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The relationship among Mental Health Status (GHQ-12), Health Related Quality of Life (EQ-5D) and Health-State Utilities in a general population

Published online by Cambridge University Press:  11 April 2011

Pedro Serrano-Aguilar ,
Yolanda Ramallo-Fariña ,
Maria Del Mar Trujillo-Martín ,
Sergio Raul Muñoz-Navarro ,
Lilisbeth Perestelo-Perez  and
Carlos De Las Cuevas-Castresana
Pedro Serrano-Aguilar
Affiliation:
Planning & Evaluation Unit, Canary Islands Health Service, Santa Cruz de Tenerife (Spain) CIBER Epidemiología y Salud Pública (CIBERESP) (Spain)
Yolanda Ramallo-Fariña
Affiliation:
CIBER Epidemiología y Salud Pública (CIBERESP) (Spain) Canary Islands Foundation for Research & Health (Fundación Canaria de Investigación y Salud – FUNCIS) Santa Cruz de Tenerife (Spain)
Maria Del Mar Trujillo-Martín*
Affiliation:
Canary Islands Foundation for Research & Health (Fundación Canaria de Investigación y Salud – FUNCIS) Santa Cruz de Tenerife (Spain)
Sergio Raul Muñoz-Navarro
Affiliation:
School of Medicine, University of La Frontera, Temuco (Chile)
Lilisbeth Perestelo-Perez
Affiliation:
Planning & Evaluation Unit, Canary Islands Health Service, Santa Cruz de Tenerife (Spain) CIBER Epidemiología y Salud Pública (CIBERESP) (Spain)
Carlos De Las Cuevas-Castresana
Affiliation:
CIBER Epidemiología y Salud Pública (CIBERESP) (Spain) Department of Psychiatry, University of La Laguna, Canary Island (Spain)
*
Address for correspondence: Dr. Ma del Mar Trujillo Martìn, Servicio Canario de la Salud. Pérez de Rozas 5, 4°. 38004 Santa Cruz de Tenerife (Spain). Fax: +34-922-475751 E-mail: [email protected]
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Summary

Aim – To assess the relationship between mental health and health-related quality of life (HRQL) in the general population, and to map GHQ-12 as a screening test for population psychological distress to a generic health state measure (EQ-5D) in order to estimate health state values and allow deriving quality-adjusted life years. Methods – Relationship between mental health and HRQL was examined from the 2004 Canary Islands’ Health Survey. Participants were classified as probable psychiatric cases according to GHQ-12. HRQL was measured by the EQ-5D index. Multivariate lineal regression analysis was used to examine the association between mental health and HRQL adjusting by socio-demographic variables and comorbidities. A multivariate regression model was built from EQ-5D to estimate health states values using GHQ-12 as exposure. Results – EQ-5D index scores decreased as the GHQ-12 scores increased. Clinical and socio-demographic factors influenced HRQL without changing the overall trend for this negative relationship. The regression equation explained 43% of the variance. For estimation of utility scores, the model showed a high predictive capacity, with a mean forecast errors of 16%. Conclusions – HRQL progressively decreased when the probability of being a psychiatric case increased. Findings enable health state values to be derived from GHQ-12 scores for populations where utilities has not or cannot be measured directly.

Declaration of Interest: Authors declare no conflicts of interest. This work was supported by the Quality Plan for the National Health Service (Spanish Ministry of Health and Social Policy).

Keywords

Health surveysmental healthquality of lifequality-adjusted life years
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 18 , Issue 3 , September 2009 , pp. 229 - 239
Copyright
Copyright © Cambridge University Press 2009

