Document Type



Author's Final Manuscript

Publication Title

British Journal of Health Psychology



Publication Date




To examine the effect of the diagnosis of asymptomatic disease on health‐related quality of life (HRQoL).


Secondary analysis of a national data set.


We analysed adult participants in the 2011–2012 National Health and Nutrition Examination Survey (NHANES) of the civilian non‐institutionalized US general population. Across three asymptomatic diseases (glucose intolerance, hyperlipidaemia, and hypertension), we examined four groups (without disease; with disease but no diagnosis; with disease and diagnosis but no treatment; and with disease, diagnosis, and treatment). For each asymptomatic disease, we examined group differences in self‐rated health (ordinal logistic regression) and Healthy Days outcomes (number of the last 30 days that physical health was not good, mental health was not good, or inactive; regression). Models were adjusted for age, sex, smoking status, insurance status, income, education, race, body mass index, and comorbid conditions.


Analyses included 6012 respondents (glucose intolerance), 2772 respondents (hyperlipidaemia), and 5524 respondents (hypertension). In adjusted models, those who did not know about their disease had the same self‐rated health scores as those without the disease, those with the disease without treatment, and those with disease and treatment. In adjusted analyses of the Healthy Days questions, those with unknown disease reported the same number of unhealthy days as those without disease with the exception of glucose intolerance. Conversely, in four of the nine possible comparisons, those with known disease without treatment reported more unhealthy days than those with who did not know about their disease.


In adjusted analyses, individuals knowing about their asymptomatic disease are more likely to experience decrements in healthy days compared to those without knowledge of their asymptomatic disease.


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