Lancashire Quality Of Life Profile Research Articles

Comparative Study of Musculoskeletal Disorders and Quality of Life between Traditional and Semi-modern Paddy Farmers of Gilan

Background and Objectives: Musculoskeletal disorders and low quality of life are the most common problems among paddy farmers in the world. Paddy farmers are exposed to inappropriate postures, long working hours and stressful environmental conditions. The aim of this study was to compare different farming methods of rice cultivation (traditional and semi-modern) on the prevalence of musculoskeletal disorders and life quality of paddy farmers.
 Methods: This descriptive-analytical study was conducted in rice fields with 150 paddy farmers as a sample group (100 traditional paddy farmers and 50 semi-modern paddy farmers). Musculoskeletal disorders and quality of life were assessed using the Nordic questionnaire and the Lancashire Quality of Life Profile, respectively.
 Results: The prevalence of musculoskeletal disorders in the neck, lower back and shoulders is higher in traditional paddy farmers compared to farmers who work in semi-modern rice cultivation system. Present results demonstrated that there was no significant difference between various rice cultivation methods and musculoskeletal disorders on life quality. Furthermore, different farming methods of paddy cultivation have no significant effect on paddy farmers' life quality.
 Conclusion: The prevalence of lower back musculoskeletal disorders among paddy farmers portrays the consequence from long-term exposure to inappropriate posture from strenous activity.

Benzodiazepine use, quality of life and psychiatric symptom burden in oral and injectable opioid agonist treatment: a cross-sectional study

BackgroundUse of benzodiazepines (BZD) in patients receiving opioid agonist treatment (OAT) is common and associated with a variety of negative health and social outcomes. This cross-sectional study investigates the impact of BZD use in OAT patients on their quality of life (QoL).MethodsA convenience sample of patients receiving oral OAT or heroin-assisted treatment in two outpatient centres in Basel, Switzerland was investigated. Participants (n = 141) completed self-report questionnaires on psychiatric symptoms and psychological distress (The Symptom Checklist 27, SCL-27), depressive state (German version of the Center for Epidemiological Studies Depression Scale), quality of life (Lancashire Quality of Life Profile, LQOLP) and use of BZD and other drugs (self-report questionnaire). Substance use was assessed by urine toxicology testing.ResultsIn bivariate analysis, total QoL scores were significantly lower for lifetime, current, and prolonged BZD users compared to participants without the respective use patterns. There was no significant relationship between BZD dose and QoL. In multivariable linear regression models controlling for psychiatric symptom load and depressive state, only lifetime use predicted lower QoL, whereas other BZD use patterns were not significantly associated.ConclusionsThe association of lower QoL and BZD use in OAT patients is strongly confounded by co-occurring depressive state and psychiatric symptoms. Careful diagnosis and treatment of co-occurring mental disorders in OAT is paramount to improve QoL in this patient population and may also help reduce BZD use.

A Methodological Review of Quality of Life Scales Used in Schizophrenia.

Evidence is lacking with regard to the most suitable instrument for measuring quality of life (QOL) in patients with schizophrenia. The researchers carried out a methodological review of literature pertaining to scales used to measure QOL in this population. Twenty-eight studies, assessing nine different QOL scales, were reviewed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. While the content of most scales proved valid, the Lancashire Quality of Life Profile (LQOLP), Self-Report Quality of Life Scale (SQOL), and Quality of Life in Schizophrenia (QLiS) outscored the other scales in almost every other domain measured by COSMIN. LQOLP and SQOL stand out among QOL scales for patients with schizophrenia, but further evidence is required to verify this finding, and no one scale appears ideal for all patients with schizophrenia.

Quality of Life of People with Severe Mental Health Problems: Testing an Interactive Model.

