Impact of psychiatric disorders and chronic physical conditions on health-related quality of life: Singapore Mental Health Study

Background: Few studies have established Quality Adjusted Life Years (QALY) losses associated with mental and chronic physical conditions in the community. The aim of the current study was to establish and compare the QALY losses associated with select mental and chronic physical conditions in Singapore. Methods: The Singapore Mental Health Study was a cross-sectional epidemiological survey of a nationally representative sample. The diagnosis of psychiatric disorders was established using the Composite International Diagnostic Interview (CIDI 3.0) and health related quality of life (HRQoL) was measured using the Euro-Qol-5D (EQ-5D). Results: Pain conditions, hypertension and MDD were associated with the highest loss of QALYs in Singapore at a population level. The marginal effect on HRQoL by - Major Depressive Disorder (MDD), Obsessive Compulsive Disorder (OCD) and Bipolar Disorder was higher than the effect of any physical condition. Limitations: The presence of chronic physical diseases was established using a check-list rather than with more objective measures and UK tariffs were used as local tariffs are not available and this might introduce some cultural bias. Conclusions: QALY losses associated with psychiatric disorders were high, emphasizing the need for recognizing them as major public health concerns and the need for appropriate resource allocation. (C) 2012 Elsevier B.V. All rights reserved.