Subjective Quality of Life in Psychiatric Patients: Diagnosis and Illness-Specific Profiles

Abstract

Objective:In accordance with the definition of health by the World Health Organization, outcome measures beyond mere syndromic recovery, such as quality of life ratings, would aid psychiatric practice and research. This is the first study of psychiatric diagnosis and illness stage specific profiles of subjective quality of life (SQOL) impairment.Method: Patients (n = 150) hospitalized at the Prague Psychiatric Center rated their SQOL using the Schwartz Outcome Scale at admission and discharge. Severity of illness and clinical improvement were measured by the Clinical Global Impression Scale. Results:The highest and lowest SQOL at admission were reported by patients with psychosis and mood disorders respectively (F = 7.3, df = 2,147, P < 0.001). SQOL improved significantly during hospitalization in all diagnostic categories (F = 90.0, df = 1,147, P < 0.001), with the smallest and largest improvement in patients with psychosis and mood disorders, respectively (F = 5.6, df = 2,147, P = 0.005). There was a trend for differences in ratings of clinical improvement by patients, compared with psychiatrists, across diagnostic categories (F = 2.9, df = 2,147, P = 0.06), with significant differences only in patients with anxiety disorders. These patients also reported the lowest SQOL at discharge (F = 3.0, df = 2,147, P = 0.05). Global improvement correlated with improvement in SQOL only in patients with mood disorders (r = -0.4, P = 0.005). Conclusions:Main psychiatric diagnostic categories differ in SQOL and in association between SQOL and treatment. These differences may reflect illness-specific mechanisms, such as depressive symptoms in mood disorders, low insight in psychotic patients, aggravation of anxiety before discharge in patients with anxiety disorders, and may aid in planning of specific treatment interventions.Can J Psychiatry 2008;53(9):587-593 Clinical Implications· SQOL is a means of studying the physical, emotional, mental, social, and behavioural well-being of a patient. · Assessing SQOL can help identify specific problems and needs, and may help in tailoring specific treatment interventions. · Assessing SQOL may improve communication and understanding between patients and medical staff. Limitations· Generalizability of findings from tertiary care centre to other settings may be limited. · We combined inpatients and patients attending day treatment program. · There were differences between groups in age and number of previous hospitalizations, which we controlled for using multiple regression.

Perceived Spirituality, Mindfulness and Quality of Life in Psychiatric Patients

“…The data are not in agreement with the findings of previous studies (e.g. Goppoldova et al 2008;Hodgson et al 2007) which suggest changes in the psychiatric patients' QoL depending on their diagnosis. These results can be explained by the fact that all participants are patients of the Psychosocial Rehabilitation Service-a service that aims to promote a better QoL through occupational therapy, psychological counselling, nursing and psychiatric careand, consequently, it appears that changes to the patients' QoL may have been promoted to the point where it has stabilised at a regular level-regardless of their diagnosis-justifying the absence of differences between groups.…”

“…Maslow (1998) stipulates the need for self-actualisation of the human being, in the way in which he or she understands and interacts with reality. This is in agreement with Gorsuch (2002), who states that ''spirituality is the quest for understanding ourselves in relationship to our view of ultimate reality, and to live in accordance with that understanding'' (p. 8). Note the absence of the concept of the divine from this definition, which was purposefully omitted; a purely ontological vision is emphasised rather than a theological perspective.…”

“…These results are consistent with the information obtained by Masthoff et al (2006) showing that psychiatric patients score significantly worse in all domains of QoL than people without psychological issues. In turn, a study by Goppoldova et al (2008), which sought to discover the specific disease profiles of psychiatric patients linked to subjective QoL, confirms the aforementioned information, stating that some psychological mechanisms of specific psychiatric conditions affect subjective QoL. Similarly, a systematic review of qualitative research on QoL and mental health in people with psychiatric problems shows that a poor QoL is related to severe psychiatric symptoms, and highlights important aspects of this relation such as well-being/malaise, control, autonomy/choice, self-perception, a feeling of belonging, activity and hope/hopelessness (Connell et al 2012).…”

Relationship between patients’ quality of life and coercion in psychiatric acute wards

“…Because the HRQoL score was non-normally distributed, only the EQ-VAS was used as the dependent variable, and the following candidate factors were used as independent variables: age, gender, duration of illness, duration of hospitalisation, GAF at admission, use of GAF change, SUMD-J, legal status of admission, the occurrence of restraint, seclusion or forced mediation and perceived coercion. We performed separate analyses for patients with and without a diagnosis of ICD-10 F2 because it was suggested that illness-specific mechanisms are associated with QoL (Goppoldova et al, 2008). The model was accepted if the maximum variance inflation factor (VIF) value was o 5.…”

Health-Related Quality of Life in Multiple System Atrophy and Progressive Supranuclear Palsy

“…We carefully analyzed the influence of social factors on HrQoL in APS and identified level of education as one of the independent determinants of the HrQoL. This may reflect insight and expectations of patients, which are known to have influence on quality of life in other chronic diseases [35,36] . Future studies on HrQoL in APS should integrate evaluation of insight (e.g.…”