Improvement of subjective quality of life (QoL) is seen as an important treatment outcome in clinical practice. The aim of this study is to test the theoretical model of Cummins, which includes a homeostatic management system. According to this model, objective variables are almost irrelevant to general well-being, while the feeling of having an influence on one’s circumstances (perceived deficit) is related to subjective QoL. The variables of the Cummins model were operationalised based on the Lancashire Quality of Life Profile, a structured interview to assess the subjective QoL of people with severe mental health problems. The Cummins model was tested using structural equation modelling and a mediator model between Objective QoL, Subjective QoL and Perceived Deficit. Subjective QoL and General Well-Being were significantly related and having a meaningful perspective in life was related to General Well-Being. Contrary to the Cummins model, both Objective QoL and Perceived Deficit had a significant relation to Subjective QoL and Perceived Deficit was a partial mediator between Objective QoL and Subjective QoL. Cummins’ theoretical model was partially confirmed. The current study suggests that meaningful (treatment) evaluation of subjective QoL can only be performed if objective QoL, General Well-Being and subjective evaluation (Perceived Deficit and Framework) are taken into account.

M234. QUALITY OF LIFE IN SCHIZOPHRENIA: THE IMPACT OF RESIDUAL SYMPTOMS AND INTERNALIZED STIGMA

BackgroundQuality of life (QOL) is seen as a key outcome variable in schizophrenia. Factors deemed relevant in this context include the severity of symptoms and internalized Stigma.MethodsPatients with schizophrenia (ICD-10) between the ages of 18 and 65 from outpatient mental health services were included into a cross-sectional study. Apart from the registration of demographic data, various rating scales were used: the Positive and Negative Syndrome Scale (PANSS), the Internalized Stigma of Mental Illness (ISMI) Scale, and the German version of the Lancashire Quality of Life Profile, the Berliner Lebensqualitätsprofil (BELP).Results80 patients (47 males, 33 females) with a mean age of 43.0 ± 10.9 years took part in this study. The mean PANSS total score was 71.1 ±25.4, the mean ISMI score was 61.1 ± 14.7 (range: 29–116), and the BELP subscale overall QoL showed a mean score of 4.73 ± 1.17 (range 1–7). Statistical analysis showed a moderate correlation between QoL and internalized stigma (r=-0.468, correlation with general life satisfaction) and a weak correlation with the PANSS total score (r=-0.246, correlation with general life satisfaction). Internalized stigma but not residual symptoms of the disorder negatively predicted QoLDiscussionOur results highlight the complex nature of QoL in individuals suffering from schizophrenia and indicate that outpatients’ quality of life correlates moderately with internalized stigma, whereas residual symptoms of the disorder play a secondary role. Accordingly, psychotherapeutic approaches should be applied to reduce internalized stigma, and, ultimately, to improve quality of life.

Subjectively different but objectively the same? Three profiles of QoL in people with severe mental health problems

PurposeQuality of life (QoL) is a broad outcome that is often used to assess the impact of treatment and care interventions in mental health services. QoL, however, is known to be influenced by individual values and preferences. To investigate this heterogeneity on the individual level, this study aimed to distinguish classes with distinct QoL profiles in a broad group of people with severe mental health problems and to identify the QoL domains that are most strongly related to the classes.MethodsQoL data of seven studies that used the Lancashire quality of life profile (LQoLP) were used in a latent class analysis. Sociodemographic variables, health-related variables, and measures of well-being were used to characterise the classes. Additionally, univariate entropy scores were used to assess the strength of the association between the ten LQoLP domains and the latent classes.ResultsTwo of the three indices of fit pointed towards a three-class model. The three classes differed significantly on all of the LQoLP domains, on well-being, and on ‘being in an intimate relationship’. No differences were found for the majority of the health-related and sociodemographic variables. The LQoLP domains ‘family relations’, ‘positive self-esteem’, and ‘negative self-esteem’ were most strongly related to the latent classes.ConclusionsThe identification of three distinct classes of QoL scores re-emphasises the heterogenic nature of QoL. The lack of differences in sociodemographic or health-related characteristics between the three classes suggests that QoL is primarily determined by subjective, personal evaluations, rather than by objective characteristics and circumstances.

