Alcohol Dependence, Other Psychiatric Disorders, and Health‐Related Quality of Life: A Replication Study in a Large Random Sample of Enrollees in the Veterans Health Administration

Abstract

The purpose of this study was to investigate the relationship between alcohol dependence and health‐related quality of life (HRQoL) in people with and without other selected psychiatric disorders. A sample of 127,308 Veterans Health Administration enrollees completed a survey that included questions about alcohol use and the Veterans SF‐36, a well‐validated measure of HRQoL. In addition, a Veterans Administration database was used to obtain respondents' past‐year history of alcohol dependence and other psychiatric disorders. Comorbid psychiatric disorders significantly moderated or attenuated the relationship between alcohol dependence and HRQoL. Respondents with a history of alcohol dependence plus one or more other psychiatric disorders had significantly lower HRQoL in domains pertaining to psychological and social functioning than respondents with alcohol dependence only. Effect size differences (mean differences of clinical groups/pooled standard deviation) were large (greater than 0.80 of one standard deviation). Respondents with a history of alcohol dependence only vs. no history of alcohol dependence had poorer HRQoL. Effect size differences were small to moderate (between 0.20 and 0.50 of one standard deviation). Findings highlight the important moderating influence of comorbid psychiatric disorders in the relationship between alcohol dependence and HRQoL. As comorbid psychiatric disorders are often associated with poorer treatment outcome, findings also provide strong corroboration for the importance of treating other psychiatric disorders concurrently with alcohol dependence.

• Alcohol
• Comorbid psychiatric
• Epidemiology
• Health‐related quality of life

Notes

^aVeterans who meet certain criteria defined by the Veterans Health Administration are eligible to receive care from the VHA. These criteria include having a service‐connected disability and falling below established income and net worth thresholds. Eligible veterans who enroll are referred to as veteran enrollees.

^bMedical and administrative records for all enrollees in the overall sample were analyzed for differences between responders and non‐responders and were used to derive weights to adjust for response bias. All rates presented in this study are weighted for sampling and response bias so they represent the overall 1999 VHA enrollment population (approximately 3.4 million) at the time of the survey.

^cThe sample of 127,308 respondents was compared with respondents not included in the analyses (n = 45,065). Mean PCS and MCS scores were 1.3 points and 1.1 points lower in the final sample, indicating that respondents in the final sample were slightly more impaired than those excluded from the analyses although the differences are not considered clinically important.