Health outcomes of schizophrenia in Thailand: Health care provider and patient perspectives

Abstract

Background Patient views are considered an important measure in schizophrenia. There are no studies of the association between patient and clinician perspectives in Thailand. The objectives of this study were to (a) describe the patterns of clinician-rated psychiatric symptoms and patient ratings of health related quality of life and (b) quantify the association between clinician and patient-rated measures. Method The cross-sectional study included a stratified representative sample of 307 patients with schizophrenia or schizoaffective disorder in treatment at mental health services during the survey period. Clinicians measured illness severity using the Brief Psychiatric Rating Scale-Expanded while patients rated their health-related quality of life using a six-dimensional EuroQoL instrument. Pearson correlation coefficient and hierarchical regression analyses were used to quantify the association between schizophrenia outcomes elicited from patients and health care providers. Results There was only a modest association between patient-rated and clinician-rated outcomes. In a regression model clinician-rated symptoms explained 33% of patient satisfaction with their quality of life. Negative, cognitive and mood symptoms but not the positive symptoms were significant predictors of patient-rated quality of life. Conclusion Policy makers and clinicians need to be aware that clinician-rated and patient-rated outcomes are very different. Improving quality of life of people with schizophrenia requires greater attention be given to negative, cognitive and mood symptoms.