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To test the relative importance of anxiety, depression and somatization as correlates of physical health-related quality of life (HRQOL) in several chronic physical disorders.
In a cross-sectional study of patients with colorectal cancer (N = 162), glaucoma (N = 100), rheumatoid arthritis (N = 168), systemic sclerosis (N = 56) and systemic lupus erythematosus (N = 56), we assessed specific disease severity and used the Symptom Distress Checklist (SCL-90) for psychologic dimensions. Outcome was assessed with the WHO Quality of Life Instrument, Short Form using hierarchical regression to determine independent correlates of HRQOL.
After adjustment for demographic features, stage of cancer and pain (final models), the SCL-90 somatization score was the only psychologic distress covariate significantly correlated to physical HRQOL in all diseases (Betas between −0.33 and −0.49) except in systemic sclerosis and scleroderma, where depression was also a correlate. In glaucoma patients, the SCL-90 somatization score was the only significant covariate for physical HRQOL in the final model.
Since reported number of bodily symptoms is both associated with physical HRQOL and treatable in its own right, our findings suggest a possible new avenue to improve the HRQOL in patients with chronic physical disease. Whether this offers greater benefit than treatments for anxiety and depression needs further research.
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Kroenke, K., Spitzer, R. L., DeGruy, F. V., 3rd, Hahn, S. R., Linzer, M., Williams, J. B., et al. (1997). Multisomatoform disorder. An alternative to undifferentiated somatoform disorder for the somatizing patient in primary care. Archives of General Psychiatry, 54(4), 352–358. PubMed
Jackson, J., Fiddler, M., Kapur, N., Wells, A., Tomenson, B., & Creed, F. (2006). Number of bodily symptoms predicts outcome more accurately than health anxiety in patients attending neurology, cardiology, and gastroenterology clinics. Journal of Psychosomatic Research, 60(4), 357–363. PubMedCrossRef
Kroenke, K., Spitzer, R. L., & Williams, J. B. (2002). The PHQ-15: Validity of a new measure for evaluating the severity of somatic symptoms. Psychosomatic Medicine, 64, 258–266. PubMed
Derogatis, L. R. (1994). SCL-90-R: Administration, scoring, and procedure manual (3rd ed.). Minneapolis, MN: National Computer Systems.
Skarstein, J., Aass, N., Fosså, S. D., Skovlund, E., & Dahl, A. A. (2000). Anxiety and depression in cancer patients: Relation between the hospital anxiety and depression scale and the European organization for research and treatment of cancer core quality of life questionnaire. Journal of Psychosomatic Research, 49(1), 27–34. PubMedCrossRef
Bazzichi, L., Maser, J., Piccinni, A., Rucci, P., Del Debbio, A., Vivarelli, L., et al. (2005). Quality of life in rheumatoid arthritis: Impact of disability and lifetime depressive spectrum symptomatology. Clinical and Experimental Rheumatology, 23(6), 783–788. PubMed
Danieli, E., Airo, P., Bettoni, L., Cinquini, M., Antonioli, Ch., Cavazzana, I., et al. (2005). Health-related quality of life measured by the Short Form 36 (SF 36) in systemic sclerosis: Correlations with indexes of disease activity and severity, disability and depressive symptoms. Clinical Rheumatology, 24, 48–54. PubMedCrossRef
Rupp, I., Boshuizen, H. C., Dinant, H. J., Jacobi, C. E., & van den Bos, G. A. (2006). Disability and health-related quality of life among patients with rheumatoid arthritis: Association with radiographic joint damage, disease activity, pain, and depressive symptoms. Scandinavian Journal of Rheumatology, 35(3), 175–181. PubMedCrossRef
Sainsbury, A., & Heatley, R. V. (2005). Review article: Psychosocial factors in the quality of life of patients with inflammatory bowel disease. Alimentary Pharmacology & Therapeutics, 21(5), 499–508. CrossRef
Vidal, A., Gómez-Gil, E., Sans, M., Portella, M. J., Salamero, M., Piqué, J. M., et al. (2008). Health-related quality of life in inflammatory bowel disease patients: The role of psychopathology and personality. Inflammatory Bowel Disease., 14(7), 977–983. CrossRef
Hyphantis, T., Tomenson, B., Bai, M., Tsianos, E., Mavreas, V., & Creed, F. (2009). Psychological distress, somatization and defense mechanisms associated with quality of life in inflammatory bowel disease patients. Digestive Diseases and Sciences. doi: 10.1007/s10620-009-0762-z.
American Joint Committee on Cancer. AJCC Staging Manual ed 6. (2002). Colon and rectum. Philadelphia: Lippincott- Raven Publishers.
