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. 2020 Aug;29(8):2073-2087.
doi: 10.1007/s11136-020-02470-0. Epub 2020 Mar 13.

Quality of life in patients with severe mental illness: a cross-sectional survey in an integrated outpatient health care model

Anne Berghöfer  1 , Luise Martin  2 , Sabrina Hense  3 , Stefan Weinmann  4 , Stephanie Roll  3
Affiliations

Quality of life in patients with severe mental illness: a cross-sectional survey in an integrated outpatient health care model

Anne Berghöfer et al. Qual Life Res. 2020 Aug.

Abstract

Purpose: This study (a) assessed quality of life (QoL) in a patient sample with severe mental illness in an integrated psychiatric care (IC) programme in selected regions in Germany, (b) compared QoL among diagnostic groups and (c) identified socio-demographic, psychiatric anamnestic and clinical characteristics associated with QoL.

Methods: This cross-sectional study included severely mentally ill outpatients with substantial impairments in social functioning. Separate dimensions of QoL were assessed with the World Health Organisation's generic 26-item quality of life (WHOQOL-BREF) instrument. Descriptive analyses and analyses of variance (ANOVAs) were conducted for the overall sample as well as for diagnostic group.

Results: A total of 953 patients fully completed the WHOQOL-BREF questionnaire. QoL in this sample was lower than in the general population (mean 34.1; 95% confidence interval (CI) 32.8 to 35.5), with the lowest QoL in unipolar depression patients (mean 30.5; 95% CI 28.9 to 32.2) and the highest in dementia patients (mean 53.0; 95% CI 47.5 to 58.5). Main psychiatric diagnosis, living situation (alone, partner/relatives, assisted), number of disease episodes, source of income, age and clinical global impression (CGI) scores were identified as potential predictors of QoL, but explained only a small part of the variation.

Conclusion: Aspects of health care that increase QoL despite the presence of a mental disorder are essential for severely mentally ill patients, as complete freedom from the disorder cannot be expected. QoL as a patient-centred outcome should be used as only one component among the recovery measures evaluating treatment outcomes in mental health care.

Keywords: Clinical global impression scale; Determinants; Integrated care; Quality of life; Severe mental disorder; WHOQOL-BREF questionnaire.

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Figures

Fig. 1
Fig. 1
a–e Mean quality of life (QoL) with 95% CI by main diagnosis in each of the domains. The line indicates the mean value of the respective WHOQOL-BREF domain in the general German population [68]. U.D. unipolar depression, B.D. bipolar depression, S. schizophrenia, S.A. schizoaffective disorder, N.D. neurotic disorder, D. dementia, Alc. alcohol addiction
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