Quality of life, delinquency and psychosocial functioning of adolescents in secure residential care: testing two assumptions of the Good Lives Model

BackgroundIn this study, two assumptions derived from the Good Lives Model were examined: whether subjective Quality of Life is related to delinquent behaviour and psychosocial problems, and whether adolescents with adequate coping skills are less likely to commit delinquent behaviour or show psychosocial problems.MethodTo this end, data of 95 adolescents with severe psychiatric problems who participated in a four-wave longitudinal study were examined. Subjective Quality of Life was assessed with the ten domains of the Lancashire Quality of Life Profile and coping skills with the Utrecht Coping List for Adolescents.ResultsResults showed that adolescents who reported a lower Quality of Life on the health domain had more psychosocial problems at follow-up. No relationship was found between Quality of Life and delinquent behaviour. In addition, active and passive coping were associated with delinquent behaviour and psychosocial functioning at follow-up.ConclusionsBased on the results of this longitudinal study, the strongest support was found for the second assumption derived from the Good Lives Model. Adolescents with adequate coping skills are less likely to commit delinquent behaviour and have fewer psychosocial problems at follow-up. The current study provides support for the use of strength-based elements in the treatment programmes for adolescents in secure residential care.

Comparing two schizophrenia-specific quality of life instruments in institutionalized people with schizophrenia

Clinical health professionals may have difficulties to select appropriate schizophrenia-specific Quality of life (QoL) instruments because of the limited information regarding their psychometric properties. Two widely used schizophrenia-specific QoL instruments (Schizophrenia Quality of Life Scale Revision 4 [SQLS-R4] and Lancashire Quality of Life Profile [LQOLP]) were compared in institutionalized people with schizophrenia, and useful recommendations for clinical health professionals were provided. Participants (n = 100) filled out the two instruments twice. Test-retest reliability, internal consistency, and confirmatory factor analyses (CFAs) were conducted. Both SQLS-R4 domains (r = 0.573–0.731) and LQOLP domains (r = 0.303–0.778) had good test-retest reliability. However, the objective QoL domains in the LQOLP showed lower internal consistency (α = 0.219–0.617) than its subjective QoL domains (α = 0.532–0.947) and the SQLS-R4 domains (α = 0.768–0.939). The CFAs with two correlated underlying instruments constructs and two correlated underlying QoL traits (viz., Physical and Psychosocial QoL) performed the best data-model fit (CFI = 0.990, RMSEA = 0.039, SRMR = 0.039), which supported the validity of both instruments. Although both SQLS-R4 and LQOLP were valid and reliable, using SQLS-R4 on institutionalized people seemed to be more psychometrically solid than using the LQOLP.

Examining the experiences and quality of life of patients with an autism spectrum disorder detained in high secure psychiatric care

PurposeAlthough individuals with an autism spectrum disorder (ASD) represent a small proportion of forensic psychiatric patients as a group they present with specific difficulties and needs. There is also evidence that if detained individuals with an ASD experience particular difficulties within custodial environments as a result of a mismatch between the difficulties associated with their ASD and the environmental demands. The purpose of this paper is to explore the experience of individuals with an ASD admitted to a high secure psychiatric care (HSPC) hospital.Design/methodology/approachUsing both a semi-structured interview and a quality of life self-report measure (the Lancashire Quality of Life Profile) the experiences and views of seven patients with an ASD detained in one HSPC hospital were qualitatively explored.FindingsWhilst a diverse range of negative and positive aspects of being within HSPC were identified by patients interviewed, those with prison experience thought HSPC was a less stressful environment with more therapeutic opportunities. As a group, patients with an ASD reported a similar or significantly better quality of life in many domains (global, leisure, financial and living situation) compared to other detained forensic patient groups.Practical implicationsAlthough most patients with an ASD interviewed reported positive experiences, there are a number of practical improvements that could be made within the hospital to reduce experienced stress levels and perhaps improve therapeutic outcomes.Originality/valueWithin the context of the Department of Health's autism strategy (2010) and subsequent update think autism (2014), the survey highlights continued ASD awareness training for staff as important. In responding to the risks and needs of individuals with an ASD in HSPC there is further support for the development of an ASD specialist service.

Validity of subjective versus objective quality of life assessment in people with schizophrenia.

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.

