Abstract
It has often been postulated that simple, short questionnaires are unable to reflect complex changes in well-being of individuals with chronic psychiatric disorders. To investigate these assumptions we included two recently developed instruments to measure quality of life (the WHOQoL-Bref and the EuroQoL EQ-5D) in a randomised control trial (RCT) in which two treatment conditions were compared. Aims of the study were to assess the sensitivity and validity of these quality of life (QoL)-instruments, to establish their relationship and to examine the predictors of changes in QoL. Subjective changes in QoL were measured on three assessments waves in a period of 18 months and compared to objective changes in psychopathology and social functioning in a sample of 76 chronic schizophrenic patients who participated in the RCT. Results indicated that both WHOQoL-Bref and EuroQoL EQ-5D are capable of detecting changes in QoL over time in physical and psychological well-being. The instruments partly measure the same aspects of QoL, indicated by 50% common variance on total scores. Reduction of positive psychotic symptoms appeared to be the most important factor in improving QoL. The weighted TTO-score of EuroQoL-5D, which is often used as an index in economic evaluations of health care, did however not correspond with these changes, which indicates that it is less sensitive to changes in social and psychological well-being. It’s use as the core measure in (economic) health evaluation in the field of psychiatry therefore seems less appropriate.
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References
T Struttmann M Fabro G Romieu et al. (1999) ArticleTitleQuality-of-life assessment in the old using the WHOQOL 100: Differences between patients with senile dementia and patients with cancer. Int Psychogeriatr 11 273–279
M Atkinson S Zibin H Chuang (1997) ArticleTitleCharacterizing quality of life among patients with chronic mental illness: A critical examination of the self-report methodology. Am J Psychiatry 154 99–105 Occurrence Handle1:STN:280:ByiC2c3psFE%3D Occurrence Handle8988966
FB Dickerson NB Ringel F Parente (1998) ArticleTitleSubjective quality of life in out patients with schizophrenia: Clinical and utilization correlates. Acta Psychiatr Scand 98 IssueID2 124–127
JW Kasckow E Twamley JJ Mulchahey et al. (2001) ArticleTitleHealth related quality of well being in chronically hospitalized patients with schizophrenia: Comparison with matched outpatients. Psychiatr Res 103 IssueID1 69–78
S Priebe UU Roeder-Wanner W Kaiser (2000) ArticleTitleQuality of life in first-admitted schizophrenia patients: A follow-up study. Psychol Med 30 IssueID1 225–230 Occurrence Handle10.1017/S0033291798008253 Occurrence Handle1:STN:280:DC%2BD3c7osFalug%3D%3D Occurrence Handle10722193
JD Huppert KA Weiss R Lim S Pratt TE Smith (2001) ArticleTitleQuality of life in schizophrenia: Contributions of anxiety and depression. Schizophr Res 51 171–180 Occurrence Handle10.1016/S0920-9964(99)00151-6 Occurrence Handle1:STN:280:DC%2BD3MvnsFGmtg%3D%3D Occurrence Handle11518637
CC Bow-Thomas DI Velligan AL Miller J Olsen (1999) ArticleTitlePredicting quality of life from symptomatology in schizophrenia at exacerbation and stabilization. Psychiatry Res 86 IssueID2 131–142
M Ritsner (2003) ArticleTitlePredicting changes in domain-specific quality of life of schizophrenia patients. J Nerv Ment Dis 191 IssueID5 287–294
WHOQoL group. Development of the World Health Organization WHOQoL BREF Quality of Life scale. Psychol Med 1998; 28: 551–558.
EuroQoL group. EuroQoL – a new facility for the measurement of health related quality of life. Health Policy 1990; 16: 199–208.
