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Table 1 Review of the literature on QoL in eating disorders subjects

From: Exploring health-related quality of life in eating disorders by a cross-sectional study and a comprehensive review

Study

Design, treatment

Setting, characteristics of whole sample

ED pts studied

Control or reference group(s)

Assessment

HRQoL Instrument

Results on general and specific HRQoL measures (> means superior QoL)

Surveys

       

[12] Spitzer et al., 1995

Two-stage survey

1000 primary care pts

30 BED (with 84% psychiatric comorbidity)

614 without Mental Disorders (MD)

PRIME-MD

SF-20

• BED (as well other MD) < No-MD.

• BED < non-BED on social functioning and bodily pain

[18] Hay 2003

Comunity survey

3010 out of 4400 (response rate 70%)

78 BED, 60 subj with extreme weight control behaviors (EWCB)

Australian normative sample

EDE

SF-36, AQoL

• BED and EWCB < Normative on MCS

[19] Doll et al., 2005

Postal survey

1439 out of 3750 students (response rate 42%)

83 (5.8% of respondents) with ED (54 BN, 22 BED, 7 AN)

1148 non-ED subjects

Ad-hoc questionnaire based on DSM-IV

SF-36

• ED < non-ED subj on MCS, but not on PCS.

• BN and BED < non-ED subj on MCS

[20] Herpetz-Dahlmann et al., 2008

Community survey

1895 adolescents

400 ED not classified according DSM criteria

1495 non-ED

SCOFF, not confirmed by interview

KINDL-R

• ED < non-ED

[21] Vallance et al., 2011

Cross-sectional study

Recruitment at the university campus and in newspapers

103 women with 2+ episodes of binge eating per month

109 women with <2 episodes of binge eating per month

EDE-Q, EDI-2

SF-36

• High frequency of binge eating predicted poorer QoL

[22] Mond et al., 2012

Two stage community study

324 interviewed at the second stage

159 ED (30 BN, 20 BED, 109 EDNOS)

232 healthy women from different survey in same area

EDE-Q + EDE

SF- 12, WHOQOL-BREF

• ED < Healthy women on MCS

[23] Mitchison et al., 2013

Population survey

3034 out of 5000 selected (response rate 60.7%)

89 AN (2.9% of respondents)

2945 subj with no history of AN

Interview based on EDE

SF-36

• AN < other subj on most domains, including MCS.

• Subj with history of AN < other subj on MCS but not on PCS.

• Impairment on social functioning and role limitations greater with current ED symptoms

Cross-sectional studies

       

ED patients

       

[24] Keilen et al., 1994

Cross-sectional study

ED outpatient center

126 ED (52 AN, 74 BN)

98 males with angina; 122 hearth transplant candidates; 54 cystic fibrosis pts; 91 students

Clinical interview (DSM-III-R)

NHP

• Specific differences between ED and pts with organic diseases

[10] Padierna et al., 2000

Cross-sectional study

ED outpatient center

197 ED (116 AN, 64 BN, 17 BED)

Norm-based scoring of Spanish general population

Clinical interview (DSM-IV)

SF-36

• ED pts < normative population.

• BED < other ED on physical functioning

[25] Gonzalez-Pinto et al., 2004

Cross-sectional study

ED outpatient center

47 AN

No control

SCID I and II

SF-36

• Predictive variables for PCS: poor outcome in previous year, comorbidity and female gender.

• For MCS: comorbidity and purging behaviors

[7] De La Rie et al., 2005

Cross-sectional study

Mixed: population via advertisements and ED centers

156 ED pts (44 AN, 43 BN, 69 EDNOS) and 148 former ED pts

Dutch normative population and 591 Mood Disorders (MD) pts

DSM-IV diagnosis based on EDE-Q + BMI and menstrual status

SF-36

• No diff among ED groups.

• ED < normative.

• Former ED < normative. ED < MD

[11] Mond et al., 2005

Cross-sectional study

Pts referred to ED treatment program

87 ED pts (34 AN, 40 BN, 10 EDNOS)

495 general population women

Clinical assessment + EDE-Q

WHOQoL-BREF

• ED pts < normative subjects.

