Subjective Quality of Life in Psychiatric Patients: Diagnosis and Illness-Specific Profiles
Bibliographic record
Abstract
Objective: In accordance with the definition of health by the World Health Organization, outcome measures beyond mere syndromic recovery, such as quality of life ratings, would aid psychiatric practice and research. This is the first study of psychiatric diagnosis and illness stage specific profiles of subjective quality of life (SQOL) impairment. Method: Patients ( n = 150) hospitalized at the Prague Psychiatric Center rated their SQOL using the Schwartz Outcome Scale at admission and discharge. Severity of illness and clinical improvement were measured by the Clinical Global Impression Scale. Results: The highest and lowest SQOL at admission were reported by patients with psychosis and mood disorders respectively ( F = 7.3, df = 2,147, P < 0.001). SQOL improved significantly during hospitalization in all diagnostic categories ( F = 90.0, df = 1,147, P < 0.001), with the smallest and largest improvement in patients with psychosis and mood disorders, respectively ( F = 5.6, df = 2,147, P = 0.005). There was a trend for differences in ratings of clinical improvement by patients, compared with psychiatrists, across diagnostic categories ( F= 2.9, df = 2,147, P = 0.06), with significant differences only in patients with anxiety disorders. These patients also reported the lowest SQOL at discharge ( F = 3.0, df = 2,147, P = 0.05). Global improvement correlated with improvement in SQOL only in patients with mood disorders ( r = −0.4, P = 0.005). Conclusions: Main psychiatric diagnostic categories differ in SQOL and in association between SQOL and treatment. These differences may reflect illness-specific mechanisms, such as depressive symptoms in mood disorders, low insight in psychotic patients, aggravation of anxiety before discharge in patients with anxiety disorders, and may aid in planning of specific treatment interventions. Objectif: Conformément à la définition de la santé de l'Organisation mondiale de la santé, des mesures des résultats qui iraient au-delà du simple soulagement des symptômes, comme par exemple des cotes de la qualité de vie, seraient utiles à la pratique et à la recherche en psychiatrie. La présente est la première étude portant sur le diagnostic psychiatrique, et les profils spécifiques des stades de la maladie, de la déficience de la qualité de vie subjective (QDVS). Méthode: Des patients ( n = 150) hospitalisés au Centre psychiatrique de Prague ont coté leur QDVS au moyen de l'Echelle de résultats de Schwartz, lors de l'admission à l'hôpital et du congé. La gravité de la maladie et les améliorations cliniques ont été mesurées à l'aide de l'Impression clinique globale. Résultats: La QDVS la plus élevée et la plus faible à l'admission a été déclarée par les patients souffrant de psychose et de troubles de l'humeur, respectivement ( F = 7,3, df = 2,147; P < 0,001). La QDVS s'améliorait significativement durant l'hospitalisation dans toutes les catégories diagnostiques ( F = 90,0, df = 1,147; P < 0,001), les plus modestes et les plus grandes améliorations se manifestant chez les patients souffrant de psychose et de troubles de l'humeur, respectivement ( F = 5,6, df = 2,147; P = 0,005). Il y avait une tendance aux différences entre les cotes des améliorations cliniques données par les patients, comparativement à celles des psychiatres dans toutes les catégories diagnostiques ( F = 2,9, df = 2,147; P = 0,06), mais les différences n'étaient significatives que chez les patients souffrant de troubles anxieux. Ces patients déclaraient aussi la QDVS la plus faible au moment du congé ( F = 3,0, df = 2,147; P = 0,05). L'amélioration globale corrélait avec l'amélioration de la QDVS seulement chez les patients souffrant de troubles de l'humeur ( r = −0,4; P = 0,005). Conclusions: Les principales catégories diagnostiques psychiatriques diffèrent en matière de QDVS et dans l'association entre la QDVS et le traitement. Ces différences peuvent refléter des mécanismes propres à la maladie, comme les symptômes dépressifs dans les troubles de l'humeur, une faible introspection chez les patients psychotiques, l'aggravation de l'anxiété avant le congé chez les patients souffrant de troubles anxieux, et peuvent aider à planifier des interventions thérapeutiques spécifiques.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".