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References

REFERENCES

Alonso, J., Angermeyer, M.C., Bernert, S., Bruffaerts, R., Brugha, T.S., Bryson, H., de Girolamo, G., Graaf, R., Demyttenaere, K., Gasquet, I., Haro, J.M., Katz, S.J., Kessler, R.C., Kovess, V., Lépine, J.P., Ormel, J., Polidori, G., Russo, L.J., Vilagut, G., Almansa, J., Arbabzadeh-Bouchez, S., Autonell, J., Bernal, M., Buist-Bouwman, M.A., Codony, M., Domingo-Salvany, A., Ferrer, M., Joo, S.S., Martínez-Alonso, M., Matschinger, H., Mazzi, F., Morgan, Z., Morosini, P., Palacín, C., Romera, B., Taub, N. & Vollebergh, W.A. (2004a). Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatrica Scandinavica, Suppl. 420, 21–27.Google Scholar
Alonso, J., Angermeyer, M.C., Bernert, S., Bruffaerts, R., Brugha, T.S., Bryson, H., de Girolamo, G., Graaf, R., Demyttenaere, K., Gasquet, I., Haro, J.M., Katz, S.J., Kessler, R.C., Kovess, V., Lépine, J.P., Ormel, J., Polidori, G., Russo, L.J., Vilagut, G., Almansa, J., Arbabzadeh-Bouchez, S., Autonell, J., Bernal, M., Buist-Bouwman, M.A., Codony, M., Domingo-Salvany, A., Ferrer, M., Joo, S.S., Martínez-Alonso, M., Matschinger, H., Mazzi, F., Morgan, Z., Morosini, P., Palacín, C., Romera, B., Taub, N. & Vollebergh, W.A. (2004b). Disability and quality of life impact of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatrica Scandinavica, Suppl. 420, 38–46.Google Scholar
Alonso, J., Ferrer, M., Gandek, B., Ware, J.E. Jr, Aaronson, N.K., Mosconi, P., Rasmussen, N.K., Bullinger, M., Fukuhara, S., Kaasa, S., Leplège, A. & IQOLA Project Group (2004c). Health-related quality of life associated with chronic conditions in eight countries: results from the International Quality of Life Assessment (IQOLA) Project. Quality of Life Research 13, 283–298.CrossRefGoogle ScholarPubMed
Ananth, H., Jones, L., King, M. & Tookman, A. (2003). The impact of cancer on genderual function: a controlled study. Palliative Medicine 17, 202–205.CrossRefGoogle ScholarPubMed
Ayuso-Mateos, J.L., Lasa, L., Vazquez-Barquero, J.L., Oviedo, A. & Diez-Manrique, J.F. (1999). Measuring health status in psychiatric community surveys: internal and external validity of the Spanish version of the SF-36. Acta Psychiatrica Scandinavica 99, 26–32.CrossRefGoogle ScholarPubMed
Badia, X., Schiaffino, A., Alonso, J. & Herdman, M. (1998). Using the EuroQoI 5-D in the Catalan general population: feasibility and construct validity. Quality of Life Research 7, 311–322.CrossRefGoogle ScholarPubMed
Badia, X., Roset, M., Montserrat, S., Herdman, M. & Segura, A. (1999). The Spanish version of EuroQol: a description and its applications. European Quality of Life scale. Medicina Clínica (Barcelona) 112, 79–86.Google ScholarPubMed
Basu, D. (2004). Quality-of-life issues in mental health care: Past, present, and future. German Journal of Psychiatry 7, 35–43.Google Scholar
Belsey, D.A., Kuh, E. & Welch, R. E. (1980). Regression Diagnostics: Identifying Influential Data and Sources of Collinearity. Wiley: New York.CrossRefGoogle Scholar
Brennan, D.S. & Spencer, A.J. (2006). Mapping oral health related quality of life to generic health state values. BMC Health Services Research 6, 96.CrossRefGoogle ScholarPubMed
Brooks, R., Rabin, R. & De Charro, F. (2003). The Measurement and Valuation of Health Status Using EQ-5D: A European Perspective. Evidence from the EuroQol BIOMED Research Programme. Kluwer Academic Publishers: Rotterdam.Google Scholar
Chatterjee, S. & Hadi, A.S. (1986). Influential observations, high leverage points, and outliers in linear regression. Statistical Science 1, 379–416.Google Scholar
Chisholm, D., Healey, A. & Knapp, M. (1997). QALYs and mental health care. Social Psychiatry and Psychiatry Epidemiology 32, 68–75.CrossRefGoogle ScholarPubMed
Cook, R.D. (1977). Detection of influential observations in linear regression. Technometrics 19, 15–18.Google Scholar
Coucill, W., Bryan, S., Bentham, P., Buckley, A. & Laight, A. (2001). EQ-5D in patients with dementia: an investigation of inter-rater agreement. Medical Care 39, 760–771.CrossRefGoogle ScholarPubMed
