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Assessment of QoL in people with severe and enduring AN.pdf (314.2 kB)

Assessment of quality of life in people with severe and enduring anorexia nervosa: a comparison of generic and specific instruments

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posted on 2023-05-19, 06:26 authored by Mitchison, D, Hay, P, Engel, S, Crosby, R, Le Grange, D, Lacey, H, Jon MondJon Mond, Slewa-Younan, S, Touyz, S

Background: Criticisms that generic measures of health-related quality of life (HRQoL) are not sensitive to impairment in anorexia nervosa (AN) has spurred the development of disease-specific measures. This study aimed to compare the psychometric properties of a generic to a disease-specific measure of HRQoL.

Methods: 63 participants with AN completed measures of a generic HRQoL (SF-12), disease-specific HRQoL (Eating Disorders Quality of Life Questionnaire; EDQOL), functional impairment (days out of role; DOR; Work and Social Adjustment Scale; WSAS), and eating disorder severity (Eating Disorder Examination; EDE) at baseline, post-treatment, and 6- and 12-months follow-up. Cronbach’s α was computed for the SF-12 and EDQOL (internal consistency). Correlations were assessed between SF-12/EDQOL scores and DOR, WSAS, and EDE scores (convergence validity). Three sets of three multiple linear regressions were performed using SF-12 and EDQOL scores as predictors and change in DOR, WSAS, and EDE global scores from baseline to (i) post-treatment, (ii) 6-month follow-up, (iii) and 12-month follow-up as dependent variables (predictive validity and sensitivity).

Results: The EDQOL displayed stronger internal consistency (α = 0.92) than the SF-12 (α = 0.80). The SF-12 converged more strongly with DOR and the WSAS (rp = −0.31 to −0.63 vs. 0.06 to 0.70), while the EDQOL converged more strongly with the EDE (rp = −0.01 to 0.48 vs. -0.01 to −0.37). The SF-12 demonstrated stronger predictive validity (β = −0.55 to 0.29) and sensitivity to changes in ED severity (β = −0.47 to 0.32).

Conclusions: The SF-12 is a valid and sensitive measure of HRQoL impairment in patients with AN. While the SF-12 may be preferred in research comparing EDs to other populations, and in research and practice as an indicator of functional impairment; the EDQOL may be preferred by clinicians and researchers interested in HRQoL impairment specifically associated with an ED and as an additional indicator of ED severity.


Publication title

BMC psychiatry



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School of Health Sciences


BioMed Central

Place of publication

United Kingdom

Rights statement

Copyright 2013 Mitchison et al.; licensee BioMed Central Ltd. Licensed under Creative Commons Attribution 2.0 Generic (CC BY 2.0)

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  • Open

Socio-economic Objectives

Mental health

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