Assessing quality of life in people living with psychosis

Assessing quality of life in people living with psychosis HELEN HERRMANThe recent Global Burden of Disease studies (Murray & Lopez, 1996) using a new index summating the death and the morbidity resulting from identifiable diseases, estimate that mental disorders contribute a high proportion of the burden of disease in all parts of the world.The focus will now move to demonstrating how much of the burden of disease can be relieved by service provision.Health care resources are limited and demand will continue to grow.The effectiveness of service provision for people living with psychosis as demonstrated by studies of patient outcomes will eventually be compared with the effectiveness of service provision for people with other illnesses (Andrews, 1999).However information about effectiveness can easily be misleading, and more work is needed before this comparison can be used meaningfully to allocate resources.Assessing the burden averted by service provision, or the effectiveness of services, requires attention to the methods and types of outcome assessments, and to study design.Longitudinal studies of patient cohorts are required (Abrahamson, 1993), with assessment of outcomes on several dimensions (Thornicroft & Tansella, 1996).The measurement of treatment outcomes may be misleading unless it includes subjective quality of life (QOL) and disability as well as symptoms and death rates.The use of appropriate QOL measures is important in highlighting needs and outcomes in areas that are si-Indirizzo per la corrispondenza: