How to measure quality of life for cost effectiveness analyses in personality disorders? A systematic review.

Objective: To assess the construct validity and responsiveness of four generic health related quality of life (HRQL) measures in personality disorders (PDs). Methods: A systematic review was undertaken. Ten databases were searched and reference lists scrutinised to identify relevant studies. Relevant data were extracted accordingly. A narrative synthesis was performed of the evidence on construct validity including known groups validity (detecting differences in HRQL scores between two different groups), convergent validity (strength of association between generic HRQL and other measures (e.g. symptom) and responsiveness (differences in generic HRQL measure scores in responders/non-responders or correlation with changes in other measures). Results: Ten studies were identified, with 6 for the EQ-5D, two involving SF-36 and another 2 the SF-12, but none on the SF-6D. Evidence indicated that the EQ-5D, SF-36 and SF-12 were probably valid measures within PDs. Four studies demonstrated that the EQ-5D Index was able to detect changes in patients. Conclusion: Generic HRQL measures appear appropriate for use in people with PDs in terms of psychometric performance. However, qualitative concerns remain as to whether they fully reflect the impact of the condition.