Subscribe to RSS
DOI: 10.1055/s-2006-940194
Möglichkeiten und Grenzen subjektiver Lebensqualität schizophrener Patienten als Outcomekriterium psychiatrischer Therapie
Possibilities and Limitations of the Use of Quality of Life as Outcome-Indicator in Schizophrenic PatientsPublication History
Publication Date:
05 October 2006 (online)
Zusammenfassung
Anliegen: Literaturübersicht zu den vorliegenden empirischen Ergebnissen der Erfassung subjektiver Lebensqualität schizophren erkrankter Menschen. Methode: Literaturrecherche und Darstellung eigener Forschungsergebnisse. Fokus auf Patienten unter deprivierten Lebensbedingungen. Ergebnisse: Es finden sich keine konsistenten Zusammenhänge zwischen objektiven Lebensbedingungen und deren subjektiver Bewertung. Als wichtigste Einflussfaktoren erweisen sich Depressivität, Persönlichkeitsfaktoren und Adaptationsmechanismen. Schlussfolgerungen: Subjektive und objektive Variablen hängen nicht linear zusammen. Zur Überwindung der dargestellten Interpretationsprobleme subjektiver Lebensqualitätsstudien werden Mindeststandards für die Anwendung subjektiver Lebensqualität als Outcomeindikator vorgeschlagen.
Abstract
Objective: A systematic review on empirical results of studies that assess Quality of Life (QoL) in schizophrenic patients. Method: A systematic overview of the literature is provided with focus on schizophrenic patients under deprived living conditions. Results: No consistent relationships are found between objective living conditions and their subjective evaluation by means of QoL-ratings. The latter are influenced by the level of depression, personality factors and adaptation. Conclusions: Objective and subjective variables represent distinct latent constructs. Standards for the use of subjective QoL as outcome indicator are suggested.
Literatur
- 1 Franz M, Meyer T, Ehlers F, Gallhofer B. Schizophrene Patienten, die trotz Dekaden der Enthospitalisierung in den psychiatrischen Krankenhäusern verblieben sind. Teil 1 der Hessischen Enthospitalisierungsstudie. Psychiat Prax. 2002; 29 245-250
- 2 Franz M, Ehlers F, Meyer T. Hessische Enthospitalisierungsstudie: Bericht für den Landeswohlfahrtsverband über den Untersuchungszeitraum 1994 - 1997. Kassel; LWV 1998
- 3 Franz M, Meyer T, Gallhofer B. Subjektive Lebensqualität schwer chronifizierter schizophrener Langzeitpatienten. Teil 3 der Hessischen Enthospitalisierungsstudie. Psychiat Prax. 2002; 29 306-310
- 4 Priebe S, Hoffman K, Isermann M, Kaiser W. Klinische Merkmale langzeithospitalisierter Patienten, Teil 1 der Berliner Enthospitalisierungsstudie. Psychiat Prax. 1996; 23 15-20
- 5 Kilian R. Ist Lebensqualität messbar? Probleme der quantitativen und Möglichkeiten der qualitativen Erfassung von Lebensqualität in der Psychiatrie. Psychiat Prax. 1995; 22 97-101
- 6 Atkinson M, Zibin S, Chuang H. Characterizing quality of life among patients with chronic mental illness: a critical examination of the self-report methodology. Am J Psychiatry. 1997; 154 99-105
-
7 Albrecht G, Vieten B, Pörksen N, Ingenleuf H-J, Günther C, Haneberg J. Enthospitalisierung chronisch psychisch kranker Langzeitpatienten. Abschlussbericht des Projektes II-4 1999, Nordrhein-Westfälischer Forschungsverbund Public Health.
