Completeness of response and quality of life in mood and anxiety disorders

Mental health care has traditionally,focused on the need to document relief of specific symptoms of a psychiatric disorder; as well as how the patient functions in social roles. Recently, there has been inn-eased attention pa id to the issue of quality of life (QOL) and psychiatric illness. There has been a growing recognition that different treatment options may vary in th eir effects on the patient's ability to function in multiple life domains. Studies focusing on the QOL ill patients suffering from mood and anxiety, d isorders have become more prevalent Depression and anxiety disorders impose a substantial cost on society in terms of both psychiatric service costs a s well as the loss of the individual to society through lost work productio n. However a change in the severity of depression or anxiety, often correla tes with a change in disability and health service utilization. Lately, the re have been a number of treatment studies of anxiety, and depressive disor ders that have examined the effect of treatment on QOL. Although treatment may reduce the severity and frequency of target symptoms, the patient's ass essment of QOL helps to differentiate a true treatment response and remissi on front a partial response. The evaluation of what constitutes all adequat e treatment response or remission is complicated and likely requires multip le assessment instruments in order to develop a complete understanding. In both anxiety and depressive disorders, the patient suffers from impaired fu nctioning, which results in increased healthcare utilization. Because these patients do respond to treatment, the idea of "wellness" as a high end sta te treatment outcome should be an important consideration when selecting a treatment option. (C) 2000 Wiley-Liss, Inc.