title: Subjective and objective quality of life at first presentation with psychosis.
abstract: Quality of life (QOL) in first-episode psychosis (FEP) is impaired when compared to non-clinical controls and several clinical factors including symptoms and untreated psychosis have been linked with poorer QOL. Measurement methods are varied, however, resulting in inconsistent findings and there is a need to simultaneously combine subjective and objective measures of QOL.
  
  
  
  We examined both subjective (n = 128) and objective QOL (n = 178) in a catchment area cohort of individuals with FEP (n = 222) to determine correspondence between patient satisfaction and clinician-rated functional domains. We also examined the contribution of sociodemographic and clinical characteristics to both subjective and objective QOL.
  
  
  
  There were complex relationships between subjective and objective QOL domains in that patient's assessments of health status (psychological well-being, symptoms/outlook, physical health) were not correlated with clinicians but there were strong correlations between social functioning domains (occupation, social relations, financial status and activities of daily living) assessed by patients and clinicians. Longer duration of untreated psychosis, being treated as an inpatient, higher positive symptoms and poorer social functioning in client-rated QOL domains predicted poorer objective QOL.
  
  
  
  We found that both subjective and objective assessments of QOL displayed a degree of clinical utility demonstrated by relationships between clinical factors and both QOL perspectives. Moreover, the lack of association between patient characteristics and QOL shows some potential malleability of QOL outcomes through intervention as there were several clinical factors linked with both subjective and objective QOL.
authors.affiliation: School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.|DETECT Early Psychosis Service, Dublin, Ireland.|School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland.
authors.forename: Laoise
authors.initials: L
authors.lastname: Renwick
authors.affiliation: Centre for Innovation and Leadership in Health Sciences, University of Southampton, Southampton, UK.|School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Drennan
authors.affiliation: School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland.
authors.forename: Ann
authors.initials: A
authors.lastname: Sheridan
authors.affiliation: DETECT Early Psychosis Service, Dublin, Ireland.
authors.forename: Liz
authors.initials: L
authors.lastname: Owens
authors.affiliation: DETECT Early Psychosis Service, Dublin, Ireland.
authors.forename: John
authors.initials: J
authors.lastname: Lyne
authors.affiliation: Early Psychosis Prevention and Intervention Centre (EPPIC), Orygen, National Centre for Excellence in Youth Mental Health, Melbourne, Victoria, Australia.
authors.forename: Brian
authors.initials: B
authors.lastname: O'Donoghue
authors.affiliation: DETECT Early Psychosis Service, Dublin, Ireland.
authors.forename: Anthony
authors.initials: A
authors.lastname: Kinsella
authors.affiliation: DETECT Early Psychosis Service, Dublin, Ireland.
authors.forename: Niall
authors.initials: N
authors.lastname: Turner
authors.forename: Eadbhard
authors.initials: E
authors.lastname: O'Callaghan
authors.affiliation: DETECT Early Psychosis Service, Dublin, Ireland.|School of Medicine, University College Dublin, Dublin, Ireland.
authors.forename: Mary
authors.initials: M
authors.lastname: Clarke
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis / Q000523:psychology*; D011788:Quality of Life
keywords: activities of daily living; psychopathology; psychotic disorder; quality of life; satisfaction