Gender differences in health-related quality of life for veterans with serious mental illness

Objective: This study assessed gender differences in health-related quality of life (HRQOL) in a national sample of veterans with serious mental illness. Methods: Data were analyzed from the Large Health Survey of Veterans, which was mailed to a national random sample of veterans in 1999. The linear and logistic multiple regression analyses included 18,017 veterans with schizophrenia, schizoaffective disorder, or bipolar disorder who completed the survey. HRQOL was measured by using the various subscales of the 36-Item Short Form of the Medical Outcomes Study (MOS SF-36) (mental component summary, physical component summary, and activities of daily living) and by questions assessing self-perceptions of health status. Results: The sample was 7.3% female, 75.7% white, and 83.8% unemployed. Mean +/- SD age was 54.3 +/- 12.2 years. After the analysis adjusted for sociodemographic characteristics, health status, and other variables, compared with male veterans, female veterans with serious mental illness had lower scores on the SF-36 physical component summary (indicating worse symptoms), were more likely to report that they were limited "a lot" in activities of daily living, and had more pain. However, female respondents were more likely to have a positive outlook on their health. Conclusions: Among veterans who received a diagnosis of serious mental illness from providers of the Department of Veterans Affairs, women reported substantially poorer HRQOL than men across several domains but women reported better self-perceived health. Attention to the particular needs of female veterans with serious mental illness is imperative as the numbers of female veterans continue to increase.