Abstract
BackgroundQuality 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.MethodsPatients 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.ResultsPatient-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).ConclusionsIn 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.
Highlights
Quality of life (QoL) is considered an important outcome in health research
This paper reports baseline measures; assessments were carried out by the Trial Support Clinician, a Specialist Registrar in Psychiatry, i.e. ratings of observer-assessed QoL were not made blind to other study ratings
In order to determine the factors associated with QoL measurement discrepancy, we firstly examined predictors of the Lancashire Quality Of Life Profile (LQOLP) and the QLS, separately
Summary
Quality of life (QoL) is considered an important outcome in health research. It can be rated by the patient, or by an external assessor. Self- or patient-rated measures of QoL in schizophrenia can be viewed with suspicion by the clinician [4] due to the perceived impact of depressive and psychotic symptoms, poor insight, and cognitive deficits [5,6]. For example, with the use of factor analysis, that subjective and objective QoL components cluster separately [10]. The majority of studies have examined the predictors of patient-rated and assessor-rated QoL separately, for example, research on
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