• Restricting AN pts > other patient groups.

• BED < other patients on PCS

[26] Engel et al., 2006

Cross-sectional study to validate EDQOL

538 recruited sample of student

155 ED, 56 diet/exercise

Validation across groups, including 327 non-ED subj

SCID + EDE + EAT-26

EDQOL, SF-36

• All EDQOL subscale scores differed between groups, with greater impairment in ED pts.

• EDQOL more sensitive than SF-36 when predicting group status (ED vs. diet/exercise)

[27] De La Rie et al., 2007

Cross-sectional study

Mixed: population via advertisements and ED centers

146 ED pts (44 AN, 43 BN, 59 EDNOS)

146 former ED

DSM-IV diagnosis based on EDE-Q + BMI and menstrual status

SEIQOL

• ED with poor QoL on all life domains.

• Former ED pts > ED pts on most domains (but ratings just above average)

[28] Latner et al., 2008

Cross-sectional study

ED outpatient center

11 AN, 5 BN, 3 BED, 30 EDNOS, 4 non-ED

New Zealand normative population

EDE-Q

SF-36

ED < normative on MCS.

• QoL general and PCS predicted by subjective bulimic episodes

[29] Bamford & Sly, 2010

Cross-sectional study

ED outpatient center

156 ED (80 AN, 40 BN, 36 EDNOS)

Comparison across ED groups

EDE-Q

EDQOL

• AN < BN and EDNOS on psychological and physical/cognitive domains

Baiano et al., present study

Cross-sectional study

ED center (in- and out-patients)

80 ED (26 BN; 33 AN; 7 BED; 14 EDNOS)

Comparison across ED groups

Clinical interview (DSM-IV)

WHOQoL-BREF

• No diff among ED groups. EDNOS > other groups on psychological health QoL

Obese patients

       

[30] Hsu et al., 2002

Cross-sectional study

37 subj awaiting GBP

9 BED

28 non-BED

EDE, TFEQ, SCID-IV

SF-36

• BED < non-BED

[31] De Zwaan et al., 2002

Cross-sectional study on pre and post-operative patients

78 obese surgical pts

78 obese (9 BED) after GBP surgery

110 preoperative control group (19 BED)

Phone interview + MFED + QWEPR

SF-36

• Postoperative pts > preoperative pts.

• Postoperative pts < US norm values on PCS

[32] Masheb & Grilo, 2004

Cross-sectional study

Pts undergoing a medical school based ED treatment

94 BED

US normative population and Obeses without binges (n = 312)

Clinical interview (DSM-IV)

SF-36

• BED < normative.

• BED < non-BED on PCS

[33] Kolotkin et al., 2004

Cross-sectional study

530 obese candidates to residential modification program

95 BED

435 non-BED

Questionnaire on Eating/Weight Patterns; BDI; SC90-R

IWQOL-Lite

• BED = non-BED when other variables are considered

[34] Rieger et al., 2005

Cross-sectional study within a RCT

118 treatment-seeking obese subj

56 BED

62 non-BED

EDE, PRIME-MD

IWQOL-Lite

• BED < non-BED on total scale, but not on physical function subscale

[35] Colles et al., 2008

Cross-sectional study

180 bariatric surgery candidates, 93 participants to a weight loss support group, 158 community respondents

38 BED, 46 subj with feelings of loss of control (LOC) during binge episodes

307 non-binge eaters

QEWP-R + semistructured interview or phone interview

SF-36

• BED < non-BED on MCS

[36] Folope et al., 2012

Cross-sectional study

130 obese in clinical nutrition center

73 ED

57 non-ED

SCOFF-F + BULIT, not confirmed by a diagnosis

QOLOD

• ED < non-ED, globally and on psychological dimension

[37] Ranzenhofer et al., 2012

Cross-sectional study

158 obese adolescents selected for weight-loss treatment

35 binge eating (6 proper BED)

123 non-binge eaters

EDE

IWQOL-A

• Binge eating < no-binge eating.

