Skip to main content

Advertisement

Log in

What does the WHOQOL-Bref measure?

Measurement overlap between quality of life and depressive symptomatology in chronic somatoform pain disorder

  • Original Paper
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Introduction

Quality of life has become an important outcome criterion for psychiatric interventions. Especially in chronic disorders with no complete recovery, the improvement of quality of life is an important treatment goal. Nevertheless, there are methodological problems in assessing quality of life. There is a possible measurement overlap between quality of life and psychopathology, especially depression, which may invalidate research results. This study addresses the quality of life of patients with chronic somatoform pain and its relation to depressive symptoms.

Method

One hundred out-patients with somatoform pain disorder at the Behavioural Medicine Pain Clinic in the Department of Psychiatry of the Medical University of Vienna were diagnosed using the SCID for Diagnostic and Statistical Manual of Mental Disorder (DSM-IV). The patients filled out the World Health Organisation Quality of Life Assessment-Bref (WHOQOL-Bref) and the Beck Depression Inventory (BDI). Pain intensity (average pain, maximum pain, minimal pain) and disability (work, leisure and family life) were assessed using visual analogue scales.

Results

Quality of life in somatoform pain disorder was reduced compared to the norm population, especially in the physical and psychological domains. There were highly significant negative correlations between, on the one hand, depressive symptomatology (BDI) and, on the other hand, the physical quality of life domain (r=−0.655, p<0.01), the psychological domain (r=−0.735, p<0.01), the social domain (r=−0.511, p<0.01) and the environmental domain (r=−0.561, p<0.01). In all domains of the WHOQOL-Bref and in the global score, significant differences between the group of patients with severe or very severe depressive symptoms and the group with no or only mild depressive symptoms were found.

Discussion

While the WHOQOL-Bref showed a poor quality of life of patients with chronic somatoform pain disorder in general and especially in the physical and in the psychological domains, the high correlation of physical and psychological quality of life scores with depressive symptomatology points to a measurement overlap. It is suggested that assessment of subjective quality of life should always be checked for the influence of depressive symptomatology on the quality of life score.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Aigner M, Bach M (1999) Clinical utility of DSM-IV pain disorder. Compr Psychiatry 40:353–357

    Article  CAS  PubMed  Google Scholar 

  2. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. APA, Washington, DC

    Google Scholar 

  3. Amir M, Roziner I, Knoll A, Neufeld MY (1999) Self-efficacy and social support as mediators in the relation between disease severity and quality of life in patients with epilepsy. Epilepsia 40:216–224

    Article  CAS  PubMed  Google Scholar 

  4. Amir M, Lewin-Epstein N, Becker G, Buskila D (2002) Psychometric properties of the SF-12 (Hebrew version) in a primary care population in Israel. Med Care 40:918–928

    Article  PubMed  Google Scholar 

  5. Angermeyer MC, Kilian R, Matschinger H (2000) WHOQOL-100 und WHOQOL-Bref. Handbuch für die deutschsprachige Version der WHO Instrumente zur Erfassung von Lebensqualität. Hogrefe, Göttingen

    Google Scholar 

  6. Angermeyer MC, Kilian R (2005) Theoretical models of quality of life for mental disorders. In: Katschnig H, Freeman H, Sartorius N (eds) Quality of life in mental disorders, 2nd edn. Wiley, New York

    Google Scholar 

  7. Becchi A, Rucci P, Piacentino A, Neri A, de Girolamo G (2004) Quality of life in patients with schizophrenia—comparison of self-report and proxy assessments. Soc Psychiatry Psychiatr Epidemiol 39:397–401

    Article  PubMed  Google Scholar 

  8. Beck AT, Steer RA (1987) Beck depression inventory—manual. The Psychological Corporation, San Antonio, TX

    Google Scholar 

  9. Bonicatto SC, Dew MA, Zaratiegui R, Lorenzo L, Pecina P (2001) Adult outpatients with depression: worse quality of life than in other chronic medical diseases in Argentina. Soc Sci Med 52:911–919

    Article  CAS  PubMed  Google Scholar 

  10. Bölsche F, Hasenbein U, Reißberg H, Schlote A, Wallesch CW (2003) Ergebnisse der anbulanten und stationären Rehabilitation in den ersten sechs Monaten nach Schlaganfall. Fortschr Neurol Psychiatr 71:458–468

    PubMed  Google Scholar 

  11. Chand PK, Mattoo SK, Sharan P (2004) Quality of life and its correlates in patients with bipolar disorder stabilized on Lithium prophylaxis. Psychiatry Clin Neurosci 58:311–318

    Article  PubMed  Google Scholar 

  12. Giles D, Shaw B (1987) Beck's cognitive theory of depression: convergence of constructs. Compr Psychiatry 28:416–427

    Article  CAS  PubMed  Google Scholar 

  13. Hautzinger M, Bailer M, Worall H, Keller F (1995) Beck-Depressions-Inventar (BDI). Testhandbuch, 2nd edn. Huber, Bern

