title: Changes and predictors of change in objective and subjective quality of life: multiwave follow-up study in community psychiatric practice.
abstract: BACKGROUND
  There is little knowledge of the predictors of objective and subjective quality of life.
  
  
  OBJECTIVE
  To describe changes at 2 and 6 years in objective and subjective quality of life in 261 individuals attending a community mental health service and to identify predictors of change in each life domain.
  
  
  METHODS
  Prospective study of demographic, diagnostic and service utilisation characteristics, psychopathology, functioning, disability, self-esteem, affect balance and service satisfaction.
  
  
  RESULTS
  Female gender, unmarried status, older age, less education and greater disability predicted a worsening of objective quality of life over time, but explain a small amount of variance. The variance in subjective quality of life was higher (>40%). Greater clinician-rated anxiety and depressive symptoms had a negative effect on satisfaction with health and general well-being. Psychological status, self-esteem and satisfaction with service were the most important predictors in almost all subjective domains; these variables should be important targets for treatment.
  
  
  CONCLUSIONS
  This study is the first to provide information to enable clinicians to make prognostic judgements about quality of life and plan effective therapeutic strategies to improve quality of life.
authors.affiliation: Dipartimento di Medicina e Sanità Pubblica, Sezione di Psichiatria e di Psicologia Clinica, Universita'di Verona, Policlinico G. B. Rossi, 37134 Verona, Italy. mirella.ruggeri@univr.it
authors.forename: Mirella
authors.initials: M
authors.lastname: Ruggeri
authors.forename: Michela
authors.initials: M
authors.lastname: Nosè
authors.forename: Chiara
authors.initials: C
authors.lastname: Bonetto
authors.forename: Doriana
authors.initials: D
authors.lastname: Cristofalo
authors.forename: Antonio
authors.initials: A
authors.lastname: Lasalvia
authors.forename: Giovanni
authors.initials: G
authors.lastname: Salvi
authors.forename: Benedetta
authors.initials: B
authors.lastname: Stefani
authors.forename: Francesca
authors.initials: F
authors.lastname: Malchiodi
authors.forename: Michele
authors.initials: M
authors.lastname: Tansella
mesh_terms: D000328:Adult; D001294:Attitude to Health; D003156:Community Mental Health Services; D004185:Disability Evaluation; D015981:Epidemiologic Factors; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D017060:Patient Satisfaction; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012649:Self Concept; D012959:Socioeconomic Factors