Table IIb. Summary of the sample, intervention, and outcome measures used in included studies that measured health-related quality of life using patient-reported outcome measures (PROMS).

Reference	Study sample (N, number of sites, country)	Study methodology	PROM(s) used	Major findings
Albert et al52	151 patients with OCD; Italy	Cross-sectional	SF-36	Patients with OCD showed greater impairment in all domains of mental health-related quality of life, especially social functioning.
Andersson et al82	23 patients with OCD; Sweden	RCT	QOLI	At post-treatment, results indicated a non-significant trend on the EQ-5D with a small effect size of 0.24. The result for QOLI was non-significant.
Besiroglu et al77	25 health care-seekers with OCD and 23 non-health care-seekers with OCD; Turkey	Cross-sectional	WHO-QOL-103 TR	Individuals whose QOL is minimally impaired by OCD are less likely to seek health care compared to significantly affected patients.
Besiroglu et al75	43 patients with comorbid OCD and MDD and 67 patients with OCD only; Turkey	Cross-sectional	WHO-QOL-BREF-TR	The OCD-MDD group reported significantly lower physical and psychological health and social relationship domain scores compared with patients with OCD only.
Besiroglu et al80	53 patients with OCD; Turkey	RCT	WHO-QOL-BREF-TR	There was no significant difference between the pre and post-treatment quality of life domain scores. Social relationship scores at follow-up were associated with baseline compulsion severity.
Bobes et al55	36 patients with OCD; Spain	Cross-sectional	SF-36	OCD patients reported significantly lower mean scores on all SF-36 scales as compared to Spanish norms, especially in social functioning, role, emotional and mental health.
Brown et al86	15 patients with OCD; USA	RCT	Q-LES-Q	Results showed a significant improvement in overall sense of well-being following participation in 12-week moderate-intensity exercise intervention.
Cordioli et al81	47 patients with OCD; Brazil	RCT	WHO-QOL-BREF	Significant improvement in the quality of life in the four domains of QOL after 12 weekly cognitive behavioral group therapy sessions.
Dehlin et al85	5 patients with scrupulosity-based OCD; USA	Multiple baseline across participants design	QOLS	Patients showed a 26% increase in QOLS scores after undergoing ACT.
Cassin et al72	28 outpatients with OCD and 28 outpatients with comorbid OCD and MDD; Canada	Cross-sectional	Q-LES-Q	Patients with comorbid OCD and MDD scored significantly lower on Q-LEQ-Q subjective feelings, overall well-being, social relations and general activities.
Didie et al18	210 patients with OCD, 45 patients with BDD and 40 patients with comorbid BDD and OCD; USA	Longitudinal	SF-36, Q-LES-Q	OCD subjects and BDD subjects had poorer quality of life as compared with the US population norms.
Dougherty et al79	30 patients with OCD (only 23 completers); USA	Longitudinal	Q-LES-Q	Pre-treatment and post-treatment analyses showed significant improvements in quality of life.
Eisen et al49	197 patients with OCD; USA	Cross-sectional	Q-LES-Q	Marital status and symptom severity of obsessions and depression contributed to the degree of impairment in QOL. OCD patients showed marked impairment in domains such as the ability to work and perform household duties, subjective sense of well-being, social relationships and ability to enjoy leisure activities compared to community norms.
Farooqi & Rasul71	60 patients with OCD; Pakistan	Cross-sectional	WHO-QOL-BREF	Female patients reported better overall QOL, especially in social and environmental domains as compared with male patients.
Fontenelle et al51	53 patients with OCD and 53 community members; Brazil	Cross-sectional	SF-36	Patients with OCD reported significantly lower levels of QOL in all domains except bodily pain. Hoarding and washing symptoms contributed significantly for the decline in the social quality of life in OCD hoarders.
Gezginc et al63	25 pregnant outpatients with OCD and 25 pregnant healthy controls; Turkey	Cross-sectional	WHO-QOL-BREF	OCD pregnant women scored lower subscores in all 4 domains as compared to health controls. Also, OCD duration was negatively correlated to the psychological health domain.
Gururaj et al70	35 patients with OCD and 35 patients with schizophrenia; India	Cross-sectional	WHO-QOL-BREF	Patients with OCD reported better QOL in the physical and environmental domains as compared to patients with schizophrenia. However, in terms of psychological and social domains, both groups reported similar QOL.
Hertenstein et al66	73 patients with OCD; Germany	Longitudinal	WHO-QOL-BREF	At baseline, participants reported a significantly diminished psychological, social, physical, and global QOL compared to the German general population. The QOL was significantly improved after 12 months of treatment.
Hollander et al24	466 patients with OCD; USA	RCT	SF-36	Patients receiving escitalopram or paroxetine reported significant improvements on most SF-36 dimensions, but patients taking 20 mg/d escitalopram were seen to improve earlier in work-related functioning.
Hou et al65	57 outpatients with OCD and 106 healthy controls; Taiwan	Cross-sectional	WHO-QOL-BREF	OCD group reported lower QOL in the general, psychological and social relationship domains as compared to the control group. Also, severe obsession and compulsion symptoms and low social support were significantly correlated to poor QOL.
Huppert et al23	66 patients with OCD and 36 healthy controls; USA	Cross-sectional	Q-LES-Q	Greater severity of OCD was correlated to worse QOL. Results suggested a linear relationship between the Q-LES-Q and OCD severity. Individuals with OCD and comorbid disorders were more impaired than individuals with only OCD.
