Quality of Life Research

, Volume 14, Issue 1, pp 171–178 | Cite as

Assessing quality of life in eating disorder patients

  • J. M. Mond
  • C. Owen
  • P. J. Hay
  • B. Rodgers
  • P. J. V. Beumont


Objective: To examine quality of life among subgroups of eating disorder patients. Method: Self-report questionnaires which included two quality of life measures were completed by 87 individuals referred for treatment to the Australian Capital Territory Eating Disorders Day Program. Health-related quality of life, as measured by the Medical Outcomes Study 12-item Short Form Mental Component Summary scale, and subjective quality of life, as measured by subscales of the World Health Organization Brief Quality of Life Assessment Scale (WHOQOL-BREF), were compared among individuals who received the diagnosis of anorexia nervosa purging subtype (n=15), anorexia nervosa restricting subtype (n=19), bulimia nervosa (n=40) and binge eating disorder (n=10), and among a general population sample of young adult women employed as a control group (n=495). Results: Eating disorder patients, when considered together, showed marked impairment in both health-related and subjective quality of life relative to normal control subjects. However, in both domains, restricting anorexia nervosa patients reported significantly better quality of life than other patient groups, after controlling for levels of general psychological distress. Scores on the Social Relationships subscale of the WHOQOL-BREF among individuals in this subgroup were similar to those of normal control subjects. Conclusions: Reliance on any one instrument is likely to be misleading in assessing the quality of life of eating disorder patients. Careful consideration needs to be given to the assessment of restricting anorexia nervosa patients in particular.


