Subjective versus interviewer assessment of global quality of life among persons with schizophrenia living in the community: A Nordic multicentre study (original) (raw)
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Validity of subjective versus objective quality of life assessment in people with schizophrenia
BMC Psychiatry, 2014
Background: Quality of life (QoL) is considered an important outcome in health research. It can be rated by the patient, or by an external assessor. We wished to identify the predictors of any discrepancies between these two approaches in people with schizophrenia. Methods: Patients with DSM schizophrenia and related disorders (N = 80) completed both patient-rated (Lancashire Quality of Life Profile; LQOLP) and assessor-rated (Heinrich's Quality of Life Scale; QLS) measures of QoL. Results: Patient-rated (LQOLP) and assessor-rated (QLS) measures showed a modest correlation (r = 0.38). In a regression analysis, independent predictors of subjectively-rated QoL being higher than objectively-assessed QoL in the same patient, were low insight score (BIS), negative symptoms (PANSS), absence of depression (CDSS), and less positive attitude toward prescribed treatment (DAI). Conclusions: In people with schizophrenia, scores on objectively-and subjectively-rated measures of quality of life can differ markedly. When comparing subjective to objective assessments, patients with depressive symptoms will value their QoL lower, and those with low insight will value their QoL higher. This has important implications for the utility and interpretation of QoL measures in schizophrenia.
Quality of life measures in schizophrenia
European Psychiatry, 2005
The recognition of the importance of evaluating the quality of life of patients with schizophrenia highlighted the importance ofdeveloping appropriate instruments. In this paper we review the available quality of life instruments focusing on their conceptual framework, structure, administration and psychometric properties. First, we address the generic instruments that have been validated for schizophrenic populations, namely the World Health Organization Quality of Life Assessment (WHOQOL), the Medical Outcome Study (MOS) 36-Item Short-Form Health Survey (SF-36) and the EuroQoL-5 Dimensions (EQ-5D). Then, we focus on instruments that have been specifically developed for patients with schizophrenia and other or severe mentally illness such as the Quality of Life Scale (QLS), the Quality of Life Interview (QoLI), the Lancashire Quality of Life Profile (LQoLP), the Sevilla Quality of Life Questionnaire (SQLQ), the Personal Evaluation of Transitions in Treatment (PETIT), and the Qualit...
The assessment of quality of life in clinical practice in patients with schizophrenia
Dialogues in clinical neuroscience, 2014
The aim of the present article is to review QoL scales used in studies investigating patients with schizophrenia over the past 5 years, and to summarize the results of QoL assessment in clinical practice in these patients. Literature available from January 2009 to December 2013 was identified in a PubMed search using the key words "quality of life" and "schizophrenia" and in a cross-reference search for articles that were particularly relevant. A total of n=432 studies used 35 different standardized generic and specific QoL scales in patients with schizophrenia. Affective symptoms were major obstacles for QoL improvement in patients with schizophrenia. Though positive symptoms, negative symptoms, and cognitive functioning may be seen as largely independent parameters from subjective QoL, especially in cross-sectional trials, long-term studies confirmed a critical impact of early QoL improvement on long-term symptomatic and functional remission, as well as of earl...
Measurement of quality of life in schizophrenia: a comparison of two scales
Social Psychiatry and Psychiatric Epidemiology, 2007
j Abstract Background People with schizophrenia have an impaired quality of life (QoL), and various QoL assessment scales are available. However it is not clear which scale should be used in different situations. We aimed to compare a patient-rated subjective QoL scale with an observer-rated QoL scale by measuring their degree of correlation and their respective associative profiles with outcome measures. Method Patients of the UK Schizophrenia Care and Assessment Program completed a patient-rated QoL ques-tionnaire (MANSA). Research staff completed the observer-rated QoL tool (QLS) as part of an assessment of symptomatology and functioning. Results The two QoL tools were moderately positively correlated (r = 0.39). Both scales were negatively correlated with positive and negative symptoms of schizophrenia and depressive symptoms, and positively correlated with functioning scores. However the two scales were influenced by different factors. The patient-rated QoL was more significantly influenced by depressive symptoms, and the observer-rated QoL was more heavily influenced by negative symptoms. Conclusions Patient-rated and observer-rated QoL are moderately related, with a number of joint determinants, but the former is sensitive to depressive influences, whilst the latter is sensitive to the negative symptomatology of schizophrenia.
