Quality of Life Research

, Volume 11, Issue 6, pp 553–561 | Cite as

Subjective quality of life in severely mentally ill patients: A comparison of two instruments

  • M. RitsnerEmail author
  • R. Kurs
  • H. Kostizky
  • A. Ponizovsky
  • I. Modai


Although many quality of life (QOL) scales have been developed, comparison of specific QOL instruments is lacking. We compared the psychometric properties of two QOL measures in parallel samples of mentally disturbed and non-patient subjects. We simultaneously administered the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and self-report items of the Lancashire Quality of Life Profile (LQOLP) to 199 patients with severe mental disorders and 175 non-patients. The patients were evaluated with psychiatric rating scales. We identified five concordant domains, and five instrument-specific domains for the LQOLP and four for the Q-LES-Q. The Q-LES-Q provides better psychometric properties than the LQOLP in both samples. Both instruments show a good capacity to evaluate QOL and discriminate between the patients and non-patient controls. Within the patient sample, both QOL measures showed similarly negative correlations with severity of depression, but not mania, positive, negative, and general symptomatology. Both instruments proved to be mental health related, but neither was mental-disorder specific. Despite the acceptable psychometric properties and correlation of general QOL indices, similar QOL domains proved to be instrument specific and not sufficiently compatible. These discrepancies should be considered when comparing evaluations from similar domains in these QOL scales.

