Validity of Self-Reports About Quality of Life Among Patients With Schizophrenia

Khatri, Nasreen; Romney, David M.; Pelletier, G.

doi:10.1176/appi.ps.52.4.534

Cited by 34 publications

(20 citation statements)

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“…Of concern are the effects of psychopathology and lack of insight on the validity of self-ratings [4][5][6]; and the impact on QOL ratings, of the interviewer-interviewee relationship [7], the side effects of drugs (exptrapyramidal reactions-EPR, tardive dyskinesia-TD, and sexual dysfunction) [8][9][10], and treatment setting [11]. While the majority of the focus in this regard has been on schizophrenia, concern has also been expressed for the affective disorders, especially depression [6,[12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Subjective Quality of Life of Community Living Sudanese Psychiatric Patients: Comparison with Family Caregivers’ Impressions and Control Group

Awadalla

Ohaeri²,

Salih

et al. 2005

Qual Life Res

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Section: Introductionmentioning

confidence: 99%

Subjective Quality of Life of Community Living Sudanese Psychiatric Patients: Comparison with Family Caregivers’ Impressions and Control Group

Awadalla

Ohaeri²,

Salih

et al. 2005

Qual Life Res

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“…In CUtLASS 1, the within-group standard deviation (SD) for the Heinrich's Quality of Life Scale 69,70 (QLS) change score at 12 months was 13. There is often difficulty in defining a clinically significant difference in scores.…”

Section: Sample Sizementioning

confidence: 99%

Antidepressant Controlled Trial For Negative Symptoms In Schizophrenia (ACTIONS): a double-blind, placebo-controlled, randomised clinical trial

Barnes

Leeson

Paton

et al. 2016

Health Technol Assess

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BackgroundNegative symptoms of schizophrenia represent deficiencies in emotional responsiveness, motivation, socialisation, speech and movement. When persistent, they are held to account for much of the poor functional outcomes associated with schizophrenia. There are currently no approved pharmacological treatments. While the available evidence suggests that a combination of antipsychotic and antidepressant medication may be effective in treating negative symptoms, it is too limited to allow any firm conclusions.ObjectiveTo establish the clinical effectiveness and cost-effectiveness of augmentation of antipsychotic medication with the antidepressant citalopram for the management of negative symptoms in schizophrenia.DesignA multicentre, double-blind, individually randomised, placebo-controlled trial with 12-month follow-up.SettingAdult psychiatric services, treating people with schizophrenia.ParticipantsInpatients or outpatients with schizophrenia, on continuing, stable antipsychotic medication, with persistent negative symptoms at a criterion level of severity.InterventionsEligible participants were randomised 1 : 1 to treatment with either placebo (one capsule) or 20 mg of citalopram per day for 48 weeks, with the clinical option at 4 weeks to increase the daily dosage to 40 mg of citalopram or two placebo capsules for the remainder of the study.Main outcome measuresThe primary outcomes were quality of life measured at 12 and 48 weeks assessed using the Heinrich’s Quality of Life Scale, and negative symptoms at 12 weeks measured on the negative symptom subscale of the Positive and Negative Syndrome Scale.ResultsNo therapeutic benefit in terms of improvement in quality of life or negative symptoms was detected for citalopram over 12 weeks or at 48 weeks, but secondary analysis suggested modest improvement in the negative symptom domain, avolition/amotivation, at 12 weeks (mean difference –1.3, 95% confidence interval –2.5 to –0.09). There were no statistically significant differences between the two treatment arms over 48-week follow-up in either the health economics outcomes or costs, and no differences in the frequency or severity of adverse effects, including corrected QT interval prolongation.LimitationsThe trial under-recruited, partly because cardiac safety concerns about citalopram were raised, with the 62 participants recruited falling well short of the target recruitment of 358. Although this was the largest sample randomised to citalopram in a randomised controlled trial of antidepressant augmentation for negative symptoms of schizophrenia and had the longest follow-up, the power of statistical analysis to detect significant differences between the active and placebo groups was limited.ConclusionAlthough adjunctive citalopram did not improve negative symptoms overall, there was evidence of some positive effect on avolition/amotivation, recognised as a critical barrier to psychosocial rehabilitation and achieving better social and community functional outcomes. Comprehensive assessment of side-effect burden did not identify any serious safety or tolerability issues. The addition of citalopram as a long-term prescribing strategy for the treatment of negative symptoms may merit further investigation in larger studies.Future workFurther studies of the viability of adjunctive antidepressant treatment for negative symptoms in schizophrenia should include appropriate safety monitoring and use rating scales that allow for evaluation of avolition/amotivation as a discrete negative symptom domain. Overcoming the barriers to recruiting an adequate sample size will remain a challenge.Trial registrationEuropean Union Drug Regulating Authorities Clinical Trials (EudraCT) number 2009-009235-30 and Current Controlled Trials ISRCTN42305247.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 29. See the NIHR Journals Library website for further project information.

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“…A literature review of quality of life in patients with schizophrenia (Pinikahana 2002) (Barry 1997;Khatri 2001;Holloway 2002;Basu 2004), is that subjective QoL, especially for people with schizophrenia, poorly reflects changes in objective QoL. Barry & Zissi (1997) Holloway & Carson (2002) conclude that the QoL approach focuses on 'the "nomothetic" (attempts to develop general laws governing the determinants of QoL and how to improve it) at the expense of the "idiographic" (concern with the individual and pertaining to the unique facts and processes that impact on their QoL)', which they regret since QoL 'is at root an individual matter'.…”

Section: Quality Of Life and Schizophreniamentioning

confidence: 99%

“…A small study by Khatri et al (2001) using the Lehman et al Quality of Life Interview also looked at the validity of responses by patients, this time with schizophrenia, as compared with patients with cancer. Both groups were asked to choose proxies (a carer or someone who knew them well) to complete the interview as well, so that responses of the two groups on subjective and objective domains could be compared.…”

Section: Suitability and Validity Of Qol/hrqol Tools To Measure Outcomesmentioning

confidence: 99%

Service users' perceptions of quality of life measurement in psychiatry

Wallcraft¹

2011

Adv. psychiatr. treat

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SummaryThis article describes the concept of quality of life (QoL) as applied to mental health. It also outlines relevant tools for measuring QoL, both generic and health-specific, and explains their approaches and purposes. These tools are intended to enable researchers to ask questions that are more patient-centred and psychosocial than traditional clinical measures for evaluating outcomes of treatment. However, a number of studies have criticised existing QoL tools in terms of their sensitivity to change and their relevance to mental health patients' concerns. Studies have shown that patients can give accurate self-reports even when ill. Given that government and professional policies favour effective service user involvement and routine outcome monitoring, more effort should be made to develop measures in partnership with service users, as this might better reflect individual priorities in assessment of quality of life.

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Validity of Self-Reports About Quality of Life Among Patients With Schizophrenia

Cited by 34 publications

References 4 publications

Subjective Quality of Life of Community Living Sudanese Psychiatric Patients: Comparison with Family Caregivers’ Impressions and Control Group

Subjective Quality of Life of Community Living Sudanese Psychiatric Patients: Comparison with Family Caregivers’ Impressions and Control Group

Antidepressant Controlled Trial For Negative Symptoms In Schizophrenia (ACTIONS): a double-blind, placebo-controlled, randomised clinical trial

Service users' perceptions of quality of life measurement in psychiatry

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