de Willige, G., Wiersma, D., Nienhuis, F. & Jenner, J. (2005). Changes in quality of life in chronic psychiatric patients: a comparison between EuroQol (EQ-5D) and WHOQol. Quality of Life Research 14, 441–451.CrossRefGoogle Scholar
Dolan, P, Gudex, C, Kind, P & Williams, A. (1996). Valuing health states: a comparison of methods. Journal of Health Economics 15, 209–231.CrossRefGoogle Scholar
Durbin, J. & Watson, G.S. (1950). Testing for serial correlation in least squares regression, I. Biometrika 37, 409–428.Google ScholarPubMed
Fuh, J.L., Wang, S.J., Lu, S.R., Juang, K.D. & Lee, S.J. (2000). Psychometric evaluation of a Chinese (Taiwanese) version of the SF-36 health survey amongst middle-aged women from a rural community. Quality of Life Research 9, 675–683.CrossRefGoogle ScholarPubMed
Gilbody, S.M., House, A.O. & Sheldon, T.A. (2001). Routinely administered questionnaires for depression and anxiety: systematic review. British Medical Journal 322, 406–409.CrossRefGoogle ScholarPubMed
Gilbody, S.M., House, A.O. & Sheldon, T. (2002). Routine administration of Health Related Quality of Life (HRQoL) and needs assessment instruments to improve psychological outcome– –a systematic review. Psychological Medicine 32, 1339–1343.CrossRefGoogle ScholarPubMed
Gold, M.R., Siegel, J.E., Russell, L.B. & Weinstein, M.C. (1996). Cost-Effectiveness in Health and Medicine. Oxford University Press: New York.CrossRefGoogle ScholarPubMed
Goldberg, D.P. (1972). The Detection of Psychiatric Illness by Questionnaire. Oxford University Press: London.Google Scholar
Hui, C. & Triandis, H.C. (1989). Effects of culture and response format in extreme responses style. Journal of Cross-Cultural Psychology 20, 296–309.CrossRefGoogle Scholar
Johnson, J.A. & Coons, S.J. (1998). Comparison of the EQ-5D and SF-12 in an adult US sample. Quality of Life Research 7, 155–166.CrossRefGoogle Scholar
Keles, H., Ekici, A., Ekici, M., Bulcun, E. & Altinkaya, V. (2007). Effect of chronic diseases and associated psychological distress on health-related quality of life. Internal Medicine Journal 37, 6–11.CrossRefGoogle ScholarPubMed
Kind, P. (1996). The EuroQuol instrument: an index of health-related quality of life. In Quality of Life and Pharmacoeconomics in Clinical Trials, 2nd ed. (ed. Spilker, B.), pp. 191–201. Lippincott-Raven Publishers: Philadelphia.Google Scholar
Knapp, M. & Mangalore, R. (2007). “The trouble with QALYs&.”. Epidemiologia e Psichiatria Sociale 16, 289–293.CrossRefGoogle ScholarPubMed
López-Bastida, J., Serrano-Aguilar, P., Monton-Álvarez, F. & Duque-Gonźlez, B. (2003). The economic burden of stroke in Spain. Value in Health 6, 615.CrossRefGoogle Scholar
López-Bastida, J., Oliva-Moreno, J., Perestelo-Pérez, L. & Serrano-Aguilar, P. (2005). Determinants of health care costs in ambulatory patients living with HIV/AIDS. Value in Health 8, A23.CrossRefGoogle Scholar
López-Bastida, J., Perestelo-Pórez, L., Montón-Álvarez, F. & Serrano-Aguilar, P. (2008). Social economic costs and health-related quality of life in patients with degenerative cerebellums ataxia in Spain. Movement Disorders 23, 212–217.CrossRefGoogle Scholar
Lubetkin, E., Jia, H., Franks, P. & Gold, M.R. (2005). Relationship among sociodemographic factors, clinical conditions, and health related quality of life: examinig the EQ-5D in the US general population. Quality of Life Research 14, 2187–2196.CrossRefGoogle Scholar
Martin, A., Rief, W., Klaiberg, A. & Braehler, E. (2006). Validity of the brief patient health questionnaire mood scale (PHQ-9) in the general population. General Hospital Psychiatry 28, 71–77.CrossRefGoogle ScholarPubMed
Matza, L., Secnik, K., Mannix, S. & Salle, F. (2005). Parent- proxy EQ-5D rating of children with attention deficit hyperactivity disorder in the US and the UK. Pharmaeconomics 23, 777–790.CrossRefGoogle ScholarPubMed
Mendlowicz, M.V. & Stein, M.B. (2000). Quality of life in individuals with anxiety disorder. American Journal of Psychiatry 157, 669–682.CrossRefGoogle Scholar
