Quality of life in obsessive-compulsive disorder: the different impact of obsessions and compulsions

Patients with obsessive-compulsive disorder (OCD) are troubled by repeated obsessions and/or compulsions, which seem senseless and frequently repugnant.

The study examines the differential impact of obsessions and compulsions on the quality of life (QoL) of patients with OCD.

Seventy-five patients (43 females, 32 males) between 21 and 62 years old with OCD (ICD 10 F42.0-F42.2) were recruited from the outpatient clinic for anxiety disorders at the Department of Psychiatry of the University of Leipzig. The severity of OCD symptoms was assessed by the Yale Brown Obsessive-Compulsive Scale (a standardized, clinician-administered scale), and depressiveness was assessed with the Beck Depression Inventory (a self-report instrument). QoL was assessed by means of the WHOQOL-BREF, a self-administered questionnaire developed by WHO.

Compulsions reduced patients' QoL in the WHOQOL-BREF domains 'physical well-being', 'psychological well-being' and 'environment', whereas obsessions did not have any impact on QoL ratings. Depressive symptoms were a strong predictor of poor QoL in OCD patients.

In order to judge the QoL of OCD patients, obsessions and compulsions have to be considered differently. Diagnosing and treating depressive symptoms is important for improving the QoL in OCD.