Does higher severity really correlate with a worse quality of life in obsessive–compulsive disorder? A meta-regression

Figures & data

Figure 1 PRISMA flowchart of the study selection.

Abbreviation: OCD, obsessive–compulsive disorder.

Table 1 Characteristics of the studies included in the meta-analysis (n = 13)

Reference	Publication date	Country	Cohort (age range)	Recruitment strategies of OCD patients	Recruitment strategies of controls	Screening of control	n	Instruments used to make OCD diagnoses	QOL outcomes
Albert et al^Citation27	2010	Italy	Adults	Consecutive patients with a principal diagnosis of OCD referring to the Mood and Anxiety Disorders Unit of the University of Turin, Italy	The normative sample included 2,031 Italian individuals drawn from the general population and who participated in the validation study of the Italian translation of the SF-36	Unscreened controls	OCD patients (n = 151) Controls (n = 2,031)	DSM-IV (SCID-I)	SF-36
Borda et al^Citation28	2013	Argentina	Children	Subjects recruited from several sources (eg, primary care physicians, mental health professionals)	Subjects recruited from local private schools	Screened controls	OCD patients (n = 23) Controls (n = 30)	ADIS-CV	PQL
Eisen et al^Citation12	2006	USA	Adults	Patients consecutively recruited from a large OCD clinic, group psychiatric practices, psychologists’ offices, and mental health clinics in Rhode Island and Massachusetts, to be part of a 5-year prospective naturalistic study of course of illness in OCD	Published community norms	Unscreened controls	OCD patients (n = 197) Controls (n = 2,474)	Interview	SF-36, WHOQOL- BREF, QLESQ
Hou et al^Citation29	2010	Taiwan	Adolescents and adults (16–70 years)	Patients were consecutively recruited from the outpatient psychiatric clinics at a medical center and a regional teaching hospital in Southern Taiwan	Subjects were recruited through advertisement in the hospital and in newspapers	Screened controls	OCD patients (n = 57) Controls (n = 106)	DSM-IV (MINI)	WHOQOL- BREF
Huppert et al^Citation30	2009	USA	Adults	Patients with OCD and controls previously enrolled in a multicenter randomized clinical trial		Screened controls	OCD patients (n = 32) Controls (n = 36)	DSM-IV (SCID-I)	SF-36, SAS, QLESQ
Kivircik Akdede et al^Citation31	2005	Turkey	Adults	Not reported	Not reported	Screened controls	OCD patients (n = 23) Controls (n = 22)	DSM-IV	WHOQOL- BREF
Koran et al^Citation32	1996	USA	Adults (19–67 years)	Patients participating in clinical trials	General US population and patients who participated in the Medical Outcome Study (1986–1987)	Unscreened controls	OCD patients (n = 60) Controls (n = 2,474)	DSM-II-R (SCID-I)	SF-36
Kumar et al^Citation33	2012	India	Adults	Consecutive patients recruited from the Behavioral Medicine Unit of the NIMHANS	Subjects recruited from the local community	Unscreened controls	OCD patients (n = 31) Controls (n = 30)	DSM-IV (MINI)	WHOQOL- BREF
Pinto et al^Citation34	2014	USA	Adults	Subjects recruited by advertisements, clinic website, clinician referral, and word of mouth	Recruited by advertisements, clinic website, clinician referral, and word of mouth	Screened controls	OCD patients (n = 25) Controls (n = 25)	DSM-IV (SCID-I)	SAS, QLESQ
Rodriguez- Salgado et al^Citation15	2006	Spain	Adults	Patients with OCD diagnosis referred to the psychiatric outpatient clinic at Ramon y Cajal General Hospital	Spanish general population	Unscreened controls	OCD patients (n = 64) Controls (n = 9,151)	DSM-IV (MINI)	SF-36
Vivan Ade et al^Citation37	2013	Brazil	Adolescents (14–18 years)	Participants were recruited from an epidemiological study conducted at high schools in the city of Porto Alegre, southern Brazil		Screened controls	OCD patients (n = 75) Controls (n = 150)	DSM-IV (K-SADS)	WHOQOL- BREF
Srivastava et al^Citation35	2011	India	Adults	Subjects enrolled consecutively from the psychiatry outpatients’ service of the University College of Medical Science and G.T.B. Hospital	Patients with OCD attending the same psychiatric services as the clinical sample and healthy volunteers	Screened controls	OCD patients (n = 45) Controls (n = 150)	DSM-IV	WHOQOL- BREF
Stengler-Wenzke et al^Citation36	2006	Germany	Adults (21–72 years)	“Clinic for patient with OCD and Anxiety Disorder” at the Department of Psychiatry of the University of Leipzig, consecutively recruited	General population data were gathered from a representative survey conducted in Germany in 2004	Unscreened controls	OCD patients (n = 75) Controls (n = 315)	ICD-10	WHOQOL- BREF

Abbreviations: ADIS-CV, Anxiety Disorders Interview Schedule for DSM-IV – Child Version; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders – fourth edition; ICD-10, International Classification of Diseases – 10th Revision; K-SADS, Kiddie Schedule for Affective Disorders and Schizophrenia; MINI, Mini International Neuropsychiatry Interview; NIMHANS, National Institute of Mental Health and Neurosciences; OCD, obsessive–compulsive disorder; PQL, Pediatric Quality of Life Inventory – Child Report; QLESQ, Quality of Life Enjoyment and Satisfaction Questionnaire; QOL, quality of life; SAS, Social Adjustment Scale–Self-Report; SF-36, Medical Outcomes Study – short form; WHOQOL-BREF, World Health Organization Questionnaire on Quality of Life: Short Form.

Figure 2 Forest plot between groups with OCD and controls on global QOL (n = 13).

Abbreviations: CI, confidence interval; OCD, obsessive–compulsive disorder; PQL, Pediatric Quality of Life Inventory – Child Report; QOL, quality of life; SMD, standardized mean difference.

Figure 3 Funnel plot of publication bias for the meta-analysis between groups with OCD and controls on global QOL.

Abbreviations: OCD, obsessive–compulsive disorder; QOL, quality of life; SMD, standardized mean difference.

Figure 4 Meta-regression of global QOL as a function of OCD severity.

Abbreviations: OCD, obsessive–compulsive disorder; QOL, quality of life; SMD, standardized mean difference.

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