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

• Published in: Quality of life research 2020-08, Vol.29 (8), p.2073-2087
• Main Authors: Berghöfer, Anne, Martin, Luise, Hense, Sabrina, Weinmann, Stefan, Roll, Stephanie
• Format: Article
• Language: English
• Subjects: Cross-Sectional Studies; Female; Humans; Male; Medicine; Medicine & Public Health; Mental disorders; Mentally Ill Persons - psychology; Middle Aged; Outpatients - psychology; Patients; Public Health; Quality of life; Quality of Life - psychology; Quality of Life Research; Sociology
• ISSN: 0962-9343; 1573-2649; 1573-2649
• DOI: 10.1007/s11136-020-02470-0

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.