling bias) assessed by 31 primary care physicians using PRIME-MD (Primary Care Evaluation of Mental Disorders) to make diagnoses of mood, anxiety, alcohol, somatoform, and eating disorders. —The six scales of the Short-Form General Health Survey and self-reported disability days, adjusting for demographic variables as well as psychiatric and medical comorbidity. —Mood, anxiety, somatoform, and eating disorders were associated with substantial impairment in HRQL. Impairment was also present in patients who only had subthreshold mental disorder diagnoses, such as minor depression and anxiety disorder not otherwise specified. Mental disorders, particularly mood disorders, accounted for considerably more of the impairment on all domains of HRQL than did common medical disorders. Finally, we found marked differences in the pattern of impairment among different groups of mental disorders just as others have reported unique patterns associated with different medical disorders. Whereas mood disorders had a pervasive effect on all domains of HRQL, anxiety, somatoform, and eating disorders affected only selected domains. —Mental disorders commonly seen in primary care are not only associated with more impairment in HRQL than common medical disorders, but also have distinct patterns of impairment. Primary care directed at improving HRQL needs to focus on the recognition and treatment of common mental disorders. Outcomes studies of mental disorders in both primary care and psychiatric settings should include multidimensional measures of HRQL. (JAMA. 1995;274:1511-1517).

AB - To determine if different mental disorders commonly seen in primary care are uniquely associated with distinctive patterns of impairment in the components of health-related quality of life (HRQL) and how this compares with the impairment seen in common medical disorders. —Survey. —Four primary care clinics. —A total of 1000 adult patients (369 selected by convenience and 631 selected by site-specific methods to avoid sampling bias) assessed by 31 primary care physicians using PRIME-MD (Primary Care Evaluation of Mental Disorders) to make diagnoses of mood, anxiety, alcohol, somatoform, and eating disorders. —The six scales of the Short-Form General Health Survey and self-reported disability days, adjusting for demographic variables as well as psychiatric and medical comorbidity. —Mood, anxiety, somatoform, and eating disorders were associated with substantial impairment in HRQL. Impairment was also present in patients who only had subthreshold mental disorder diagnoses, such as minor depression and anxiety disorder not otherwise specified. Mental disorders, particularly mood disorders, accounted for considerably more of the impairment on all domains of HRQL than did common medical disorders. Finally, we found marked differences in the pattern of impairment among different groups of mental disorders just as others have reported unique patterns associated with different medical disorders. Whereas mood disorders had a pervasive effect on all domains of HRQL, anxiety, somatoform, and eating disorders affected only selected domains. —Mental disorders commonly seen in primary care are not only associated with more impairment in HRQL than common medical disorders, but also have distinct patterns of impairment. Primary care directed at improving HRQL needs to focus on the recognition and treatment of common mental disorders. Outcomes studies of mental disorders in both primary care and psychiatric settings should include multidimensional measures of HRQL. (JAMA. 1995;274:1511-1517).

UR - http://www.scopus.com/inward/record.url?scp=0028842902&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028842902&partnerID=8YFLogxK

U2 - 10.1001/jama.1995.03530190025030

DO - 10.1001/jama.1995.03530190025030

M3 - Article

VL - 274

SP - 1511

EP - 1517

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0002-9955

IS - 19

ER -