title: Validity of subjective versus objective quality of life assessment in people with schizophrenia.
abstract: BACKGROUND
  Quality of life (QoL) is considered an important outcome in health research. It can be rated by the patient, or by an external assessor. We wished to identify the predictors of any discrepancies between these two approaches in people with schizophrenia.
  
  
  METHODS
  Patients with DSM schizophrenia and related disorders (N = 80) completed both patient-rated (Lancashire Quality of Life Profile; LQOLP) and assessor-rated (Heinrich's Quality of Life Scale; QLS) measures of QoL.
  
  
  RESULTS
  Patient-rated (LQOLP) and assessor-rated (QLS) measures showed a modest correlation (r = 0.38). In a regression analysis, independent predictors of subjectively-rated QoL being higher than objectively-assessed QoL in the same patient, were low insight score (BIS), negative symptoms (PANSS), absence of depression (CDSS), and less positive attitude toward prescribed treatment (DAI).
  
  
  CONCLUSIONS
  In people with schizophrenia, scores on objectively- and subjectively-rated measures of quality of life can differ markedly. When comparing subjective to objective assessments, patients with depressive symptoms will value their QoL lower, and those with low insight will value their QoL higher. This has important implications for the utility and interpretation of QoL measures in schizophrenia.
authors.affiliation: Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester, M13 9PL, UK. karen.hayhurst@manchester.ac.uk.
authors.forename: Karen P
authors.initials: KP
authors.lastname: Hayhurst
authors.affiliation: Laureate House Mental Health Unit, Manchester Mental Health & Social Care Trust, Wythenshawe Hospital, Southmoor Road, Manchester, UK. Jenny.Massie@mhsc.nhs.uk.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Massie
authors.affiliation: Centre for Biostatistics, Institute of Population Health, The University of Manchester, Manchester, UK. graham.dunn@manchester.ac.uk.
authors.forename: Graham
authors.initials: G
authors.lastname: Dunn
authors.affiliation: Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester, M13 9PL, UK. shon.lewis@manchester.ac.uk.
authors.forename: Shôn W
authors.initials: SW
authors.lastname: Lewis
authors.affiliation: Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester, M13 9PL, UK. richard.drake@manchester.ac.uk.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Drake
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003866:Depressive Disorder / Q000523:psychology; D057915:Drug Substitution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011618:Psychotic Disorders / Q000188:drug therapy; D011788:Quality of Life; D012559:Schizophrenia / Q000188:drug therapy; D012563:Schizophrenia, Paranoid / Q000188:drug therapy; D012565:Schizophrenic Psychology; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents