Quality of life in mental disorders: challenges for research and clinical practice

The term quality of life (Qol) has become a rallying cry for all those who strive to integrate patients' subjective experience of their life during illness into clinical care. With its intuitive appeal, Qol seems to be understood by everyone involved in managing health and disease. However, when examining the ever increasing research literature, it becomes clear that many methodological questions still beset this field, since neither a commonly accepted definition nor a gold standard for measuring Qol exist. On the contrary, one is irritated by the myriad of different instruments and it remains questionable how valid and comparable research results obtained with different instruments are. It is argued that, especially when attempting to measure Qol in mental disorders: a) in addition to "subjective", also "objective" (i.e., external) assessment is needed; b) the inclusion of psychopathological symptoms in Qol instruments has to be controlled for; c) in addition to well-being and satisfaction, also functioning and environmental assets have to be assessed; d) different life areas have to be considered separately, and e) changes over time have to be taken into account. A concluding section in the paper reflects on the still largely missing transfer of research results into clinical care.