An instrument to assess mental patients? capacity to appraise and report subjective quality of life
Quality of Life Research, 2005
Quality of life (QOL) is increasingly recognized as an important outcome measure in treatment studies and service evaluation. However, patients or service users may sometimes lack the capacity to either evaluate or express their subjective QOL, for example due to cognitive impairment, communication disorders, symptom distress or burden of completing the assessment itself. This paper describes the development of an instrument, the capacity to report subjective quality of life inventory (CapQOL), which evaluates the ability of patients to appraise their subjective QOL and to complete related measures. The CapQOL is a simple and brief screening tool, designed for use in people with a wide range of mental disabilities. It helps researchers to identify individuals who are unable to appraise or report their subjective quality of life. We administered the CapQOL to 442 patients with early psychosis. About 89% of the participants were assessed to be able to complete a subjective QOL measure. The CapQOL demonstrated satisfactory psychometric properties. Further validation studies in people with psychosis as well as other mental disabilities are indicated.
Schizophrenia Research, 2010
Subjective quality of life (SQOL) is an important outcome in the treatment of patients with schizophrenia. However, there is only limited evidence on factors influencing SQOL, and little is known about whether the same factors influence SQOL in patients with schizophrenia and other mental disorders. This study aimed to identify the factors associated with SQOL and test whether these factors are equally important in schizophrenia and other disorders. For this we used a pooled data set obtained from 16 studies that had used either the Lancashire Quality of Life Profile or the Manchester Short Assessment of Quality of Life for assessing SQOL. The sample comprised 3936 patients with schizophrenia, mood disorders, and neurotic disorders. After controlling for confounding factors, within-subject clustering, and heterogeneity of findings across studies in linear mixed models, patients with schizophrenia had more favourable SQOL scores than those with mood and neurotic disorders. In all diagnostic groups, older patients, those in employment, and those with lower symptom scores had higher SQOL scores. Whilst the strength of the association between age and SQOL did not differ across diagnostic groups, symptom levels were more strongly associated with SQOL in neurotic than in mood disorders and schizophrenia. The association of employment and SQOL was stronger in mood and neurotic disorders than in schizophrenia. The findings may inform the use and interpretation of SQOL data for patients with schizophrenia.
A prospective study of Quality of life in schizophrenia in three European countries
Schizophrenia Research, 2007
Only a small number of studies have tried to identify factors influencing the subjective QoL of patients suffering from schizophrenia in a longitudinal design. These studies suffer from small clinical samples or compare baseline data only with a single follow-up. The European Schizophrenia Cohort Study overcomes these shortcomings by providing data from five time points on 1208 patients in psychiatric treatment in three European countries over a period of 2 years. QoL was measured with the brief version of Lehman's Quality of Life Interview. Random effects, between-effects and within-effects regression models were computed in order to measure the influence on subjective QoL of patients' socio-demographic and clinical characteristics and objective QoL. Objective QoL scores were generally found to be related to the equivalent subjective QoL scores. People's financial situation, and depressive and positive symptoms had a general effect on almost all subjective domains. The significant effects of objective finances on subjective domains like health and social relations raise interesting possibilities for intervention. Sufficient financial resources appear to be a necessary condition for achieving satisfactory QoL in schizophrenia patients. However, changes in individual's characteristics and circumstances did not relate as strongly as expected to changes in QoL, suggesting effective intervention may be difficult.