Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Luisenstr. 57, 10117, Berlin, Germany.
Klinik f. Pädiatrie m.S. Pneumologie, Immunologie und Intensivmedizin, Otto-Heubner-Centrum für Kinder- und Jugendmedizin, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Qual Life Res. 2020 Aug;29(8):2073-2087. doi: 10.1007/s11136-020-02470-0. Epub 2020 Mar 13.
This study (a) assessed quality of life (QoL) in a patient sample with severe mental illness in an integrated psychiatric care (IC) programme in selected regions in Germany, (b) compared QoL among diagnostic groups and (c) identified socio-demographic, psychiatric anamnestic and clinical characteristics associated with QoL.
This cross-sectional study included severely mentally ill outpatients with substantial impairments in social functioning. Separate dimensions of QoL were assessed with the World Health Organisation's generic 26-item quality of life (WHOQOL-BREF) instrument. Descriptive analyses and analyses of variance (ANOVAs) were conducted for the overall sample as well as for diagnostic group.
A total of 953 patients fully completed the WHOQOL-BREF questionnaire. QoL in this sample was lower than in the general population (mean 34.1; 95% confidence interval (CI) 32.8 to 35.5), with the lowest QoL in unipolar depression patients (mean 30.5; 95% CI 28.9 to 32.2) and the highest in dementia patients (mean 53.0; 95% CI 47.5 to 58.5). Main psychiatric diagnosis, living situation (alone, partner/relatives, assisted), number of disease episodes, source of income, age and clinical global impression (CGI) scores were identified as potential predictors of QoL, but explained only a small part of the variation.
Aspects of health care that increase QoL despite the presence of a mental disorder are essential for severely mentally ill patients, as complete freedom from the disorder cannot be expected. QoL as a patient-centred outcome should be used as only one component among the recovery measures evaluating treatment outcomes in mental health care.
本研究（a）评估了在德国选定地区综合精神卫生护理（IC）计划中严重精神疾病患者样本的生活质量（QoL），（b）比较了不同诊断组的 QoL，（c）确定了与 QoL 相关的社会人口学、精神病史和临床特征。
本横断面研究纳入了社会功能严重受损的严重精神疾病门诊患者。使用世界卫生组织通用 26 项生活质量（WHOQOL-BREF）量表评估生活质量的各个维度。对整体样本和诊断组分别进行描述性分析和方差分析（ANOVA）。
共有 953 名患者完整填写了 WHOQOL-BREF 问卷。该样本的生活质量低于一般人群（平均 34.1；95%置信区间（CI）32.8 至 35.5），其中单相抑郁症患者的生活质量最低（平均 30.5；95%CI 28.9 至 32.2），痴呆症患者的生活质量最高（平均 53.0；95%CI 47.5 至 58.5）。主要精神诊断、生活状况（独居、伴侣/亲属、辅助）、疾病发作次数、收入来源、年龄和临床总体印象（CGI）评分被确定为生活质量的潜在预测因素，但仅解释了变异的一小部分。
尽管存在精神障碍，但能提高生活质量的医疗保健方面对严重精神疾病患者至关重要，因为不能期望完全摆脱这种疾病。生活质量作为以患者为中心的结果，应该作为评估精神卫生保健治疗结果的恢复措施之一，而不是唯一的组成部分。