Empowerment in a Mental Health Institution

Objectives: To examine the association between empowerment and quality of life among adult forensic patients. Method: The Empowerment Scale and the Lancashire Quality of Life Profile were used to assess perception on personal empowerment and quality of life in 98 detained adult forensic patients in Prison Hospital of Tirana. Results: The proportion of adult forensic patients scoring above personal empowerment and the quality of life was significantly low in the detained group for the five factors of empowerment Hierarchical multiple regression models showed that self-efficiency-self-esteem, power-powerlessness, community activism, righteous anger, and optimism-control over the future were significantly low among detained adult forensic patients, indicating that detention contributed to increased symptom levels of psychiatric symptoms. Conclusions: For adult forensic patients, even brief detention is associated with a low perception on personal empowerment and a quality of life that interfere in rehabilitation plans. Governments should consider the many viable alternatives to incarceration of adult forensic patients, such as temporary placement in a supervised residential facility, to minimize the risks of psychological harm to this vulnerable population. DOI: 10.5901/ajis.2014.v3n6p229

Adolescents in secure residential care: the role of active and passive coping on general well-being and self-esteem.

Coping, general well-being and self-esteem play an important role during the process of adaptation to turning points in life-course. This study aimed to investigate the effect of coping on both the development of general well-being and self-esteem of adolescents with severe psychiatric problems in secure residential care. In addition, risk and protective factors were taken into account. Adolescents between the age of 16 and 18 (N = 172) were followed for 1.5 years. General well-being and self-esteem were assessed with the Lancashire Quality of Life Profile and the Self-Perception Profile for Adolescents, respectively. In addition, the Utrecht Coping List for Adolescents and the Structured Assessment of Violence Risk in Youth were administered. Results showed that the longitudinal relation between general well-being and self-esteem is no longer significant after adding active and passive coping to the model. The use of active coping strategies was associated with a higher self-esteem. The use of passive coping strategies was associated with a lower self-esteem and also a lower perceived general well-being. Having multiple risks in the individual and/or social/contextual domain affected the developmental pattern of general well-being. During treatment of adolescents with severe psychiatric problems in secure residential care, attention should be paid for enhancing those capabilities and skills, like coping, which help adolescents to fulfill their needs and consequently enhance their well-being. Enhancing the well-being of adolescents might in the long run decrease the chance of reoffending and/or psychiatric relapse.

Clinical correlates of objective and subjective quality of life among middle-aged and elderly female inpatients with chronic schizophrenia

ObjectiveThe aim of this study was to illustrate the relationship between objective and subjective measures of quality of life (QOL) and to identify the factors influencing QOL in a sample of middle-aged and elderly female patients with schizophrenia in Japan. MethodsMiddle-aged and elderly female inpatients with schizophrenia (n=66; mean age [SD]: 68.0 [8.0]) were assessed using the Quality of Life Scale (QLS), Lancashire Quality of Life Profile (LQLP), Positive and Negative Symptoms Scale (PANSS), and Rehabilitation Evaluation Hall and Baker (REHAB). Correlation analyses among the measures and regression analyses of objective and subjective QOL measures (QLS and LQLP) were conducted. Explanations of results for the two types of QOL measures in terms of psychotic symptomatology and adjustment variables (PANSS and REHAB) are discussed. ResultsThere was no salient correlation between objective and subjective QOL measures. The regression analyses identified PANSS anergia and REHAB community skills as factors influencing objective QOL, whereas PANSS depression and paranoid/belligerence were factors influencing subjective QOL. ConclusionsResults indicated that objective and subjective QOL domains should be treated separately in clinical practice for this patient population. Some QOL factors identified in the regression analyses can be used as targets to improve QOL. The findings have important clinical implications for the assessment and treatment of this patient population.

Friends and symptom dimensions in patients with psychosis: a pooled analysis.

BackgroundHaving friends is associated with more favourable clinical outcomes and a higher quality of life in mental disorders. Patients with schizophrenia have fewer friends than other mentally ill patients. No large scale studies have evaluated so far what symptom dimensions of schizophrenia are associated with the lack of friendships.MethodsData from four multi-centre studies on outpatients with schizophrenia and related disorders (ICD F20-29) were included in a pooled analysis (N = 1396). We established whether patients had close friends and contact with friends by using the equivalent items on friendships of the Manchester Short Assessment of Quality of Life or of the Lancashire Quality of Life Profile. Symptoms were measured by the Brief Psychiatric Rating Scale or by the identical items included in the Positive and Negative Syndrome Scale.ResultsSeven hundred and sixty-nine patients (55.1%) had seen a friend in the previous week and 917 (65.7%) had someone they regarded as a close friend. Low levels of negative symptoms and hostility were significantly associated with having a close friend and contact with a friend. Overall, almost twice as many patients with absent or mild negative symptoms had met a friend in the last week, compared with those with moderate negative symptoms.ConclusionsHigher levels of negative symptoms and hostility are specifically associated with the lack of friendships in patients with psychotic disorders. These findings suggest the importance of developing effective treatments for negative symptoms and hostility in order to improve the probability of patients with schizophrenia to have friends.

