Clinician-rated functioning and patient-rated quality of life in schizophrenia: implications of their correspondence for psychopathology and side effects.
OBJECTIVE
Past studies have found inconsistent associations between subjective and objective measures of quality of life (QOL) in schizophrenia. We hypothesized that this may be due to heterogeneity in the demographic and/or clinical variables inherent in the samples and we investigated this possibility.


METHODS
We stratified the patients according to a descriptive measure of correspondence between self-reported QOL and clinician-rated functioning. We then examined whether heterogeneous patterns existed among the subgroups in terms of demographic variables, symptom severity, associations between self-reported and clinician-rated psychopathology and associations between side effects, QOL and functioning.


RESULTS
The subgroups significantly differed with respect to clinician-rated positive symptoms (F=3.075, p<.05), subjective symptoms (somatization, F=5.768, p<.01; obsessive-compulsive, F=3.885, p<.05; interpersonal sensitivity, F=8.278, p<.001; depression, F=9.368, p<.001; anxiety, F=6.909, p<.01; hostility, F=7.787, p<.01; phobic anxiety, F=9.551, p<.001; paranoia, F=5.304, p<.01; psychoticism, F=5.071, p<.01) and in- and outpatient ratio (Chi(2)=11.58, p<.01). Only the subgroup with relatively good correspondence between clinician-rated functioning and self-reported QOL showed significant low to moderate associations between the aforementioned measures and side effects. In addition, they showed similar levels of significant associations between the positive and subjective symptoms. In contrast, other discordant subgroups lacked overall associations between side effects, functioning and QOL as well as between subjective and objective measures of psychopathology.


CONCLUSIONS
Low to moderate levels of correspondence between subjective QOL and objective functioning were partly supportive of the independence of the constructs. Insight is likely to be a mediating variable of the correspondence between self-report and clinician-rated measures and should be considered in studies using self-report measures.
Jung
Hee Yeon
HY
Department of Psychiatry, Boramae Medical Center, College of Medicine Seoul National University, Seoul, 156-707, Republic of Korea.
Hwang
Samuel Suk-Hyun
SS
Yi
Jung Seo
JS
Kim
Yeni
Y
Kim
Yong Sik
YS
D000328:Adult; D000704:Analysis of Variance; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D010555:Personality Inventory / Q000706:statistics & numerical data; D010820:Physicians / Q000523:psychology; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011599:Psychopathology / Q000379:methods*; D011788:Quality of Life; D012559:Schizophrenia / Q000175:diagnosis* / Q000503:physiopathology; D012565:Schizophrenic Psychology; D012649:Self Concept; D055815:Young Adult