Akdede et al60	23 patients with OCD and 22 healthy controls; Turkey	Cross-sectional	WHO-QOL-BREF-TR	OCD patients reported worse QOL in the psychological and social domains. There were significant correlations between attention, visual tracking and working memory and the psychological, social and environmental domains of QOL.
Koran et al59	60 outpatients with OCD and U.S. population published norms (2474); USA	Cross-sectional	SF-36	Patients with OCD perceived the mental health domains of their quality of life as more impaired than the physical health domains. Severity of OCD was related to lower scores on the social functioning domain.
Koran et al64	147 patients with OCD, U.S. population published norms (2474); USA	RCT	SF-36	Both the active drug and placebo groups reported significant improvements in psychosocial domains of HRQOL. For subjects who went through 40 weeks of treatment with extended-release fluvoxamine, there were increased improvements in the psychosocial domains.
Kugler et al68	102 patients with OCD; USA	Cross-sectional	MOS-36	Social functioning QOL was significantly worse and physical health QOL was significantly better in OCD patients as compared to persons with PD, MDD and schizophrenia. Resistance against obsessive-compulsive symptoms mediated the relationship between obsessive-compulsive symptom severity and social functioning QOL.
Kumar et al58	31 patients with OCD and 30 healthy controls; India	Cross-sectional	WHO-QOL-BREF	OCD patients reported worse QOL as compared with healthy controls. Also, there was a negative correlation between cognitive appraisals (thought control, importance of thoughts and inflated responsibility) and psychological domains.
Masellis et al73	43 patients with OCD; Canada	Cross-sectional	IIRS	QOL was particularly affected by obsessional severity compared to compulsion severity. Comorbid depression severity greatly predicted poor QOL, accounting for 54% of the variance.
Moritz et al116	79 patients with OCD and 32 healthy controls; Germany	Longitudinal	SF-36	OCD patients reported significantly decreased mean QOL scores for every domain as compared to healthy controls. Correlations with QOL were most evident for depression severity and number of OCD symptoms.
Norberg et al62	188 patients with OCD; USA	Cross-sectional	QOLI	OCD patient sample's total QOLI scores were at the 11th percentile in comparison to clinical norms.
Ooms et al61	16 patients with OCD; Netherlands	Longitudinal	WHO-QOL-BREF	Baseline QOL scores of OCD patients were significantly lower in all domains as compared to a Dutch normative population. There were distinct improvements in the general score and in the physical, psychological and environmental domains following deep brain stimulation.
Rapaport et al50	521 patients with OCD, non-psychiatric community sample (67), MDD (366), chronic/double depression (576), PD (302), PTSD (139), dysthymia (315), SP (358), premenstrual dysphoric disorder (437), 11 multicenter trials; USA	Cross-sectional (retrospective data)	Q-LES-Q	OCD subjects showed greater impairment on the social relationship, family relationships, leisure, ability to function and vision items. Depression and anxiety comorbidity significantly predicted Q-LES-Q scores for OCD subjects.
Rodriguez-Salgado et al53	64 outpatients with OCD and 9151 respondents from the general population; Spain	Cross-sectional	SF-36	OCD patients had significantly decreased mean QOL scores for all SF-36 subscales except those related to physical health and pain in comparison to the general population.
Simpson et al83	108 patients with OCD. Study conducted at two academic outpatient Clinics; USA	RCT	Q-LES-Q	No significant difference in the rate of change in quality of life between the two groups (augmentation of SRIs with ERP versus stress management training), post-hoc analyses however revealed modest but significantly superior quality of life at study completion (post-test).
Solanki et al69	50 outpatients with OCD and 50 patients with schizophrenia; India.	Cross-sectional	WHO-QOL-BREF	There was no statistically significant difference in the QOL between the OCD and schizophrenia group. Both groups scored the lowest on the social relationship domain.
Srivastava et al56	45 outpatients with OCD, 50 patients with MDD and 150 healthy controls; India	Cross-sectional	WHO-QOL-BREF	Compared with healthy controls, OCD patients reported a lower QOL in the physical well-being, psychological well-being, social and environmental domains. Compared to MDD patients, the QOL of patients with OCD was significantly higher in psychological well-being, social and environmental domains.
Stengler-Wenzke et al57	75 outpatients with OCD, 243 patients with schizophrenia and 315 respondents from the general population; Germany	Cross-sectional	WHO-QOL-BREF	Compared with general population, QOL of patients with OCD and schizophrenia was lower in all domains. OCD patients scored lower scores in the domains of psychological well-being and social relationship and overall QOL than patients with schizophrenia.
Stengler-Wenzke et al74	75 outpatients with OCD; Germany	Cross-sectional	WHO-QOL-BREF	Compulsions were found to be negatively associated with QOL. Depressive symptoms were also negatively associated with QOL.
Twohig et al84	79 patients with OCD; USA	RCT	QOLS	QOL improved in both conditions (ACT and progressive relaxation training) but was marginally in favor of ACT at post treatment.
Vikas et al67	32 patients with OCD and 30 patients with depression; India	Cross-sectional	WHO-QOL-BREF	OCD patients had the lowest scores in the psychological health domain whereas they had relatively high scores in the social relationship domains. OCD patients in comparison to depressed patients had significantly higher scores in QOL domains of physical and psychological health.