Quality of Life in Obsessive-Compulsive Disorder

After a millennium of preoccupation with heaven, Western civilization began, during the Florentine Renaissance, to attend again to the quality of this life. Slowly in the sixteenth through nineteenth centuries, and rapidly in the twentieth, the medical scientific revolution that began with Vesalius and Harvey has improved quality of life. Physicians (and others) now attempt to quantify medicine's contribution, first because they are advocates for the whole person, and second because politicians question the high cost of medical services and technology. The journal Quality of Life Research was created to communicate research findings, and an on-line search of journal articles reveals hundreds of publications within the past few years spanning a wide range of diseases and procedures. Attempts to measure quality of life have forced the acknowledgment that the concept is multifaceted and culturally bound. After many years of study and with input from expert panels, the World Health Organization has organized its assessment questionnaire into six broad domains that can be examined cross-culturally: (1) physical; (2) psychological; (3) level of independence; (4) social relationships; (5) environment; and (6) spirituality, religion, and personal beliefs. 40 But many other conceptual schemes have been applied. 17 , 20 Thus, in assessing quality of life, an investigator must choose a focus, from global quality of life to one or more domains within one or more dimensions. This article focuses on health-related quality of life (HRQL) in adult patients with obsessive-compulsive disorder (OCD). Included within this concept are the relationships of health to family, social and vocational functioning, sense of emotional and physical well-being, and global quality of life. This article reviews what little is known regarding the effects of OCD on HRQL and then considers future research directions.