Profiles of quality of life in opiate-dependent individuals after starting methadone treatment: A latent class analysis

BackgroundThis study aimed to identify classes of quality of life (QoL) among opiate-dependent individuals five to ten years after starting methadone treatment in order to tailor services to the needs of this population. MethodsA cross-sectional study of 159 opiate-dependent individuals who started outpatient methadone treatment in the region of Ghent, Belgium, between 1997 and 2002. A face-to-face structured interview was administered based on the Lancashire Quality of Life Profile, the EuropASI, Brief Symptom Inventory and the Verona Service Satisfaction Scale for Methadone Treatment. Latent class analysis was used to determine patterns of QoL. Analyses of variance and chi-square tests were used to test whether class membership was related to socio-demographic, health- and drug-related variables. ResultsBased on fit criteria, a three-class model was selected. Class Low (14.5%), ‘opiate-dependent individuals living in marginal conditions’, is characterised by low QoL scores on all domains. Class Intermediate (25.8%), ‘stabilized, but socially excluded opiate-dependent individuals’ shows high scores on the domains ‘safety’ and ‘living situation’, but low scores on all other QoL domains. Class High (59.7%), ‘socially included opiate-dependent individuals’, is characterised by high QoL scores on all domains, except ‘finances’. ConclusionThe findings of this study illustrate the existence of different profiles of QoL among opiate-dependent individuals after starting methadone maintenance treatment and demonstrate the need for a continuing care approach. Insight into distinct classes of QoL can be used to design person-centred support, relevant to an individual's personal life.

Association between symptoms and quality of life in patients with schizophrenia: A pooled analysis of changes over time

Quality of life is an important outcome in the treatment of patients with schizophrenia. It has been suggested that patients' quality of life ratings (referred to as subjective quality of life, SQOL) might be too heavily influenced by symptomatology to be a valid independent outcome criterion. There has been only limited evidence on the association of symptom change and changes in SQOL over time. This study aimed to examine the association between changes in symptoms and in SQOL among patients with schizophrenia. A pooled data set was obtained from eight longitudinal studies that had used the Brief Psychiatric Rating Scale (BPRS) for measuring psychiatric symptoms and either the Lancashire Quality of Life Profile or the Manchester Short Assessment of Quality of Life for assessing SQOL. The sample comprised 886 patients with schizophrenia. After controlling for heterogeneity of findings across studies using linear mixed models, a reduction in psychiatric symptoms was associated with improvements in SQOL scores. In univariate analyses, changes in all BPRS subscales were associated with changes in SQOL scores. In a multivariate model, only associations between changes in the BPRS depression/anxiety and hostility subscales and changes in SQOL remained significant, with 5% and 0.5% of the variance in SQOL changes being attributable to changes in depression/anxiety and hostility respectively. All BPRS subscales together explained 8.5% of variance. The findings indicate that SQOL changes are influenced by symptom change, in particular in depression/anxiety. The level of influence is limited and may not compromise using SQOL as an independent outcome measure.

The validity of subjective quality of life measures in psychotic patients with severe psychopathology and cognitive deficits: an item response model analysis.

Subjective quality of life (SQOL) is an established patient-reported outcome in the evaluation of treatments for psychosis. The use of SQOL measures in the presence of psychiatric symptoms and cognitive deficits has been questioned. However, there is little evidence on whether items function differently as indicators of SQOL in psychotic patients with different levels of symptoms and deficits. Substantial differential item functioning (DIF) would, indeed, challenge the validity of established measures. We aimed to investigate the validity of a widely used measure of subjective quality of life (SQOL), i.e., the Lancashire Quality of Life Profile (LQOLP), in the presence of cognitive deficits and psychiatric symptoms in patients with severe and enduring psychosis. We analysed SQOL ratings of 690 psychotic patients on the LQOLP using item response modelling to detect differential item functioning (DIF) attributable to psychiatric symptoms and cognitive deficits. Patients with more severe general psychopathology were less likely to rate their 'personal safety' positively (OR .96, 95% CI .93-.99). More severely depressed patients were less likely to endorse positive 'life as a whole' (OR .93, 95% CI .89-.98) and 'mental health' (OR .93, 95% CI .91-.97) ratings. There was no DIF attributable to cognitive deficits. The findings suggest that the validity of the LQOLP in psychotic patients may be impaired by DIF due to psychopathology, although the magnitude of effects is unlikely to be of clinical significance. The validity appears not to be compromised by cognitive deficits.

