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The British Journal of Psychiatry (2005) 187: 121-130
© 2005 The Royal College of Psychiatrists

Changes and predictors of change in objective and subjective quality of life

Multiwave follow-up study in community psychiatric practice

MIRELLA RUGGERI, MD, PhD

Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Italy

MICHELA NOSÈ, MD, CHIARA BONETTO, Dr Stat, PhD, DORIANA CRISTOFALO, Dr Sci. Edu., ANTONIO LASALVIA, MD, PhD, GIOVANNI SALVI, MD, BENEDETTA STEFANI, MD, FRANCESCA MALCHIODI, MD and MICHELE TANSELLA, MD

Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Italy

Correspondence: Professor Mirella Ruggeri, Dipartimento di Medicina e Sanità Pubblica, Sezione di Psichiatria e di Psicologia Clinica, Universita'di Verona, Policlinico G. B. Rossi, 37134 Verona, Italy. Tel: +39 (045) 8074441; fax: +39 (045) 585871; e-mail: mirella.ruggeri{at}univr.it

Declaration of interest None. Funding detailed in Acknowledgements.

Background There is little knowledge of the predictors of objective and subjective quality of life.

Aims To describe changes at 2 and 6 years in objective and subjective quality of life in 261 individuals attending a community mental health service and to identify predictors of change in each life domain.

Method Prospective study of demographic, diagnostic and service utilisation characteristics, psychopathology, functioning, disability, self-esteem, affect balance and service satisfaction.

Results Female gender, unmarried status, older age, less education and greater disability predicted a worsening of objective quality of life over time, but explain a small amount of variance. The variance in subjective quality of life was higher (>40%). Greater clinician-rated anxiety and depressive symptoms had a negative effect on satisfaction with health and general well-being. Psychological status, self-esteem and satisfaction with service were the most important predictors in almost all subjective domains; these variables should be important targets for treatment.

Conclusions This study is the first to provide information to enable clinicians to make prognostic judgements about quality of life and plan effective therapeutic strategies to improve quality of life.


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