    Google Scholar 

  14. Herrman H, Hawthorne G, Thomas R (2002) Quality of life assessment in people living with psychosis. Soc Psychiatry Psychiatr Epidemiol 37:510–519

    Article  PubMed  Google Scholar 

  15. Huxley P, Evans S, Burns T, Fahy T, Green J (2001) Quality of life outcome in a randomized controlled trial of case management. Soc Psychiatry Psychiatr Epidemiol 36:249–255

    Article  CAS  PubMed  Google Scholar 

  16. Kahneman D, Diener E, Schwarz N (1999) Well-being: the foundations of hedonic psychology. Russel Sage Foundation, New York

    Google Scholar 

  17. Katschnig H (1997) How useful is the concept of quality of life in psychiatry? Curr Opin Psychiatry 10:337–345

    Article  Google Scholar 

  18. Katschnig H (2005) How useful is the concept of quality of life in psychiatry? In: Katschnig H, Freeman H, Sartorius N (eds) Quality of life in mental disorders, 2nd edn. Wiley, New York

    Google Scholar 

  19. Katschnig H, Freeman H, Sartorius N (eds) (2005a) Quality of life in mental disorders. 2nd edn. Wiley, New York

  20. Katschnig H, Krautgartner M, Schrank B, Angermeyer MC (2005b) Quality of life in depression. In: Katschnig H, Freeman H, Sartorius N (eds) Quality of life in mental disorders, 2nd edn. Wiley, New York

    Google Scholar 

  21. Lung FW, Huang YL, Shu BC, Lee FY (2004) Parental rearing style, premorbid personality, mental health and quality of life in chronic regional pain: a causal analysis. Compr Psychiatry 45:206–212

    Article  PubMed  Google Scholar 

  22. Monroe SM, Steiner SC (1986) Social support and psychopathology: interrelations with preexisting disorder, stress, and personality. J Abnorm Psychology 95:29–39

    CAS  Google Scholar 

  23. Müller K, Schwesig R, Leuchte S, Riede D (2001) Koordinationstraining und Lebensqualität-Eine Längsschnittuntersuchung bei Pflegepersonal mit Rückenschmerzen. Gesundheitswesen 63:609–618

    PubMed  Google Scholar 

  24. Oliver J, Huxley P, Bridges K, Mohamad H (eds) (1996) Quality of life and mental health services. Routledge, London

  25. Petrak F, Hardt J, Kappis B, Nickel R, Tiber-Egle U (2003) Determinants of health-related quality of life in patients with persistent somatoform pain disorder. Eur J Pain 7:463–471

    Article  PubMed  Google Scholar 

  26. Sainfort F, Becker M, Diamond R (1996) Judgments of quality of life of individuals with severe mental disorders. Am J Psychiatry 153:497–502

    CAS  PubMed  Google Scholar 

  27. Schwarz N, Clore GL (1983) Mood, misattribution, and judgments of well-being: informative and directive functions of affective states. J Pers Soc Psychol 45:513–523

    Google Scholar 

  28. Sher KJ, Trull TJ (1996) Methodological issues in psychopathology research. Annu Rev Psychol 47:371–400

    Article  CAS  PubMed  Google Scholar 

  29. Skevington SM (1998) Investigating the relationship between pain and discomfort and quality of life, using the WHOQOL. Pain 76:395–406

    Article  CAS  PubMed  Google Scholar 

  30. Skevington SM, Wright A (2001) Changes in the quality of life of patients receiving antidepressant medication in primary care: validation of the WHOQOL-100. Br J Psychiatry 178:261–267

    Article  CAS  PubMed  Google Scholar 

  31. Skevington SM, Lotfy M, O'Connell KA, WHOQOL Group (2004a) The World Health Organization's WHOQOL-Bref quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res 13:299–310

    CAS  PubMed  Google Scholar 

  32. Skevington SM,·Sartorius N,·Amir M, The WHOQOL-Group1 (2004b) Developing methods for assessing quality of life in different cultural settings: the history of the WHOQOL instruments. Soc Psychiatry Psychiatr Epidemiol 39:1–8

    Article  PubMed  Google Scholar 

  33. Taylor W, Myers J, Simpson RT, McPherson KM, Weatherall M (2004) Quality of life of people with rheumatoid arthritis as measured by the World Health Organization Quality of Life Instrument, short form (WHOQOL-Bref): score distributions and psychometric properties. Arthritis Rheum 15(51):350–357

    Google Scholar 

  34. Wells KB, Stewart A, Hays RD, Burnam A, Rogers W, Daniels M, Berry S, Greenfield S, Ware J (1989) The functioning and well-being of depressed patients: results from the medical outcomes study. J Am Med Assoc 262:914–919

    CAS  Google Scholar 

  35. WHOQOL Group (1998) Development of the World Health Organization WHOQOL-Bref quality of life assessment. Psychol Med 28:551–558

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Martin Aigner.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Aigner, M., Förster-Streffleur, S., Prause, W. et al. What does the WHOQOL-Bref measure?. Soc Psychiat Epidemiol 41, 81–86 (2006). https://doi.org/10.1007/s00127-005-0997-8

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-005-0997-8

Key words

Navigation