[Can quality of life in psychotherapy be measured with clinician-ratings? A comparison of patient- and clinician-ratings using the SF-8].
OBJECTIVE
Quality of life is a major criterion of the outcome of psychotherapeutic interventions. The concept of quality of life emphasizes patient self-ratings. However, they can be burdensome or inappropriate in some cases. Therefore we have compared self-ratings and clinician-ratings of quality of life.


METHODS
Self- and clinician-ratings of the SF-8 (1-week recall version) were measured from consecutive samples of 1 812 inpatients from eleven psychotherapeutic clinics at admission and at discharge six weeks later. A physical summary score (PSS) and a mental summary score (MSS) were calculated. Pearson product-moment correlations were used.


RESULTS
Self- and clinician-ratings of the PSS correlate r=0.48 at admission and r=0.58 at discharge, of the MSS r=0.46 and r=0.51, respectively. Concerning single items we find the highest correlation for item 4 (bodily pain: r=0.53 and r=0.55), the lowest for item 6 (social functioning: r=0.26 and r=0.30). Change scores of the PSS correlate r=0.20, of the MSS r=0.32. Correlations differ between diagnostic groups: Correlations are low for patients with either schizophrenia (F2), depressive episode (F32) or personality disorder (F60-62), comparatively higher for patients with dysthymia. Comparing correlations across the 11 clinics reveals substantial differences, for the MSS ranging from r=0.38 to r=0.58 at admission and r=0.27 to r=0.68 at discharge.


CONCLUSIONS
Patient self-ratings of quality of life as a psychotherapeutic outcome measure using the SF-8 Health Survey could not be substituted by clinician-ratings, they should be used as complements.
Schulz
H
H
Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg. schulz@uke.uni-hamburg.de
Harfst
T
T
Andreas
S
S
Kawski
S
S
Koch
U
U
Rabung
S
S
D000328:Adult; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods*; D018802:Patient-Centered Care / Q000639:trends*; D011594:Psychometrics / Q000379:methods*; D011602:Psychophysiologic Disorders / Q000175:diagnosis* / Q000534:rehabilitation*; D011613:Psychotherapy / Q000379:methods*; D011788:Quality of Life; D015203:Reproducibility of Results; D012647:Self-Assessment; D012680:Sensitivity and Specificity; D016896:Treatment Outcome