- 8 Awad A G, Voruganti L NP, Heslegrave R J. A conceptual model of quality of life in schizophrenia: description and preliminary clinical validation. Qual Life Res. 1997; 6 21-26
- 9 Baker F, Intagliata J. Quality of life in the evaluation of community support systems. Eval Program Plann. 1982; 5 69-79
- 10 Barry M M, Crosby C. Quality of life as an evaluative measure in assessing the impact of community care on people with long-term psychiatric disorders. Br J Psychiatry. 1996; 168 210-216
- 11 Bengtsson-Tops A, Hansson L. Subjective quality of life in schizophrenic patients living in the community: relationship to clinical and social characteristics. Eur Psychiatry. 1999; 14 256-263
- 12 Carpiniello B, Lai G, Pariante C M, Carta M G, Rudas M. Symptoms, standards of living and subjective quality of life: A comparative study of schizophrenic and depressed outpatients. Acta Psychiatr Scand. 1997; 96 235-241
- 13 Dickerson F B, Ringel N B, Parente F. Subjective quality of life in out-patients with schizophrenia: clinical and utilization correlates. Acta Psychiatr Scand. 1998; 98 124-127
- 14 Flanagan S, Doyle M, Browne S, Larkin C, O'Callaghan E. A survey of the self-rated quality of life of individuals with schizophrenia in community residential settings. Irish J Psychol Med. 2000; 17 22-24
- 15 Hansson L, Middelboe T, Merinder L, Bjarnason O, Bengtsson-Tops A, Nilsson L, Sandlund M, Sourander A, Sørgaard K W, Vinding H. Predictors of subjective quality of life in schizophrenic patients living in the community: a nordic multicenter study. Int J Soc Psychiatry. 1999; 45 247-258
- 16 Hoffmann K, Priebe S, Isermann M, Kaiser W. Lebensqualität, Bedürfnisse und Behandlungsbewertung langzeithospitalisierter Patienten: Teil II der Berliner Enthospitalisierungsstudie. Psychiat Prax. 1997; 24 221-226
- 17 Huxley P, Evans S, Burns T, Fahy T, Green J. Quality of life outcome in a randomized controlled trial of case management. Soc Psychiatry Psychiatr Epidemiol. 2001; 36 249-255
- 18 Lehman A F, Ward N C, Linn L S. Chronic mental patients: the quality of life issue. Am J Psychiatry. 1982; 139 1271-1276
- 19 Sullivan G, Wells K B, Leake B. Quality of life of seriously mentally ill persons in Mississippi. Hosp Community Psychiatry. 1991; 42 752-754
- 20 Larsen E B, Gerlach J. Subjective experience of treatment, side-effects, mental state and quality of life in chronic schizophrenic out-patients treated with depot neuroleptics. Acta Psychiatr Scand. 1996; 93 381-388
- 21 Hoffmann K, Isermann M, Kaiser W, Priebe S. Lebensqualität im Verlauf der Enthospitalisierung. Teil IV der Berliner Enthospitalisierungsstudie. Psychiat Prax. 2000; 27 183-188
- 22 Okin R L, Dolnick J A, Pearsall D T. Patients' perspectives on community alternatives to hospitalization: a follow-up study. Am J Psychiatry. 1983; 140 1460-1464
- 23 Stein L I, Test M A. Alternatives to mental hospital treatment. Arch Gen Psychiatry. 1980; 37 392-397
- 24 Chandler D W, Meisel J, McGowen M, Mintz J, Madison K. Client outcomes in two model capitated integrated service agencies. Psychiatr Serv. 1996; 47 (2) 175-180
- 25 Olfson M. Assertive Community Treatment: an evaluation of the experimental evidence. Hosp Community Psych. 1990; 41 634-641
-
26 Daly I.
Quality of life evaluation in health services research. In: Priebe S, Oliver JPJ, Kaiser W Quality of Life and Mental Health Care. Petersfield; Wrightson Biomedical Publishing Ltd 1999: 67-79 - 27 Bond G R, Miller L D, Krumwied R D, Ward R S. Assertive case management in three CMHCs: a controlled study. Hosp Community Psych. 1988; 39 411-418
- 28 McClary S, Lubin B, Evans C. Evaluation of a community treatment program for young adult schizophrenics. J Clin Psychol. 1989; 45 806-808
- 29 Taylor R E, Leese M, Clarkson P, Holloway F, Thornicroft G. Quality of life outcomes for intensive versus standard community mental health services: PRiSM Psychosis Study 9. Br J Psychiatry. 1998; 173 416-422
- 30 Hansson L, Middelboe T, Sorgaard K W, Bengtsson-Tops A, Bjarnason O, Merinder L, Nilsson L, Sandlund M, Korkeila J, Vinding H R. Living situation, subjective quality of life and social network among individuals with schizophrenia living in community settings. Acta Psychiatr Scand. 2002; 106 343-350
- 31 Lehman A F, Possidente S, Hawker F. The quality of life of chronic patients in a state hospital and in community residences. Hosp Community Psych. 1986; 37 901-907
-
32 Angermeyer M C, Kilian R.
Theoretical models of quality of life for mental disorders. In: Katschnig H, Freeman H, Sartorius N Quality of Life in Mental Disorders (2nd edition). Chichester; Wiley 2006: 21-31 - 33 Becker M, Diamond R, Sainfort F. A new patient focused index for measuring quality of life in persons with severe and persistent mental illness. Qual Life Res. 1993; 2 239-251
- 34 Franz M, Meyer T, Gallhofer B. Are importance ratings useful in the assessment of subjective quality of life in schizophrenic patients?. Int J Methods Psychiatr Res. 1999; 8 204-211
- 35 Diener E, Suh E M, Lucas R E, Smith H L. Subjective well-being: three decades of progress. Psychol Bull. 1999; 125 276-302
- 36 Andrews F M, Withey S B. Social Indicators of Well-being. Americans' Perceptions of Life Quality. New York; Plenum Press 1976