Exploratory Study on Domain-Specific Determinants of Opiate-Dependent Individuals’ Quality of Life

Background/Aims: Studies on determinants of quality of life (QoL) among opiate-dependent individuals are scarce. Moreover, findings concerning the role of severity of drug use are inconsistent. This exploratory study investigates the association between domain-specific QoL and demographic, social, person, health and drug-related variables, and potential indirect effects of current heroin use on opiate-dependent individuals’ QoL. Methods: A cohort of opiate-dependent individuals who started outpatient methadone treatment at least 5 years previously (n = 159) were interviewed about their current QoL, psychological distress, satisfaction with methadone treatment and the severity of drug-related problems using the Lancashire Quality of Life Profile, the Brief Symptom Inventory, the Verona Service Satisfaction Scale for Methadone Treatment and the EuropASI. Results: None of the QoL domains were defined by the same compilation of determinants. No direct effect of current heroin use on QoL was retained, but path analyses demonstrated its indirect effects on the domains of ‘living situation’, ‘finances’ and ‘leisure and social participation’. Conclusion: These findings illustrate the particularity of each QoL domain and the need for a multidimensional approach to the concept. The relationship between current heroin use and various domains of opiate-dependent individuals’ QoL is complex, indirect and mediated by psychosocial and treatment-related variables.

Changes in quality of life in forensic psychiatric outpatients after 6 months of community‐based treatment

AbstractOver the last few decades, quality of life (QoL) has become an important outcome measure for treatment success in general psychiatry. So far, this is not the case in forensic psychiatry, although several (treatment) models include factors related to QoL, such as the good lives model. In this study, we investigated change in QoL over a 6‐month treatment period in 102 forensic outpatients with personality disorders (PDs) or traits of PDs. To this end, the extended Dutch version of the Lancashire Quality of Life Profile was used.Objective indicators of QoL did not change during these 6 months, with one exception: Significantly more patients reported to have a helping friend at the second time point. Eight of 10 subjective indicators of QoL changed differentially for patients with different baseline levels of QoL. Those with low scores showed significant improvement on nine indicators, whereas those with high scores reported a lower QoL after 6 months on five indicators. Treatment intensity, mood and severity of PD did not mediate these changes. Subjective QoL deserves consideration as an important theoretical construct in forensic treatment and the Lancashire QoL Profile is sensitive to change during such treatment. Copyright © 2010 John Wiley & Sons, Ltd.

Current quality of life and its determinants among opiate-dependent individuals five years after starting methadone treatment

PurposeThis study explores the current QoL of opiate-dependent individuals who started outpatient methadone treatment at least 5 years ago and assesses the influence of demographic, psychosocial, drug and health-related variables on individuals’ QoL.MethodsParticipants (n = 159) were interviewed about their current QoL, psychological distress and severity of drug-related problems, using the Lancashire Quality of Life Profile, the Brief Symptom Inventory and the Addiction Severity Index. Potential determinants of QoL were assessed in a multiple linear regression analysis.ResultsFive years after the start of methadone treatment, opiate-dependent individuals report low QoL scores on various domains. No association was found between drug-related variables and QoL, but a significant negative impact of psychological distress was identified. Severity of psychological distress, taking medication for psychological problems and the inability to change one’s living situation were associated with lower QoL. Having at least one good friend and a structured daily activity had a significant, positive impact on QoL.ConclusionsOpiate-dependent individuals’ QoL is mainly determined by their psychological well-being and a number of psychosocial variables. These findings highlight the importance of a holistic approach to treatment and support in methadone maintenance treatment, which goes beyond fixing the negative physical consequences of opiate dependence.