title: Improvement in health-related quality of life among adults with serious mental illness receiving inpatient treatment: a prospective cohort study.
abstract: OBJECTIVE
  This study examined changes in health-related quality of life in adult inpatients with serious mental illness engaged in a 6- to 8-week intensive treatment program.
  
  
  METHODS
  Admission and discharge assessment with the MOS 36-item Short-Form Health Survey was completed (June 2010-June 2012) for 410 adults aged 18-68 years. Paired t tests and effect size estimates were calculated for the overall sample, and reliable change index scores and clinical significance were calculated to estimate individual-level response and recovery rates. Hierarchical stepwise regression analyses were conducted to explore patient pretreatment characteristics, including total number of DSM-IV-TR diagnoses, that influence treatment response.
  
  
  RESULTS
  Large effect size improvements were demonstrated for the Mental Component Summary score (Cohen d = 1.5), including subjective ratings of vitality (Cohen d = 1.1), social functioning (Cohen d = 1.3), role-emotional functioning (Cohen d = 1.3), and mental health (Cohen d = 1.3). Equivocal findings for change in physical health were demonstrated, with the majority of patients demonstrating no significant change in function (t409 = 0.14, P = .89) but approximately equal numbers of patients demonstrating improvement and deterioration. The pretreatment characteristic of a tendency to be interpersonally distant, cold, and disengaged was predictive of a poorer outcome on Mental Component Summary treatment response (P < .001).
  
  
  CONCLUSIONS
  In light of a heavy burden of illness and high psychiatric comorbidity of this sample, treatment response was generally positive for improvement in mental health functioning. This study adds to a growing body of evidence indicating robust treatment response even for those with serious mental illness when treatment is intensive and multimodal.
authors.affiliation: Menninger Clinic, 12301 Main St, Houston, TX 77030 cfowler@menninger.edu.
authors.forename: J Christopher
authors.initials: JC
authors.lastname: Fowler
authors.forename: Alok
authors.initials: A
authors.lastname: Madan
authors.forename: Jon G
authors.initials: JG
authors.lastname: Allen
authors.forename: Thomas
authors.initials: T
authors.lastname: Ellis
authors.forename: Jane
authors.initials: J
authors.lastname: Mahoney
authors.forename: Susan
authors.initials: S
authors.lastname: Hardesty
authors.forename: B Christopher
authors.initials: BC
authors.lastname: Frueh
authors.forename: John M
authors.initials: JM
authors.lastname: Oldham
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D055815:Young Adult