-
37 Argyle M.
Causes and correlates of happiness. In: Kahnemann D, Diener E, Schwarz N Well-being: The Foundations of Hedonic Psychology. New York; Sage 1999: 353-373 - 38 Meyer T. Vorstellungen schizophrener Menschen über Lebensqualität. Hamburg; Verlag Dr. Kovac 2004
- 39 Veenhoven R. Conditions of happiness. Dodrecht; Reidel 1984
- 40 Diener E. Assessing subjective well-being: progress and opportunities. Soc Indic Res. 1994; 31 103-157
- 41 Campbell A, Converse P E, Rodgers W L. The Quality of American Life: Perceptions, Evaluations, and Satisfactions. New York; Sage 1976
- 42 McCrae R R. Well-being scales do not measure social desirability. J Gerontol. 1986; 41 390-392
-
43 Franz M, Plüddemann K, Gruppe H, Gallhofer B.
Modifikation und Anwendung der Münchner Lebensqualitäts-Dimensionen-Liste bei schizophrenen Patienten. In: Möller H-J, Engel R, Hoff P Befunderhebung in der Psychiatrie: Negativsymptomatik, Lebensqualität und andere neue Entwicklungen. Berlin; Springer 1996: 103-111 - 44 Karow A, Moritz S, Lambert M, Schoder S, Krausz M. PANSS syndromes and quality of life in schizophrenia. Psychopathology. 2005; 38 320-326
- 45 Tims H, Diaz P. Psychopathology and quality of life in schizophrenia and related disorders: a literature review. Quality of Life Newsletter. 2002; 29 9-10
- 46 Os J van, Gilvarry C, Bale R, Horn E van, Tattan T, White I, Murray R. To what extent does symptomatic improvement result in better outcome in psychotic illness? UK700 Group. Psychol Med. 1999; 29 1183-1195
- 47 Brieger P, Röttig S, Marneros A. Lebensqualität bei unipolar depressiven und bipolar affektiven Patienten. Psychiat Prax. 2004; 31 304-309
- 48 Kuehner C. Subjective quality of life; validity issues with depressed patients. Acta Psychiatr Scand. 2002; 106 62-70
- 49 Meyer T, Karow A, Naber D, Franz M. Anmerkungen zur kritischen Betrachtung eines modernen Konstrukts - Subjektive Lebensqualität. Nervenarzt. 2005; 76 623-625
- 50 McKenna S P, Hunt S M. A new measure of quality of life in depression: testing the reliability an construct validity of the QLDS. Health Pol. 1992; 22 321-330
-
51 Katschnig H, Krautgartner M, Schrank B, Angermeyer M C.
Quality of life in depression. In: Katschnig H, Freeman H, Sartorius N Quality of Life in Mental Disorders (2nd edition). Chichester; Wiley 2006: 129-140 - 52 Norman R M, Malla A K, McLean T, Pant L, Voruganti N, Cortese L, McIntosh E, Chengand S, Rickwood A. The relationship of symptoms and level of functioning in schizophrenia to general wellbeing and the Quality of Life Scale. Acta Psychiatr Scand. 2000; 102 303-309
- 53 Beck A T. Cognitive Therapy and the Emotional Disorders. New York; International Universities Press 1976
-
54 Crosby F, Muehrer P, Loewenstein G.
Relative deprivation and explanation: Models and concepts. In: Olson JM, Herman CP, Zanna MP Relative Deprivation and Social Comparison: The Ontario Symposium (Vol. 4). Hillsdale NJ; Lawrence Erlbaum Associates 1986 - 55 Crosby F. Relative Deprivation and Working Women. New York; Oxford University Press 1982
- 56 Meyer T, Franz M. Vorstellungen von schizophren Erkrankten über Lebensqualität. Gesundheitswesen. 2005; 67 120-123
- 57 Kilian R, Lindenbach I, Löbig U, Uhle M, Angermeyer M C. Self-perceived social integration and the use of day centers of persons with severe and persistent schizophrenia living in the community: A qualitative analysis. Soc Psychiat Soc Epidemiol. 2001; 36 545-552
- 58 Festinger L. A theory of social comparison processes. Hum Relat. 1954; 7 117-140
- 59 Franz M, Meyer T, Reber T, Gallhofer B. The importance of social comparison for high levels of subjective quality of life in chronic schizophrenic patients. Qual Life Res. 2000; 9 481-489
- 60 Wood J V, Taylor S E, Lichtman R R. Social comparison in adjustment to breast cancer. J Pers Soc Psychol. 1985; 49 1169-1183