Psychiatric patients Quality of life scales Reliability Validity 


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  1. 1.
    Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA 1995; 273: 59-65.Google Scholar
  2. 2.
    Testa MA, Simonson DC. Assessment of Quality of Life Outcomes. N Engl J Med 1996; 334: 835-840.Google Scholar
  3. 3.
    Katsching H. Schizophrenia and quality of life. Acta Psychiatr Scand Suppl 2000; 102 (407): 33-37.Google Scholar
  4. 4.
    WHOQOL Group. The World Health Organization Quality of Life Assessment 1q(WHOQOL): Position paper from the World Health Organization. Soc Sci Med 1995; 41: 1403-1409.Google Scholar
  5. 5.
    Lehman A. Measures of quality of life among persons with severe and persistent mental disorders. Soc Psychiatry Psychiatr Epidemiol 1996; 31: 78-88.Google Scholar
  6. 6.
    Priebe SI, Roeder-Wanner UU, Kaiser W. Quality of life in first-admitted schizophrenia patients: A follow-up study. Psychol Med 2000; 30: 225-230.Google Scholar
  7. 7.
    Browne S, Roe M, Lane A, et al. Quality of life in schizophrenia: Relationship to sociodemographic factors, symptomatology and tardive dyskinesia. Acta Psychiat Scand 1996; 94: 118-124.Google Scholar
  8. 8.
    Heslegrave RJ, Awad AG, Boruganti LN. The influence of neurocognitive deficits and symptoms on the quality of life in schizophrenia. J Psychiatry Neurosci 1997; 22: 235-243.Google Scholar
  9. 9.
    Carpiniello B, Lai GL, Pariante CM, Carta MG, Rudas N. Symptoms, standards of living and subjective quality of life: A comparative study of schizophrenic and depressed outpatients. Acta Psychiat Scand 1997; 96: 235-241.Google Scholar
  10. 10.
    Koivumaa-Honkanen HT, Honkanen R, Antikainen R, Hintikka J, Viinamaki H. Self-reported life satisfaction and treatment factors in patients with schizophrenia, major depression and anxiety disorder. Acta Psychiatr Scand 1999; 99: 377-384.Google Scholar
  11. 11.
    Tollefson GD, Andersen SW. Should we consider mood disturbance in schizophrenia as an important determinant of quality of life? J Clin Psychiatry 1999; 60(Suppl 5): 23-29.Google Scholar
  12. 12.
    Ho BC, Nopoulos P, Flaum M, Arndt S, Andreasen NC. Two-year outcome in first-episode schizophrenia: predictive value of symptoms for quality of life. Am J Psychiatry 1998; 155: 1196-1201.Google Scholar
  13. 13.
    Voruganti L, Heslegrave R, Awad AG, Seeman MV. Quality of life measurement in schizophrenia: Reconciling the quest for subjectivity with the question of reliability. Psychol Med 1998; 28: 165-172.Google Scholar
  14. 14.
    Cramer JA, Rosenheck R, Xu W, Thomas J, Henderson W, Charney DS. Quality of Life in Schizophrenia: A Comparison of Instruments. Schizophr Bull 2000; 26: 659-666.Google Scholar
  15. 15.
    Barry MM, Zissi A. Quality of life as an outcome measure in evaluating mental health services: A review of the empirical evidence. Soc Psychiatry Psychiatr Epidemiol 1997; 32: 38-47.Google Scholar
  16. 16.
    Van Nieuwenhuizen C, Schene AH, Boevink WA, Wolf JRLM. Measuring the quality of life of clients with severe mental illness: A review of instruments. Psychiatr Rehabil J 1997; 20: 33-41.Google Scholar
  17. 17.
    Bishop SL, Walling DP, Dott SG, Folkes CC, Bucy J. Refining quality of life: Validating a multidimensional factor measure in the severe mentally ill. Qual Life Res 1999; 8: 151-160.Google Scholar
  18. 18.
    Lehman AF, Postrado LT, Rachuba LT. Convergent validation of quality of life assessments for persons withsevere mental illnesses. Qual Life Res 1993; 2: 327-333.Google Scholar
  19. 19.
    Heinrichs DW, Hanlon TE, Carpenter WT Jr. The Quality of Life Scale: An instrument for rating the schizophrenic deficit syndrome. Schizophr Bull 1984: 10: 388-398.Google Scholar
  20. 20.
    Oliver J, Huxley P, Bridges K, Mohammed H. Quality of Life and Mental Health Service. London and New York: Routledge, 1996.Google Scholar
  21. 21.
    Endicott J, Nee J, Harrison W, Blumenthal R. Quality of Life Enjoyment and Satisfaction Questionnaire: A new measure. Psychopharmacol Bull 1993: 29: 321-326.Google Scholar
  22. 22.
    Dott SG, Walling DP, Bishop SL, Bucy JE, Folkes CC. The efficacy of short-term treatment for improving quality of life: A pilot study. J Nerv Ment Dis 1996; 184: 507-509.Google Scholar
  23. 23.
    Russo J, Roy-Byrne P, Reeder D, et al. Longitudinal assessment of quality of life in acute psychiatric inpatients: Reliability and validity. J Nerv Ment Dis 1997; 185: 166-175.Google Scholar
  24. 24.
    Gupta S, Kulhara P, Verma SK. Quality of life in schizophrenia and dysthymia. Acta Psychiat Scand 1998; 97: 290-296.Google Scholar
  25. 25.
    Zissi A, Barry MM, Cochrane R. A mediational model of quality of life for individuals withsevere mental health problems. Psychol Med 1998; 28: 1221-1230.Google Scholar
  26. 26.
    Kemmler G, Holzner B, Kopp M, et al. Comparison of two quality-of-life instruments for cancer patients: The functional assessment of cancer therapy-general and the European Organization for Researchand Treatment of Cancer Quality of Life Questionnaire-C30. J Clin Oncol 1999; 17: 2932-2940.Google Scholar
  27. 27.
    American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC: American Psychiatric Association, 1994.Google Scholar
  28. 28.
    Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987; 13: 261-276.Google Scholar
  29. 29.
    Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry 1979; 134: 382-389.Google Scholar
  30. 30.
    Bech P, Rafaelsen OJ, Kramp P, Bolwig TG. The Mania Rating Scale: Scale construction and inter-observer agreement. Neuropharmacology 1978; 17: 430-431.Google Scholar
  31. 31.
    Lehman AF. The well-being of chronic mental patients: Assessing their quality of life. Arch Gen Psychiatry 1983; 40: 369-373.Google Scholar
  32. 32.
    Oliver JP, Huxley PJ, Priebe S, Kaiser W. Measuring the quality of life of severely mentally ill people using the Lancashire Quality of Life Profile. Soc Psychiatry Psychiatr Epidemiol 1997; 32: 76-83.Google Scholar
  33. 33.
    Hintze JL NCSS 6.0. Statistical System for Windows. User's Guide. Number Cruncher Statistical Systems: Kaysville, Utah, 1998.Google Scholar
  34. 34.
    van Nieuwenhuizen C, Schene A, Boevink W, Wolf J. The Lancashire quality of life profile: first experiences in the Netherlands. Community Ment Health J 1998; 34: 513-525.Google Scholar
  35. 35.
    Tempier R, Mercier C, Leouffre P, Caron J. Quality of life and social integration of severely mentally ill patients: A longitudinal study. J Psychiatry Neurosci 1997; 22: 249-255.Google Scholar
  36. 36.
    Tempier R, Caron J, Mercier C, Leouffre P. Quality of life of severely mentally ill individuals: A comparative study. Community Ment Health J 1998; 34: 477-485.Google Scholar
  37. 37.
    Atkinson M, Zibin S, Chuang H. Characterizing quality of life among patients withch ronic mental illness: A critical examination of the self-report methodology. Am J Psychiatry 1997; 154: 99-105.Google Scholar
  38. 38.
    Larsen EB, Gerlach J. Subjective experience of treatment, side-effects, mental state and quality of life in chronic schizophrenic out-patients treated with depot neuroleptics. Acta Psychiatr Scand 1996; 93: 381-388.Google Scholar
  39. 39.
    Packer S, Husted J, Cohen S, et al. Psychopathology and quality of life in schizophrenia. J Psychiatry Neurosci 1997; 22: 231-234.Google Scholar

Copyright information

© Kluwer Academic Publishers 2002

Authors and Affiliations

  • M. Ritsner
    • 2
    Email author
  • R. Kurs
    • 1
  • H. Kostizky
    • 1
  • A. Ponizovsky
    • 1
  • I. Modai
    • 1
    • 2
  1. 1.Institute for Psychiatric StudiesSha'ar Menashe Mental Health CenterHaderaIsrael
  2. 2.Bruce Rappaport Faculty of Medicine, TechnionHaifaIsrael

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