The Patient’s View on Quality of Lifeand Eating Disorders
Simone de la Rie, MA
*Greta Noordenbos, PhD
Marianne Donker, PhD
Eric van Furth, PhD
This study investigated thepersonal views of eating disorder (ED)patients on their quality of life (QOL).
The views of 146 current EDpatients and 146 former ED patients ontheir QOL were studied using a self-reportquestionnaire. Patients were requested toname the most important aspects of their lifeand they subsequently rated themselves onthese aspects. Qualitative analysis clustereditems into meaningfulcategories.
A sense of belonging was men-tioned most often (93.0%) by the partici-pants. Work or education, health and well-being were also mentioned frequently. Fur-thermore, participants stated a sense ofself, disease-speciﬁc psychopathology, lifeskills, leisure activities, a sense of purpose,ﬁnancial situation, living condition, andpets. Current ED patients more frequentlymentioned disease-speciﬁc psychopathol-ogy than former ED patients. Current EDpatients reported poor QOL on most do-mains, particularly on self-image and well-being. Former ED patients reported betterQOL than current ED patients, but ratingswere just above average.
The views on QOL of EDpatients broadens the scope of relevantdomains of QOL. The assessment of theseviews may be a useful adjunct to the useof standardized QOL measures.
2006by Wiley Periodicals, Inc.
eating disorders; quality oflife; patient outcomes
(Int J Eat Disord 2007; 40:13–20)
The quality of life (QOL) of patients with an eating disorder (ED) was reported to be poor.
Padierna et al.
showed that after 2 years of treatment andfollow-up, ED patients were still more dysfunc-tional in all areas of life than women of the generalpopulation although their perception of their QOLhad improved. De la Rie et al.
also showed that EDpatients, even after symptoms are no longer mani-fest, still report a poorer QOL than a normal refer-ence group.The QOL for EDs in most of these studies wasassessed using general health-related QOL mea-sures, such as the Short Form-36 (SF-36)
or theNottingham Health Proﬁle.
Although the use of a generic health-related QOL measure helps to pro-vide insight into the QOL of a patient group in com-parison to other patient groups or a normal refer-ence group, it has several limitations. In their study on EDs and emotional and physical well-being, Dollet al.
found that an EDhistory of students is accom-panied by health-related QOL impairment in emo-tional well-being. However, anorexia nervosa (AN)participants reported fewer limitations on the SF-36,although they reported several severe comorbid psy-chiatric symptoms. Doll et al.
suggest that the SF-36 is insensitive to emotional distress, particularly in AN patients. In a study on QOL of inpatients with AN Gonzalez-Pinto et al.
found global deteriorationin the perception of health-related QOL, especially in mental health and vitality of the SF-36. Purging behaviors and comorbidity were found to predictpoor QOL of AN patients. Mond et al.
found thatalthough ED patients participating in an EDs Day Program reported poorer QOL than normal controls,restrictive AN patients tended to report better QOLthan other patient groups, after adjusting for levelsof general psychological distress. Mond et al.
com-pared two general health-related QOL-measures,namely the SF-12 and the WHOQOL-BREF. They found differences between the SF-12 and the WHO-
Centre for Eating Disorders Ursula, Leidschendam,The Netherlands
University of Leiden, Department of Clinical and HealthPsychology, Leiden, The Netherlands
Erasmus MC, Department of Public Health, University MedicalCentre Rotterdam, Rotterdam, The NetherlandsAccepted 4 July 2006
Simone de la Rie, Centre for Eating DisordersUrsula, P.O. Box 422, 2260 AK Leidschendam, The Netherlands.E-mail: firstname.lastname@example.orgPublished online 29 August 2006 in Wiley InterScience(www.interscience.wiley.com). DOI: 10.1002/eat.20338
2006 Wiley Periodicals, Inc.
International Journal of Eating Disorders 40:1 13–20 2007—