JA Jenner FJ Nienhuis D Wiersma G Van de Willige (2004) ArticleTitleHallucination focused Integrative Treatment improves burden, control, and symptoms in schizophrenia patients with drug-resistant hallucinations, a RCT. Schizophr Bull 30 IssueID1 127–139
D Wiersma JA Jenner FJ Nienhuis G Van de Willige (2004) ArticleTitleHallucination focused integrative treatment improves quality of life in schizophrenia patients. Acta Psychiatr Scand 109 194–201
AD Stant EM TenVergert H Groen et al. (2003) ArticleTitleCost-effectiveness of the HIT programme in patients with schizophrenia and persistent auditory hallucinations. Acta Psychiatr Scand 107 361–368
JA Jenner (2002) ArticleTitleHIT: An integrative treatment for patients with persistent auditory hallucinations. Psychiatr Serv 53 897–898
DG Altman (1995) Practical Statistics for Medical Research. Chapman &Hall London
World Health Organization. WHO SCAN: Schedules for Clinical Assessment in Neuropsychiatry. Geneve, 1992.
Carroll RE O’ K Smith M Couston JA Cossar PC Hayes (2000) ArticleTitleA comparison of the WHOQOL-100 and the WHOQOL-BREF in detecting change in quality of life following liver transplantation. Qual Life Res 9 121–124
R Brooks (1996) ArticleTitleEuroQoL: The current state of play. Health Policy 37 53–72 Occurrence Handle10.1016/0168-8510(96)00822-6 Occurrence Handle1:STN:280:BymB1c7mt1Q%3D Occurrence Handle10158943
P Kind P Dolan C Gudex A Williams (1998) ArticleTitleVariations in population health status: Results from a United Kingdom national questionnaire survey. Br Med J 316 736–741
P Dolan C Gudex P Kind A Williams (1996) ArticleTitleThe time trade-off method: Results from a general population study. Health Econ 5 141–154
Kay SR, Opler LA, Lindenmayer JP. The Positive and Negative Syndrome Scale (PANSS): Rationale and standardisation. Br J Psychiatry Suppl 1989; 59–67.
JP Lindenmayer S Grochowski RB Hyman (1995) ArticleTitleFive factor model of schizophrenia: Replication across samples. Schizophr Res 14 229–234
G Haddock J McCarron N Tarrier EB Faragher (1999) ArticleTitleScales to measure dimensions of hallucinations and delusions: The psychotic symptom rating scale (PSYRATS). Psychol Med 29 879–889
D Wiersma Ad Jong HJM Kraaijkamp J Ormel (1990) GSDS-II: The Groningen Social Disabilities Schedule, Second Version. Department of Psychiatry, University of Groningen The Netherlands
TL Patterson RM Kaplan DV Jeste (1999) ArticleTitleMeasuring the effect of treatment on quality of life in patients with schizophrenia: Focus on utility-based measures. CNS Drugs 12 49–64
M Doyle S Flanagan S Browne M Clarke D Lydon E Larkin (1999) ArticleTitleSubjective and external assessments of quality of life in schizophrenia: Relationship to insight. Acta Psychiatr Scand 99 466–472
K Burstrom M Johannesson F Diderichsen (2001) ArticleTitleHealth- related quality of life by disease and socio-economic group in the general population in Sweden. Health Policy 55 51–69
G Hawthorne J Richardson N Day H McNeil (2000) Validation of the WHOQoL-BREF. Centre for Health Program Evaluation Melbourne
X Badia A Casado JA Sacristan JC Gomez KJ Gregor S Gavart (Eds) (2000) the EFESO Study Group. Antipsychotic Treatment and Changes in Health Related Quality of Life in Schizophrenic Patients using the EQ-5D. Davos The 10th Biennial Winter Workshop on Schizophrenia Switzerland
JD Huppert TE Smith (2001) ArticleTitleLongitudinal analysis of subjective quality of life in schizophrenia: Anxiety as the best symptom predictor. J Nerv Ment Dis 189 IssueID10 669–675
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de Willige, G.v., Wiersma, D., Nienhuis, F.J. et al. Changes in quality of life in chronic psychiatric patients: A comparison between EuroQol (EQ-5D) and WHOQoL. Qual Life Res 14, 441–451 (2005). https://doi.org/10.1007/s11136-004-0689-y
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DOI: https://doi.org/10.1007/s11136-004-0689-y