How Do Mental and Physical Health Conditions Affect Quality of Life in Singapore?

What you need to know

• Chronic pain and mental health disorders like depression have major impacts on health-related quality of life in Singapore’s population
• Generalized anxiety disorder had the largest effect on quality of life at the individual level
• Younger adults, women, unemployed individuals, and those with lower income reported lower quality of life scores
• Findings highlight key health conditions to prioritize in public health programs

Understanding quality-adjusted life years

To understand the impact of different health conditions on people’s lives, researchers use a measure called quality-adjusted life years (QALYs). This combines how long someone lives with the quality of life they experience during that time.

The quality of life part is measured on a scale from 0 to 1, where 1 represents perfect health and 0 represents a health state equivalent to death. For example, living one year in perfect health would equal 1 QALY. Living one year with a health condition that reduces quality of life to 0.7 on the scale would equal 0.7 QALYs.

By looking at how many QALYs are lost due to different health conditions, researchers can get a sense of which conditions have the biggest impact on people’s overall wellbeing and functioning. This information can then help guide decisions about where to focus healthcare resources and interventions.

Key findings on quality of life impacts

The study surveyed over 6,000 adults in Singapore about their health conditions and quality of life. Some key findings include:

• Chronic pain had the largest impact at the population level, accounting for an estimated loss of over 14,000 QALYs per year
• Major depressive disorder was the second largest contributor, with nearly 7,000 QALYs lost annually
• Generalized anxiety disorder had the biggest effect on quality of life scores for individuals with the condition
• Other conditions with significant impacts included obsessive-compulsive disorder, cardiovascular disease, and bipolar disorder

Mental health disorders

The study found that several mental health disorders had major impacts on quality of life:

Generalized anxiety disorder (GAD): This had the largest effect on quality of life scores for individuals with the condition. People with GAD often experience persistent and excessive worry about various aspects of life. The symptoms can significantly interfere with daily activities and functioning.

Major depressive disorder: This was the second largest contributor to QALY losses at the population level. Depression can cause persistent feelings of sadness, loss of interest in activities, and difficulty with daily functioning.

Obsessive-compulsive disorder (OCD): OCD was the third largest contributor to QALY losses. It involves recurring, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions) that significantly interfere with daily life.

Bipolar disorder: This condition, which involves alternating episodes of depression and mania, also had a significant impact on quality of life scores.

The researchers noted that the impact of generalized anxiety disorder was larger in this study compared to previous research in Singapore. This may reflect an increase in the prevalence and severity of anxiety in recent years, though more research is needed to confirm this trend.

Chronic physical conditions

While mental health disorders had large impacts, chronic physical conditions also significantly affected quality of life:

Chronic pain: This had the largest impact at the population level due to its relatively high prevalence. Chronic pain conditions included in the study were arthritis, back problems, and migraines.

Cardiovascular disease: This category included conditions like heart disease, stroke, and high blood pressure. It was one of the top contributors to QALY losses.

Ulcers: Stomach ulcers and inflammatory bowel conditions had a notable impact on individual quality of life scores.

Lung disease: Conditions like chronic bronchitis and emphysema also reduced quality of life, though they affected a smaller portion of the population.

Factors associated with lower quality of life

In addition to specific health conditions, the study identified some general factors associated with lower quality of life scores:

• Younger age (18-34 years old)
• Female gender
• Unemployment
• Lower income levels

The finding that younger adults reported lower quality of life was somewhat surprising, as this differed from previous studies in Singapore. The researchers suggested this could reflect increasing stress and mental health challenges for younger generations, but noted more research is needed to understand this trend.

Implications for public health

The study’s findings highlight several key areas to prioritize for public health initiatives in Singapore:

1. Chronic pain management: Given the large population-level impact, improving chronic pain treatment and prevention could significantly boost quality of life.

2. Mental health services: Expanding access to care for conditions like depression, anxiety, and OCD should be a priority.

3. Cardiovascular health: Continued focus on preventing and managing heart disease and related conditions is important.

4. Youth mental health: The lower quality of life scores among younger adults suggest a need for targeted mental health support for this age group.

5. Socioeconomic factors: Addressing unemployment and income inequality could help improve overall population health and wellbeing.

By focusing on these areas, public health programs may be able to reduce the burden of disease and improve quality of life for Singapore’s population.

Conclusions

• Chronic pain and mental health disorders like depression have the largest impacts on quality-adjusted life years in Singapore’s population
• Generalized anxiety disorder shows a particularly large effect on individual quality of life
• Younger adults report lower quality of life scores than older age groups, a trend that warrants further research
• Findings can help guide prioritization of public health initiatives to address key drivers of reduced quality of life

While the study provides valuable insights, the researchers note some limitations. The data on chronic conditions was self-reported, which can sometimes be less accurate than medical records. Additionally, as a cross-sectional study (looking at one point in time), it cannot establish causal relationships between factors.

Despite these limitations, the large, representative sample and comprehensive assessment of both physical and mental health conditions make this an important contribution to understanding health-related quality of life in Singapore. The findings can help inform healthcare planning and resource allocation to address the conditions with the greatest impact on population wellbeing.