• Girls with binge eating < boys with binge eating

Cohort studies

       

Survey

      

[38] Wade et al., 2012

Longitudinal multi-wave survey

9,688 population of women

2223 ED

7465 non-ED

Ad-hoc questionnaire, EDE-Q, not confirmed by interview

SF-36

• ED < non-ED, globally and on PCS and MCS

ED outpatient treatments

      

[39] Padierna et al., 2002

2 years cohort study

ED outpatient center

131 ED (90 AN, 41 BN)

Spanish normative population

Clinical interview (DSM-IV)

SF-36

• Improvement in PCS and social function, followed by MCS.

• Scores after 2 years still below normative population.

• Severity of ED affected improvement

[40] Muñoz et al., 2009

Cohort study (baseline, after 1 year)

358 subj in treatment programs in Health centers

61 AN, 47 BN, 245 EDNOS

305 general population women

Clinical interview (DSM-IV)

HeRQoLED, SF-36

• ED < general population.

• After 1 year PCS improved but not MCS.

• AN < other ED at baseline, and smaller improvements after 1 year

[41] Adair et al., 2010

Cohort study (baseline, 3 and 6 months follow-ups) to validate EDQLS

ED treatment programs

130 ED pts (56 AN, 39 BN, 35 EDNOS)

QoL measures at different point in time

Clinical

EDQLS, Quality of Life Inventory, SF-12

• EDQLS total scores increased at 3 and 6 months.

• EDQLS responsiveness exceeded that of other QoL instruments

Specific treatments

       

[42] Marchesini et al., 2002

Intervention study (3–5 months CBT)

96 obese enrolled in a CBT program

46 BED (44% of sample)

76 untreated controls in waiting list

Interview, BES, EDE

SF-36

• Treated subjects improved in QoL, with improvement larger in BED, both in general scores and in PCS and MCS

[43] Nickel et al., 2005

Intervention study (10 weeks RCT with topiramate)

60 BN women recruited through advertisements

30 BN on topiramate

30 BN on placebo

SCID-I and SCD-II

SF-36

• Topiramate improved QOL to a greater extent than placebo

[44] Wilfley et al., 2008

Intervention study (24 weeks RCT with sibutramine)

304 BED recruited through advertisements

152 BED on sibutramine

152 BED on Placebo

EDE

IWQOL-Lite

• Sibutramine efficaciuos on psychopathology but not on QoL

Residential treatments

       

[45] Abraham et al., 2006

Cohort study (baseline, at discharge and 12 months follow-up)

In-patient in ED center

206 ED pts (71 AN, 55 BN, 80 EDNOS)

35 subj without diagnosis

Clinical interview

EEE-C QOLscores, SF12

• QoL improved during inpatient treatment and between admission and 12 months after discharge.

• AN, BN and EDNOS < no diagnosis.

• Specific differences among ED groups on some dimensions

[46] McHugh, 2007

Prospective residential cohort study

ED residential center

65 AN (33 high Readiness for Change - RFC - females vs. 32 low RFC females)

Comparison between high- and low-RFC

Clinical interview (DSM-IV)

SF-36 v2

• Participants’ QoL below US average.

• 81% discharged below the US average.

• No diff between RFC and non-RFC

Surgical interventions

       

[47] Green et al., 2004

Cohort study

65 surgical (GBP) pts

33 BED

32 non-BED

ED-SCID, QWEP-R

SF-36

• QoL improved from pre-surgery to post-surgery.

       

• BED < non-BED on social functioning at pre-surgery and after 6 months postsurgery

  1. Glossary of QoL instruments.
  2. AQoL, assessment of quality of life.
  3. EDE-Q, eating disorder examination questionnaire.
  4. EDQLS, eating disorders quality of life.
  5. EEE-C QOL, eating and exercise examination QOL.
  6. HeRQoLED, health related quality of life for the eating disorders.
  7. IWQOL, impact of weight on quality of life-lite.
  8. Kindl-R: Revised German-language questionnaire to assess Health-Related Quality of Life in children and adolescents.
  9. NHP, Nottingham health profile questionnaire.
  10. QOLOD, quality of life, obesity and dietetics rating scale.
  11. SEIQOL, schedule for the evaluation of individual quality of life.
  12. SF-36, short form (36) health survey.
  13. WHOQoL-Bref: brief version of the world health organization quality of life questionnaire.