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