Nordlund, A., Ekberg, K. & Kristenson, M. (2005). EQ-5D in a general population survey– –a description of the most commonly reported EQ-5D health states using the SF-36. Quality of Life Research 14, 1099–1109.CrossRefGoogle Scholar
Ormel, J. & Vonkorff, M. (2000). Synchrony of change in depression and disability. What next? Archives of General Psychiatry 57, 381–382.CrossRefGoogle ScholarPubMed
Picardi, A., Abeni, D. & Pasquini, P. (2001). Assessing psychological distress in patients with skin diseases: reliability, validity and factor structure of the GHQ-12. Journal of the European Academy of Dermatology and Venereology 15, 410–417.CrossRefGoogle ScholarPubMed
Reed, C., Monz, B.U., Perahia, D.G., Gandhi, P., Bauer, M., Dantchev, N., Demyttenaere, K., García-Cebrián, A., Grassi, L., Quail, D., Tylee, A. & Montejo, A.L. (2009). Quality of life outcomes among patients with depression after 6 months of starting treatment: Results from FINDER. Journal of Affective Disorders 113, 296–302.CrossRefGoogle ScholarPubMed
Rief, W., Martin, A., Klaiberg, A. & Brähler, E. (2005). Specific effects of depression, panic, and somatic symptoms on illness behaviour. Psychosomatic Medicine 67, 596–601.CrossRefGoogle Scholar
Rothman, KJ. (1986). Modern Epidemiology. Little Brown and Company: Boston.Google Scholar
Saarni, S.I., Joutsenniemi, K., Koskinen, S., Suvisaari, J., Pirkola, S., Sintonen, H., Poikolainen, K. & Lönnqvist, J. (2008). Alcohol consumption, abstaining, health utility, and quality of life - A general population survey in Finland. Alcohol and Alcoholism 43, 376–386.CrossRefGoogle ScholarPubMed
Sengupta, N, Nichol, MB, Wu, J & Globe, D. (2004). Mapping the SF-12 to the HUI3 and VAS in a managed care population. Medical Care 42, 927–937.CrossRefGoogle Scholar
Shaligram, D., Girimaji, S.C. & Chaturvedi, S.K. (2007). Quality of life issues in caregivers of youngsters with thalassemia. Indian Journal of Pediatrics 74, 275–278.CrossRefGoogle ScholarPubMed
Stouthard, M., Essink-Bot, M.L. & Bonsel, G.J. (2000). Disability weights for diseases. A modified protocol and results for a Western European region. European Journal Public Health 10, 24–30.CrossRefGoogle Scholar
Supina, A.L., Johnson, J.A., Patten, S.B., Williams, J.V. & Maxwell, C.J. (2007). The usefulness of the EQ-5D in differentiating among persons with major depressive episode and anxiety. Quality of Life Research 16, 749–754.CrossRefGoogle ScholarPubMed
Torrance, G.W., Feeny, D. & Furlong, W. (2001). Visual Analog Scales: do they have a rolein the measurement of preferences for health states? Medical Decision Making 21, 329–334.CrossRefGoogle Scholar
U.S. Department of Health and Human Services. Centers for Disease Control and Prevention (2000). Measuring Healthy Days: Population Assessment of Health-Related Quality of Life. Retrieved December 2, 2008, from http://www.cdc.gov/hrqol/pdfs/mhd.pdfGoogle Scholar
Van Weel-Baumgarten, E.M., Schers, H.J., van den Bosch, W.J., van den Hoogen, H.J. & Zitman, F.G. (2000). Long-term follow-up of depression among patients in the community and in family practice settings. A systematic review. Journal of Family Practice 49, 1113–1120.Google ScholarPubMed
White, H. (1980). A heterocedasticity- consistent covariance matrix estimator and a direct test for heterocedasticity. Econometrica 48, 817–838.CrossRefGoogle Scholar
World Health Organization (2001). The World Health Report 2001. Mental Health: New Understanding, New Hope. World Health Organization: Geneva.Google Scholar
Wu, S.C., Li, C.Y. & Ke, D.S. (2000). The agreement between self-reporting and clinical diagnosis for selected medical conditions among the elderly in Taiwan. Public Health 114, 137–142.CrossRefGoogle ScholarPubMed
Yates, W.R., Mitchell, J., Rush, A.J., Trivedi, M.H., Wisniewski, S.R., Warden, D., Hauger, R.B., Fava, M., Gaynes, B.N., Husain, M.M. & Bryan, C. (2004). Clinical features of depressed outpatients with and without co-ocurring general medical conditions in STAR*D. General Hospital Psychiatry 26, 421–429.CrossRefGoogle Scholar