The impact of mental illness on quality of life: A comparison of severe mental illness, common mental disorder and healthy population samples
Patient-centred outcomes such as quality of life (QOL) are valued and used extensively in mental healthcare evaluations, but concerns remain about their practical application due to perceived measurement issues, including responsiveness and relationships with objective indicators and depression. Evidence from general population studies challenge some assumptions, suggesting that measurement difficulties might relate to the characteristics of mental health samples, rather than measurement itself. This paper assesses the impact of mental illness on QOL and its measurement, examining whether the life-conditions, opportunities and QOL of different mental health-status groups vary, and if explanatory models of domain-specific and global QOL differ. Objective life-conditions, access to life-opportunities and subjective QOL were assessed over 2 years, using the same methodology in severe mental illness (SMI; n = 149 (baseline)/n = 126 (follow-up)), common mental disorder (CMD; n = 794/354) and no disorder (n = 1119/583) groups. Objective life-conditions were worse in the SMI group than in mentally healthy population and CMD groups, but the opportunities available to the SMI group were no more restricted than the CMD group. Subjective QOL ratings reflected this; SMI group scores were lower than the healthy population and in some life-domains the CMD group. Models of QOL suggested that life-quality was explained differently in the three groups. QOL studies combining mental health samples should control for health-status group, and domain-specific and global indicators of lifestyle and opportunity.
KeywordsCommon mental disorder General population Measurement Severe mental illness Quality of life
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- 1.NHS Executive/Social Services Inspectorate. All About Quality of Life. London: NHS Exec/SSI, 1999.Google Scholar
- 2.Department of Health. National Service Framework for Mental Health: Modern Standards and Service Models for Mental Health. London: DH, 1999.Google Scholar
- 3.National Institute for Mental Health in England. About the National Institute for Mental Health in England (NIMHE) [online]. Available:http://www.nimhe.org.uk/nimhe.html (accessed November, 2001).
- 11.Moore M, Hofer S, McGee H, Ring L. Can the concepts of depression and quality of life be integrated using a time perspective. Health and QOL Outcomes 2005; 3 1 [Online] Available: http://www.hglo/content/3/1/1 (accessed 2nd May, 2006).
- 12.Andrews F, Withey SB (1976) Social Indicators of Well-being: Americans Perceptions of Quality of Life. Plenum Press, New YorkGoogle Scholar
- 20.Huxley P (2002) Mental Illness. In: Davies M (ed.) The Blackwell Companion to Social Work (2nd edn). Blackwell, LondonGoogle Scholar
- 21.Campbell A, Converse PE, Rogers WL (1976) The Quality of American Life: Perceptions, Evaluations, Satisfactions. Russell Sage Foundation, New YorkGoogle Scholar
- 22.Evans S, Huxley P. Quality of life measurement in mental health: Some recent findings. In: Proceedings of the 3rd Conference of the International Society for Quality of Life Studies. Univerity of Girona, 2000: 271–281.Google Scholar
- 26.Department of Environment, Transport & Regions. Indices of deprivation 2000 (Regeneration Research Summary No31) [online]. Available:http://www.urban/odpm.gov.uk/research/id2000/index.htm (accessed 26th April, 2003).
- 27.Office of National Statistics. Why census shows fewer men (online). Available from: http://www.statistics.gov.uk/census2001/methodology.asp (accessed March, 2003).
- 28.MORI. Single Regeneration Budget Challenge Fund Evaluation (1996–2001). London: Market Opinion Research International, 2001.Google Scholar
- 29.Brugha T, Evans S (2003) Better or Worse: A Longitudinal Study of the Mental Health of Adults Living in Private Households in Great Britain. TSO, LondonGoogle Scholar
- 30.Goldberg D, Huxley P (1992) Common Mental Disorders: A Bio-Social Model. Routledge, LondonGoogle Scholar
- 31.Goldberg D (1992) General Health Questionnaire (GHQ-12). NFER-Nelson, WindsorGoogle Scholar
- 32.Goldberg D, Williams P (1988) A Users Guide to the General Health Questionnaire. NFER-Nelson, WindsorGoogle Scholar
- 36.Oliver JPJ (1991) The social care directive: development of a quality of life profile for use in community services for the mentally ill. Soc Wk Soc Sci Rev 3:5–45Google Scholar
- 37.Bradburn N (1969) The Structure of Psychological Well-being. Aldine Publishing Co., ChicagoGoogle Scholar
- 38.Rosenberg M (1965) Society and Adolescent Self-image. Princeton University Press, PrincetonGoogle Scholar
- 40.Tabachnick BG, Fiddell LS (2001) Using Multivariate Statistics (4th edn). Allyn & Bacon, BostonGoogle Scholar
- 41.Cohen J (1988) Statistical Power Analysis for the Behavioural Sciences (2nd edn.). Erlbaum, Hillsdale, NJGoogle Scholar
- 43.Department for Work & Pensions. Statistical summary — March 2002 [online]. Available:http://www.dwp.asd.asd1/stats_summary/Stats_summary_March2002_AllDWP.pdf (accessed April, 2003).
- 44.Department for Work & Pensions. Statistical summary — June 2002 [online]. Available:http://www.dwp.asd.asd1/stats_summary/Stats_summary_June2002_AllDWP.pdf (accessed April, 2003).
- 45.Department for Work & Pensions. Statistical summary — September 2002 [online]. Available:http://www.dwp.asd. asd1/stats_summary/Stats_summary_Sept2002.pdf (Accessed April, 2003).
- 46.Department for Work & Pensions. Statistical summary — December 2002 [online]. Available:http://www.dwp.asd.asd1/stats_summary/Stats_summary_December2002_All DWP.pdf (accessed April, 2003).
- 47.Department for Work & Pensions. DWP statistical summary — March 2003 [online]. Available:http://www.dwp.asd.asd1/stats_summary/Stats_summary_March2003.pdf (accessed April, 2003).