-
61 Wood J V, Taylor K L.
Serving self-relevant goals through social comparison. In: Suls J, Wills TA Social Comparison: Contemporary Theory and Research. Hillsdale; Lawrence Erlbaum Associates 1991: 23-49 - 62 Meyer T, Franz M, Gallhofer B. Subgruppen und Prognose besonders schwer zu enthospitalisierender schizophrener Langzeitpatienten: Eine Differenzierung des harten Kerns. Teil 2 der Hessischen Enthospitalisierungsstudie. Psychiat Prax. 2002; 29 301-305
- 63 Schwarz N. Stimmung als Information: Untersuchungen zum Einfluss von Stimmungen auf die Bewertung des eigenen Lebens. Heidelberg; Springer 1987
- 64 Cheng S-T. Subjective quality of life in the planning and evaluation of programs. Eval Program Plann. 1988; 11 123-134
- 65 Kilian R, Dietrich S, Toumi M, Angermeyer M C. The effects of first generation and second generation antipsychotics on the quality of life of people with schizophrenia in routine outpatient treatment. Acta Psychiatr Scand. 2004; 110 108-118
- 66 Vorunganti L, Heslegrave R, Awad A G, Seeman M V. Quality of life measurement in schizophrenia: reconciling the quest for subjectivity with the question of reliability. Psychol Med. 1998; 28 165-172
- 67 Kaiser W, Priebe S. Zur Messung von Veränderungen der subjektiven Lebensqualität bei chronisch schizophrenen Patienten. Nervenarzt. 1998; 69 219-227
- 68 Franz M, Meyer T, Spitznagel A, Schmidt H, Wening K, Gallhofer B. Responsiveness of subjective quality of life in schizophrenic patients: a quasi-experimental pilot study. Eur Psychiatry. 2001; 16 99-103
- 69 Fakhoury W KH, Kaiser W, Roeder-Wanner U U, Priebe S. Subjective evaluation: Is there more than one criterion?. Schizophr Bull. 2002; 28 319-327
- 70 Priebe S, Kaiser W, Huxley P, Röder-Wanner U-U, Rudolf H. Do different subjective evaluation criteria reflect distinct constructs?. J Nerv Ment Dis. 1998; 186 385-392
- 71 Ritsner M, Modai I, Endicott J, Rivkin O, Nechamkin Y, Barak P, Goldin V, Ponizovski A. Differences in quality of life domains and psychopathologic and psychosocial factors in psychiatric patients. J Clin Psychiatry. 2000; 61 880-889
- 72 Ruggeri M, Bisoffi G, Fontecedro L, Warner R. Subjective and objective dimensions of quality of life in psychiatric patients: a factor analytical approach: The South Verona outcome project 4. Br J Psychiatry. 2001; 178 268-275
- 73 Warner R, Girolamo G de, Belelli G, Bologna C, Fioritti A, Rosini G. The quality of life of people with schizophrenia in Boulder, Colorado, and Bologna, Italy. Schizophr Bull. 1998; 24 559-568
- 74 Hansson L, Eklund M, Bengtsson-Tops A. The relationship of personality dimensions as measured by the temperament and character inventory and quality of life in individuals with schizophrenia or schizoaffective disorder living in the community. Qual Life Res. 2001; 10 133-139
- 75 Kentros M K, Terkelsen K, Hull J, Smith T E, Goodman M. The relationship between personality and quality of life in persons with schizoaffective disorder and schizophrenia. Qual Life Res. 1997; 6 118-122
- 76 Ritsner M, Farkas H, Gibel A. Satisfaction with quality of life varies with temperament types of patients with schizophrenia. J Nerv Ment Dis. 2003; 191 668-674
- 77 Sibitz I, Gössler R, Katschnig H, Amering M. „Wissen - genießen - besser leben” - Ein Seminar für Psychoseerfahrene zur Verbesserung der Lebensqualität. Psychiat Prax. 2006; 33 170-176
-
78 Linehan M M.
Acceptance and change. In: Hayes SC, Jacobson NS, Follette VM, Dougher MJ Acceptance and change: Content and context in psychotherapy. Reno; Context Press 1994: 73-86
PD Dr. Michael Franz
Universitätsklinikum Gießen Marburg, Standort Gießen · Arbeitsgruppe Sozialpsychiatrie
Am Steg 24
35392 Gießen
Email: michael.franz@psychiat.med.uni-giessen.de