[Perceptions of quality of life in schizophrenic patients]

Subjective quality of life in schizophrenic persons is a commonly applied indicator in outcomes research. However, it remains unclear whether the content of the construct is adequately represented from the patients' point of view, and whether changing representations in the course of illness should be accounted for in terms of re-prioritization of the concept.

Identification of specific perceptions of quality of life (QoL) of schizophrenic persons and analysis of changes of those perceptions with increasing chronicity.

The present study is a reanalysis of responses to a short, structured, open-ended interview taken from different studies in social psychiatry research. 403 schizophrenic persons from different care settings (psychiatric hospitals, community based institutions) as well as 178 mentally healthy persons were interviewed with regard to positive and negative aspects of their QoL. A qualitative content-analysis resulted in a comprehensive hierarchy of categories. The proportion of persons who mentioned a respective QoL-aspect was compared. Relationship between chronicity and perceptions of QoL were analysed by means of chi (2)(trend)-tests.

Schizophrenic persons mentioned about one fewer QoL domain compared to the mentally healthy (8.3 (sd = 2.8) vs. 9.6 (sd = 2.0), P < 0.001). They had fewer assertions on work aspects as well as in social domains (family, social relationships, partnership). The proportion of statements in social domains was negatively associated with the degree of chronicity. Among other things the schizophrenic persons showed a higher proportion of statements regarding "oral needs" (food, drinking-related statements, smoking) and (problems with) daily activities; both domains were associated with the degree of chronicity.

Differences between schizophrenic and mentally healthy persons in their perceptions of QoL were more pronounced with increasing chronicity. It remains unclear at which point in the course of illness this is best understood in terms of re-prioritization or even re-conceptualization of the entire concept.