The presence of subthreshold OCD is correlated with poorer QoL. More research is needed to evaluate if specific therapeutic interventions targeting subthreshold obsessive-compulsive symptoms can lead to a significant improvement in the QoL of the affected individuals.
Although Quality of Life in patients with Mood Disorders has been widely investigated, there are very few studies that examine the relationship between quality of life and subthreshold affective symptoms. The aim of this study was to analyze the relationship between mood spectrum and subjective quality of life in the general population. A sample of 200 healthy subjects was recruited from the general population. None of the subjects were treated with psychotropic medications or were receiving psychotherapy at the time of the assessments. Subjects were 22-55 years old. The mean age was 33.56 years. Subjects rated themselves on the 'Quality of Life Enjoyment and Satisfaction Questionnaire' (Q-LES-Q) and the 'Self-Report Questionnaire for Mood Spectrum' (MOODS-SR). We found a statistically significant correlation between Q-LES-Q total score and MOODS-SR total score (r = -0.43; p < 0.001) and between Q-LES-Q total score and depressive symptoms-related subtotal score of MOODS-SR (r = -0.35; p < 0.001), but not between Q-LES-Q total score and manic symptoms-related subtotal score of MOODS-SR. Our data suggests that subjects who report subthreshold affective symptomatology also report a low degree of enjoyment and satisfaction from life. The depressive aspects of the mood spectrum seem to have the greatest negative influence.
Objective: This study aimed to verify a possible correlation between panic symptoms and photosensitivity, not only in panic disorder (PD) but also in the panic-agoraphobic spectrum. Method:One hundred and sixty-nine healthy and drug-free subjects completed the Structured Clinical Interview for Panic-Agoraphobic Spectrum-Lifetime version (SCI-PAS-Lifetime) and the Photosensitivity Assessment Questionnaire (PAQ). Results:The SCI-PAS-Lifetime total score was positively correlated with the total score of the PAQ photophobia subdimension (r = 0.44; P < 0.001); the SCI-PAS-Lifetime total score was not significantly correlated with the photophilia subdimension. As photophobia increased, we observed significant score increases in all SCI-PAS-Lifetime domains. Bivariate correlation showed higher coefficient correlation between the panic-like symptoms domain and photophobia (r = 0.44; P < 0.001). Conclusions:A high total score in the SCI-PAS-Lifetime, which denotes more typical features of the spectrum, is associated with a higher level of light sensitivity and intolerance toward bright stimuli. This finding reflects clinical evidence that widely documents photophobic behaviours in subjects with PD and the importance of light stimuli exposure during the onset and course of such a disorder. Bright stimulation seems to be relevant both in PD diagnosed according to current DSM criteria and in the entire panic-agoraphobic spectrum, from nuclear elements of the disorder through subclinical states to the normal condition. Clinical Implications· This study confirms clinical evidence and literature data that document photophobic behaviours in subjects with panic disorder (PD), as well as the importance of light stimuli exposure during the onset and course of such a disorder. · The possible presence of panic spectrum elements in patients affected by psychiatric disorders other than PD and their relation to light hypersensitivity suggest the importance of carefully assessing subsyndromic panic symptoms. They may explain seasonal changes in some aspects of the course of evident clinical Axis I disorders. · The relation between light stimulation and panic spectrum elements could have meaningful implications for the course and prognosis of the clinical manifestations, especially with reference to seasonal changes, with significant consequences for clinical remission and maintenance therapy. Limitations· We considered a small sample that was not homogeneously distributed between men and women; photophobia and photophilia scores did not have a Gaussian distribution. · The Photosensitivity Assessment Questionnaire was designed for a Mediterranean population, and its outside test validity and reliability were evaluated in an Italian population only. · Further studies using larger, homogeneous samples are needed to conduct a more in-depth investigation of the relations between spectrum model, nosographic entities of current classification systems, and light sensitivity.
Several studies have evaluated the quality of life (QOL) in patients with Panic Disorder (PD). For instance, the Epidemiological Catchment Area Study (ECA) assessed the quality of life (QoL) using the subjective evaluation of health, psychosocial functioning and financial status as parameters (Regier et al., 1984). Among the general population, people with PD or panic attacks reported a low level of physical health in 35% of cases and a low degree of mental health in 38% of cases, similarly to people suffering from Major Depressive Disorder (29% and 39% respectively), but more frequently than the in individuals not affected by any disorder (24% and 12% respectively). Furthermore, 27% of patients with PD were in need of some form of social or financial support in contrast to 16% of people suffering from depression and 12% of unaffected people. The National Comorbidity Survey (NCS) (Magee et al., 1996) found serious interference in activities in 27% of agoraphobic patients. For instance, the agoraphobic subjects reported an average of 1.1 days of work lost in the previous month due to their psychopathology. Several Authors have studied the relationship between PD and a worse quality of life and/or a worse ability to function. In a review on the topic, Mendlowicz & Stein (2000) provided an integrated view of the issue of quality of life in patients with anxiety disorders and concluded that the existing studies almost uniformly show a marked impairment of quality-of-life and psychosocial functioning in individuals with anxiety disorders. However, as noted by the Authors above, “despite the growing number of studies undertaken during the past 15 years, the investigation of quality of life in individuals with anxiety disorders is still in its infancy.” Rucci et al. (1993) evaluated the prevalence of subthreshold psychiatric disorders in primary care and their association with the patients health perception, disability in daily activities and psychological distress Subjects with subthreshold disorders reported levels of psychological distress, disability in daily activities and perceived health comparable to those of patients with full-fledged ICD-10 disorders. Despite the scientific and clinical importance of the topic, relatively few studies have evaluated the prevalence and impact of subthreshold affective disorders in general (Schotte & Cooper, 1999) and panic symptoms in particular (for instance Bellini & Galverni, 2003) in non psychiatric populations. Moreover, the literature on the relationship between sub-threshold or residual PD and quality of life is scant. To this end, we decided to investigate the impact of panic-agoraphobic “spectrum” on the quality of life of subjects who did not meet the criteria for a full blown PD. We adopted the definition of “spectrum” developed by Cassano and colleagues (Cassano & Pini, 2000; Rucci & Maser, 2000), which refers to a dimensional view of psychopathology that includes a broad array of manifestations of the target disorder, including its most severe symptoms as well as a range of more subtle features related to the core condition, which may include temperamental traits, prodromal indicators, or residual symptoms. Although they are frequently associated with specific DSM-IV disorders, these conditions are also found in individuals who have never met full DSM-IV diagnostic criteria. Our hypothesis for this study was that the presence of subthreshold panic-agoraphobic symptomatologies in otherwise healthy individuals would significantly impair the quality of life despite the absence of a full-blown PD diagnosis.
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