Compton, C. C., Fielding, L. P., Burgart, L. J., et al. (2000). Prognostic factors in colorectal cancer. College of American Pathologists Consensus Statement, 1999. Archives of Pathology and Laboratory Medicine, 124(7), 979. PubMed
American Rheumatism Association Diagnostic and Therapeutic Committee. (1980). Subcommittee for scleroderma criteria: Preliminary criteria for the classification of systemic sclerosis (scleroderma). Arthritis and Rheumatism, 23, 581–590. CrossRef
Aasman, P., & Heijl, A. (1992). Evaluation of methods for automated hemifield analysis in perimetry. Archives of Ophthalmology, 110, 812–819.
Bruce, B., & Fries, J. (2003). The Stanford health assessment questionnaire (HAQ): A review of its history, issues, progress, and documentation. Journal of Rheumatology, 30(1), 167–178. PubMed
Committee on Prognosis Studies. (1986). Prognosis studies in SLE: An activity index. Arthritis and Rheumatism, 29(4), 93.
Clements, P., Lachenbruch, P., Siebold, J., White, B., Weiner, S., Martin, R., et al. (1995). Inter and intraobserver variability of total skin thickness score (Modified Rodnan TSS) in systemic sclerosis. Journal of Rheumatology, 22, 1281–1285. PubMed
Matucci-Cericic, M., D’ Angelo, S., Denton, C. P., Vlachoyiannopoulos, P., & Silver, R. (2003). Assessment of lung involvement. Clinical and Experimental Rheumatology, 21(29), 19–23.
Clements, P. J., Becvar, R., Drosos, A. A., Ghattas, L., & Gabrielli, A. (2003). Assessment of gastrointestinal involvement. Clinical and Experimental Rheumatology, 21(29), 15–18.
Steen, V. D., Mayes, M. D., & Merkel, P. A. (2003). Assessment of kidney involvement. Clinical and Experimental Rheumatology, 21(29), 29–31.
Parker, J. C., Buckelew, S. P., Smarr, K. L., Buescher, K. L., Beck, N. C., Frank, R. G., et al. (1990). Psychological screening in rheumatoid arthritis. Journal of Rheumatology, 17, 1016–1021. PubMed
Donias, S., Karastergiou, A., & Manos, N. (1991). Standardization of the symptom checklist-90-R rating scale in a Greek population (in Greek with English abstract). Psychiatriki, 2, 42–48.
WHOQOL Group. (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL Group. Psychological Medicine, 28(3), 551–558. CrossRef
Skevington, S. M., Lotfy, M., O’Connell, K. A., & WHOQOL Group. (2004). The World Health Organization’s WHOQOL-BREF quality of life assessment: Psychometric properties and results of the international field trial. A report from the WHOQOL group. Quality of Life Research, 13(2), 299–310. PubMedCrossRef
Taylor, W. J., Myers, J., Simpson, R. T., McPherson, K. M., & Weatherall, M. (2004). Quality of life of people with rheumatoid arthritis as measured by the World Health Organization Quality of Life Instrument, short form (WHOQOL-BREF): Score distributions and psychometric properties. Arthritis and Rheumatism, 51(3), 350–357. PubMedCrossRef
Ginieri-Coccossis, M., Triantafillou, E., Antonopoulou, V., Tomaras, B., & Christodoulou, G. (2001). Quality of life in relation to WHOQOL-100 questionnaire (in Greek). Athens: Beta Medical Arts.
Altman, D. G. (1991). Practical statistics for medical research. London: Chapman and Hall.
Miles, J., & Shevlin, M. (2003). Applying regression and correlation (pp. 165–191). London: Sage.
Creed, F. H., & Dickens, C. (2007). Depression in the medically ill. In A. Steptoe (Ed.), Depression and physical illness (pp. 3–18). Cambridge: Cambridge University Press.
Creed, F., Tomenson, B., Guthrie, E., Ratcliffe, J., Fernades, L., Rigby, C., Read, N., & Thomson, D. G., (2009). On behalf of the North of Eangland IBS Research Group. Predictors of long term outcome in people with severe irritable syndrome who receive antidepressant or psychological treatment. Alimentary Pharmacology and Therapeutics (Submitted).
Creed, F., Guthrie, E., Ratcliffe, J., Fernandes, L., Rigby, C., Tomenson, B., et al. (2005). Does psychological treatment help only those patients with severe irritable bowel syndrome who also have a concurrent psychiatric disorder? Australian and New Zealand Journal of Psychiatry, 39(9), 807–815. PubMedCrossRef
- Somatization is associated with physical health-related quality of life independent of anxiety and depression in cancer, glaucoma and rheumatological disorders
Paraskevi V. Voulgari
Alexandros A. Drosos
- Springer Netherlands