Eating disorders Health-related quality of life Subjective quality of life 


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  1. Frisch, MB. 1999Quality of life assessmentMaruish, ME eds. The Use of Psychological Testing for Treatment Planning and Outcomes Assessment2Lawrence Erlbaum AssociatesNew Jersey162170Google Scholar
  2. Ware, JE, Kosinski, M, Keller, SD. 1994SF-36 Physical and Mental Health Summary Scales. A User’s ManualThe Health Institute, New England Medical CenterBostonGoogle Scholar
  3. Spitzer, RL, Kroenke, K, Linzer, M.,  et al. 1995Health-related quality of life in primary care patients with mental disordersJAMA2745111517CrossRefGoogle Scholar
  4. Andrews, G, Sanderson, K, Beard, J. 2000Methods of calculating disability from mental disorderBr J Psychiatry173123131Google Scholar
  5. Beumont, PJV, Kopec-Shrader, EM, Lennerts, W. 1995Eating disorder patients at a NSW hospital: Comparison with state-wide dataAust N Z J Psychiatry2996103PubMedGoogle Scholar
  6. Agras, WS. 2001The consequences and the costs of the eating disordersPsychiatric Clinics of North America24371379CrossRefPubMedGoogle Scholar
  7. Norman, DK, Herzog, DB. 1984Persistent social maladjustment in bulimia: A one-year follow-upAm J Psychiatry141444446PubMedGoogle Scholar
  8. Keel, PK, Mitchell, JE, Miller, KB, Davis, TL, Crow, SJ. 2000Social adjustment over 10 years following diagnosis with bulimia nervosaInt J Eat Disord272128CrossRefPubMedGoogle Scholar
  9. Sullivan, PF, Bulik, CM, Fear, JL, Pickering, A. 1998Outcome of anorexia nervosa: A case–control studyAm J Psychiatry155939946PubMedGoogle Scholar
  10. Windauer, U, Lennerts, W, Talbot, P, Touyz, SW, Beumont, PJV. 1993How well are ‘cured’ anorexia nervosa patients? An investigation of 16 weight-recovered anorexic patientsBr J Psychiatry163195200PubMedGoogle Scholar
  11. Anderson, DA, Williamson, DA,  et al. 2000Outcome measurement in eating disordersIsHak, WWBurt, T. eds. Outcome Measurement in Psychiatry: A Critical ReviewAmerican Psychiatric Publishing IncWashington, DC289301Google Scholar
  12. Vitousek, K, Watson, S, Wilson, GT. 1998Enhancing motivation for change in treatment-resistant eating disordersClin Psychol Rev18391420CrossRefPubMedGoogle Scholar
  13. Garner, DM, Garner, MV, Rosen, LW. 1993Anorexia nervosa ‘restricters’ who purge: Implications for subtyping anorexia nervosaInt J Eat Disord13171185PubMedGoogle Scholar
  14. Padierna, A, Quintana, JM, Arostegui, I, Gonzalez, N, Horcajo, MJ. 2000The health-related quality of life in eating disordersQual Life Res9667674CrossRefPubMedGoogle Scholar
  15. Wilfley, DE, Wilson, GT, Agras, WS 2003The clinical significance of binge eating disorderInt J Eat Disord34S96106CrossRefPubMedGoogle Scholar
  16. Fairburn, CG, Beglin, SJ. 1994Assessment of eating disorders: Interview or self-report questionnaire?Int J Eat Disord16363370PubMedGoogle Scholar
  17. Kessler, RC, Andrews, G, Colpe, LJ,  et al. 2002Short screening scales to monitor population prevalences and trends in non-specific psychological distressPsychol Med32959976CrossRefPubMedGoogle Scholar
  18. Ware, JE, Kosinski, M, Keller, SD. 1996A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validityMed Care34220233CrossRefPubMedGoogle Scholar
  19. WHOQOL Group1998Development of the World Health Organization WHOQOL-BREF Quality of Life AssessmentPsychol Med28551558Google Scholar
  20. Garrow, JS. 1988Obesity and Related DiseasesChurchill LivingstoneEdinburghGoogle Scholar
  21. Mond, JM, Rodgers, B, Hay, PJ, Owen, C, Beumont, PJV. 2004Non-response bias in a general population survey of eating-disordered behaviourInt J Eat Disord368998CrossRefPubMedGoogle Scholar
  22. American Psychiatric Association1994Diagnostic and Statistical Manual of Mental Disorders. (DSM-IV)4APAWashington, DCGoogle Scholar
  23. World Health Organization1992International Classification of Disease and Related Disorders (ICD-10)World Health OrganizationGenevaGoogle Scholar
  24. Anderson, AE, Bowers, WA, Watson, T. 2001A slimming program for EDNOS: Reconceptualizing a confusing, residual diagnostic categoryPsychiatric Clinics of North America24271280CrossRefPubMedGoogle Scholar
  25. Sanderson, K, Andrews, G. 2002Prevalence and severity of mental health-related disability and relationship to diagnosisPsychiatr Serv538086CrossRefPubMedGoogle Scholar
  26. WHOQOL Group. Development of the WHOQOL: Rationale and current status. Int J Mental Health 1994; 23: 24–56Google Scholar
  27. Schmidt, U, Tiller, J, Morgan, HG. 1995The social consequences of eating disordersSzmukler, GDare, CTreasure, J eds. Handbook of Eating Disorders: Theory, Treatment and ResearchJohn Wiley & SonsNew York199210Google Scholar
  28. Andrews, G, Slade, T. 2001Interpreting scores on the Kessler Psychological Distress Scale (K10)Aust N Z J Public Health25494497PubMedGoogle Scholar
  29. Schmeck, K, Poustka, F. 1998uality of life and child psychiatric disordersKatschnig, HFreeman, HSartorius, N eds. Quality of Life in Mental DisordersJohn Wiley & SonsNew York179191Google Scholar
  30. Walsh BT, Garner DM. Diagnostic issues. In: Garner D, Garfinkel P (eds), Handbook of Treatment for Eating Disorders. 2nd ed. New York: Guilford Press, 25–33Google Scholar
  31. Beumont, PJV. 2002The clinical presentation of anorexia and bulimia nervosaFairburn, CGBrownell, KD eds. Eating Disorders and Obesity: A Comprehensive Handbook2Guilford PressNew York162170Google Scholar
  32. Katschnig, H. 1998How useful is the concept of quality of life in psychiatry?Katschnig, HFreeman, HSartorius, N eds. Quality of Life in Mental DisordersJohn Wiley & SonsNew York316Google Scholar
  33. Orley, J, Saxena, S, Hermann, H. 1998Quality of life and mental illness: Reflections from the perspective of the WHOQOLBr J Psychiatry172291293PubMedGoogle Scholar
  34. Warner, R. 1999The emics and etics of quality of life assessmentSoc Psychiatry Psychiatr Epidemiol34117121CrossRefPubMedGoogle Scholar
  35. Lehman, A. 1996Measures of quality of life among persons with severe and persistent mental disordersSoc Psychiatry Psychiatr Epidemiol317888CrossRefPubMedGoogle Scholar
  36. Bemis Vitousek, K, Daly, J, Heiser, C. 1991Reconstructing the internal world of the eating-disordered individual: Overcoming denial and distortion in self-reportInt J Eat Disord10647666Google Scholar
  37. Sainfort, F, Becker, M, Diamond, R. 1996Judgments of quality of life of individuals with severe mental disorders: Patient self-report versus provider perspectivesAm J Psychiatry153497502PubMedGoogle Scholar
  38. Skantze, K, Malm, U, Dencker, SJ, May, PRA, Corrigan, PW. 1992Comparisons of quality of life to standard of living in schizophrenic outpatientsBr J Psychiatry161797801PubMedGoogle Scholar
  39. Striegel-Moore, RH, Franko, DL. 2003Epidemiology of binge eating disorderInt J Eat Disord34S19S29CrossRefPubMedGoogle Scholar
  40. Braun, DL, Sunday, SR, Halmi, KA. 1994Psychiatric comorbidity in patients with eating disordersPsychol Med24859867PubMedGoogle Scholar
  41. Carter, JC, Aime, AA, Mills, JS. 2001Assessment of bulimia nervosa: A comparison of interview and self-report questionnaire methodsInt J Eat Disord30187192CrossRefPubMedGoogle Scholar
  42. Padierna, A, Quintana, JM, Arostegui, I, Gonzalez, N, Horcajo, MJ. 2002Changes in health-related quality of life among patients treated for eating disordersQual Life Res11545552CrossRefPubMedGoogle Scholar
  43. Lehman, AF. 1983The effects of psychiatric symptoms on quality of life assessments among the chronic mentally illEval Prog Plan6143151CrossRefGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • J. M. Mond
    • 1
  • C. Owen
    • 2
  • P. J. Hay
    • 3
  • B. Rodgers
    • 4
  • P. J. V. Beumont
    • 5
  1. 1.Neuropsychiatric Research InstituteFargoUSA
  2. 2.Department of Psychological MedicineThe Canberra HospitalCanberraAustralia
  3. 3.School of MedicineJames Cook UniversityTownsvilleAustralia
  4. 4.Centre for Mental Health ResearchThe Australian National UniversityCanberraAustralia
  5. 5.Department of Psychological MedicineUniversity of SydneySydneyAustralia

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