Elsevier

Psychiatry Research

Volume 152, Issue 1, 30 July 2007, Pages 45-54
Psychiatry Research

Quality of life of ‘normal’ controls: Association with lifetime history of mental illness

https://doi.org/10.1016/j.psychres.2006.09.008Get rights and content

Abstract

This study assessed the perceived quality of life of individuals who were not in treatment for a psychiatric disorder and who were volunteers for a program to recruit control subjects. Subjects completed the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and a diagnostic evaluation for lifetime history of mental disorders. Individuals were assigned to one of four categories according to the results of the diagnostic evaluation: Never Mentally Ill (NMI), one episode of a Minor Mental Disorder (MMD), Currently Not Mentally Ill with a serious history of mental illness (CNMI), and Currently Mentally Ill (CMI). Subjects in the two healthiest groups (NMI, MMD) reported the greatest life satisfaction and generally did not differ from each other. Subjects in the CNMI group reported significantly less satisfaction than subjects in the NMI and MMD groups, but greater life satisfaction than subjects who were currently mentally ill (CMI). The results demonstrate that an individual's current quality of life is strongly related to the extent of his or her history of mental illness. The findings provide the first available benchmarks for the Q-LES-Q for the degree of life satisfaction experienced by an untreated sample of individuals.

Introduction

Measurement of quality of life has become an important aspect of assessing the health of patients in treatment for psychiatric disorders. In particular, the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) (Endicott et al., 1993) has been used widely to measure life satisfaction in patients during pre and post treatment phases of therapy.

Studies often use the short-form of the Q-LES-Q, which is identical to the General Activities subscale of the larger instrument. Baseline levels of life satisfaction have been low across a wide range of psychiatric disorders (Kocsis et al., 1997, Miller et al., 1998, Pollack et al., 1998, Freeman et al., 1999, Koran et al., 2002, Rapaport et al., 2002, Liebowitz et al., 2003, Ritsner et al., 2003), and post-treatment scores have shown statistically significant improvement for patients with mood and anxiety related illnesses (Kocsis et al., 1997, Pollack et al., 1998, Russell et al., 2001, Schneider et al., 2001, Koran et al., 2002, Rapaport et al., 2002, Liebowitz et al., 2003).

The degree to which Q-LES-Q post-treatment scores are consistent with those from healthy individuals who are not in treatment for a mental illness is not known because very few studies have collected quality of life data from controls. Chand et al. (2004) reported that controls selected by a general health questionnaire reported a mean score of 67% on the General Activities subscale of the Q-LES-Q. Gelfin et al. (1998) found that never mentally ill subjects screened with the use of a standardized psychiatric interview reported a raw mean score of 55.1 on the General Activities subscale, which represents 73% of the total possible score. Additional research is needed to better understand how different referent groups of ‘normal’ controls score on measures of quality of life. The current study assessed the quality of life of subjects who were not in treatment for a psychiatric disorder, separated into groups according to lifetime history of mental illness.

Section snippets

Methods

Subjects were participants in a centralized recruitment program (CRP) for controls for studies at the New York State Psychiatric Institute. A description of the recruitment and assessment procedures for the CRP is included in this report. Additional information about this program can be found in previous reports (Schechter et al., 1994, Schechter et al., 1998, Schechter and Lebovitch, 2005). The protocol was begun after IRB approval was obtained.

Background

The social demographic characteristics of the participants in each group are presented in Table 4. In total, 529 subjects completed the diagnostic evaluation and the Q-LES-Q on the same day. Approximately 25% (n = 130) of the subjects were Never Mentally Ill (NMI) and about 52% (n = 274) were currently healthy, but had a history of at least one episode of mental illness. Of those, 9% of the overall sample (n = 49) had experienced only one episode of a minor mental disorder (MMD), and 43% (n = 225) were

Discussion

This investigation assessed perceived quality of life in a sample of subjects who were not in treatment for a psychiatric disorder. The findings demonstrate that an individual's current quality of life is strongly related to the extent of his or her history of mental illness. Subjects with no history of mental disorders (NMI) reported significantly greater life satisfaction across a wide range of areas in comparison to subjects who were currently healthy, but had a clinically significant

Acknowledgement

This investigation was supported in part by National Institute of Mental Health grants MH-30906 and MH-61274, and by the New York State Department of Mental Health. We also gratefully acknowledge the contributions made by Shelly Lebovitch, Tracey Strasser, Ph.D., Tara Singer, Ph.D., Gina McSheffrey, Jennifer Kuperman, M.S., and Christa Santangelo, Ph.D. during the data collection phase of the project.

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