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Predictors of quality of life in people with severe mental illness

Study methodology with baseline analysis in the UK700 trial

Published online by Cambridge University Press:  03 January 2018

Thomas Fahy ,
Andy Kent ,
Theresa Tattan ,
Elizabeth Van Horn  and
Ian White
Thomas Fahy*
Affiliation:
Maudsley Hospital, London
Andy Kent
Affiliation:
St Georges' Hospital Medical School, London
Theresa Tattan
Affiliation:
Manchester Royal Infirmary
Elizabeth Van Horn
Affiliation:
St Mary's Hospital, London
Ian White
Affiliation:
London School of Hygiene and Tropical Medicine
*
Dr Thomas Fahy, Maudsley Hospital, 103 Denmark Hill, London SE5 8AZ
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Abstract

Background

It is not clear which model of case management is most likely to improve quality of life in people with severe mental illness.

Aims

To use baseline data derived from the UK700 Case Management Trial to assess the relative importance of clinical, social and unmet needs variables as predictors of subjective quality of life in patients with severe mental illness.

Method

Patients (n=708) were assessed on quality of life (Lancashire Quality of Life Profile), needs (Camber well Assessment of Need), psychopathology and social functioning. Variables that were amenable to change through case management were investigated as predictors of quality of life.

Results

Social variables accounted for 7% of the variance for subjective quality of life, compared with 19% for clinical variables, and 20% for unmet needs. The strongest predictors of subjective quality of life were unmet basic, social and functioning needs, depression and positive psychotic symptoms.

Conclusions

Subjective quality of life in severely mentally ill patients is predicted by clinical variables and unmet needs. The results identify priority areas for the attention of case managers who seek to improve quality of life in these patients.

Type
Papers
Information
The British Journal of Psychiatry , Volume 175 , Issue 5 , November 1999 , pp. 426 - 432
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest

Funded by the UK NHS Research and Development Programme and the Department of Health.

References

Andreassen, N. (1989) Scale for the assessment of negative symptoms (SANS). British Journal of Psychiatry, 155 (suppl. 7), 53–58.CrossRefGoogle Scholar
Åsberg, M., Montgomery, S. A., Perris, C., et al (1978) A comprehensive psychopathological rating scale. Acta Psychiatrica Scandinavica, 271 (suppl.), 5–27.CrossRefGoogle Scholar
Bums, T., Creed, F., Fahy, T., et al (1999) Intensive versus standard case management for severe psychotic illness: a randomised trial. Lancet, 353, 2185–2189.Google Scholar
Corrigan, P. W. & Bukan, B. (1995) The construct validity of subjective quality of life for the severely mentally ill. Journal of Nervous and Mental Disease, 183, 281–285.CrossRefGoogle ScholarPubMed
Holloway, F. (1991) Case management for the mentally ill: looking at the evidence. International Journal of Social Psychiatry, 37, 2–13.CrossRefGoogle ScholarPubMed
Huxley, P. & Warner, R. (1992) Case management, quality of life, and satisfaction with services of long-term psychiatric patients. Hospital and Community Psychiatry, 43, 799–802.Google ScholarPubMed
Jablensky, A., Schwartz, R. & Tomov, T. (1980) WHO collaborative study of impairments and disabilities associated with schizophrenic disorders. A preliminary communication. Objective and methods. Acta Psychiatrka Scandinavica, 285 (suppl.), 152–163.CrossRefGoogle Scholar
Jacobsson, L., von Knorring, L., Mattson, B., et al (1971) The comprehensive psvchopathological rating scale–CPRS– in patients with schizophrenic syndromes. Acta Psychiatrica Scandinavica, 271 (suppl.), 39–44.Google Scholar
Kalser, W., Priebe, S., Barr, W., et al (1997) Profiles of subjective quality of life in schizophrenic in- and outpatient samples. Psychiatry Research, 66, 153–166.Google Scholar
Lehman, A. F. (1983a) The well-being of chronic mental patients: assessing their quality of life. Archives of General Psychiatry, 40, 369–373.CrossRefGoogle Scholar
Lehman, A. F. (1983b) The effects of psychiatric symptoms on quality of life assessments among the chronic mentally ill. Evaluation and Programme Planning, 6, 143–151.CrossRefGoogle ScholarPubMed
Lehman, A. F., Ward, N. C. & Linn, L. S. (1982) Chronic mental patients: the quality of life issue. American Journal of Psychiatry, 10, 1271–1276.Google Scholar
McGuffin, P., Farmer, A. & Harvey, I. (1991) A polydiagnostic application of operational criteria in studies of psychotic illness. Development and reliability of the OPCRIT system. Archives of General Psychiatry, 48, 764–770.CrossRefGoogle ScholarPubMed
Merson, S., Tyrer, P., Onyett, S., et al (1992) Early intervention in psychiatric emergencies: a controlled clinical trial. Lancet, 339, 1311–1314.CrossRefGoogle ScholarPubMed
Montgomery, S. A. & Åsberg, M. (1979) A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.CrossRefGoogle ScholarPubMed
Oliver, J. (1991) The social care directive: development of a quality of life profile for use in community services for the mentally ill. Social Work and Social Sciences Review, 3, 5–45.Google Scholar
Oliver, J. & Mohamad, H. (1992) The quality of life of the chronically mentally ill: a comparison of public, private, and voluntary residential provisions. Journal of British Association of Social Wirkers, 22, 391–404.Google Scholar
Phelan, M., Slade, M., Thomicroft, G., et al (1995) The Camber well Assessment of Need: the validity and reliability of an instrument to assess the needs of people with severe mental illness. British Journal of Psychiatry, 167, 589–595.CrossRefGoogle Scholar
Simpson, C. J., Hyde, C. E. & Faragher, E. B. (1989) The chronically mentally ill in community facilities: a study of quality of life. British Journal of Psychiatry, 154, 77–82.CrossRefGoogle ScholarPubMed
Sullivan, G., Wells, K. B. & Leake, B. (1992) Clinical factors associated with better quality of life in a seriously mentally ill population. Hospital and Community Psychiatry. 43, 794–798.Google Scholar
Tyrer, P. & Remington, M. (1979) Controlled comparison of day hospital and out-patient treatment for neurotic disorders. Lancet, 135, 163–167.Google Scholar
UK700 Group (1999) Comparison of intensive and standard case management for patients with psychosis. Rationale of the trial. British Journal of Psychiatry, 174, 74–78.CrossRefGoogle Scholar
Warner, R. & Huxley, P. (1993) Psychopathology and quality of life among mentally ill patients in the community. British and US samples compared. British Journal of Psychiatry, 163, 505–509.CrossRefGoogle ScholarPubMed
World Health Organization (1992) WHO Co-Ordinated Multi-Centre Study on the Course and Outcome of Schizophrenia. Geneva: WHO.Google Scholar
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