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Am J Psychiatry 1997; 154:99-105
Copyright © 1997 by American Psychiatric Association
Characterizing quality of life among patients with chronic mental illness: a critical examination of the self-report methodology
M Atkinson, S Zibin and H Chuang
Department of Psychiatry, University of Calgary, Foothills Hospital, Alta., Canada.
OBJECTIVE: The purposes of the study were 1) to characterize the quality of
life of three patient groups with chronic mental illness, 2) to evaluate
differences in reported life quality among the three groups, and 3) to
evaluate the validity of a self-report methodology by comparing these
results with several objective indicators of life quality. METHOD: The
study group consisted of chronically mentally ill patients with
schizophrenia (N = 69), bipolar disorder (N = 37), or major depression (N =
35). Subjects were administered the Quality of Life Index, and comparisons
of both objective and self-report life quality indices were made among the
three groups. Quality of life ratings of these subjects were also compared
with those of patients with a chronic physical illness. RESULTS: The two
groups with mood disorders reported significantly lower scores on the
Quality of Life Index than the patients with schizophrenia. Moreover, the
scores on the Quality of Life Index for patients with schizophrenia were
very similar to those of the comparison group of physically ill patients.
The opposite trend emerged when groups were compared with respect to
objective indicators of life quality. Schizophrenic patients experienced
more objectively aversive life circumstances than either of the affectively
disturbed groups. CONCLUSIONS: The validity of self- report measures of
life satisfaction is questioned, particularly for use with affectively
disturbed populations, since scores may be influenced by affective bias,
poor insight, and recent life events.
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