Quality of Life Impairment in Schizophrenia, Mood and Anxiety Disorders

Over the past few decades health-related quality of life (HRQL) has emerged as the new image of medicine viewed from a psychosocial perspective. The concept of Quality of Life has attracted a good deal of interest, not only from a clinical perspective but also from psychosocial, health economics as well as cultural aspects. More recently, the neurobiological brain substrates that modulate many aspects of subjective experiences, which is relevant to quality of life such as affect, mood, cognition, pleasure, reward responses as well as feeling of wellbeing and satisfaction has been explored and elucidated. Such increased interest in HRQL is highlighted by the large number of recent publications. Over the past 10 years at least 350 papers were published describing aspects of HRQL in the psychiatric and mental field. Among them 78% dealt with HRQL in schizophrenia and schizoaffective disorders, 21% with major depression, 14% with anxiety disorders and 4% with bipolar disorder. It is gratifying to witness the enhanced interest and popularity in HRQL research and publications, yet the field continues to suffer from conceptual inconsistencies as well as a good deal of methodological limitations. It is worrisome that we still do not have a clear understanding of the concept itself as applied to mental health and illness as well as the complex array of its determinants. Similarly there is a lag in the application of quality of life data in improving clinical practice.

Over the past few decades health-related quality of life (HRQL) has emerged as the new image of medicine viewed from a psychosocial perspective. The concept of Quality of Life has attracted a good deal of interest, not only from a clinical perspective but also from psychosocial, health economics as well as cultural aspects. More recently, the neurobiological brain substrates that modulate many aspects of subjective experiences, which is relevant to quality of life such as affect, mood, cognition, pleasure, reward responses as well as feeling of wellbeing and satisfaction has been explored and elucidated. Such increased interest in HRQL is highlighted by the large number of recent publications. Over the past 10 years at least 350 papers were published describing aspects of HRQL in the psychiatric and mental field. Among them 78% dealt with HRQL in schizophrenia and schizoaffective disorders, 21% with major depression, 14% with anxiety disorders and 4% with bipolar disorder. It is gratifying to witness the enhanced interest and popularity in HRQL research and publications, yet the field continues to suffer from conceptual inconsistencies as well as a good deal of methodological limitations. It is worrisome that we still do not have a clear understanding of the concept itself as applied to mental health and illness as well as the complex array of its determinants. Similarly there is a lag in the application of quality of life data in improving clinical practice.

Over the past few decades health-related quality of life (HRQL) has emerged as the new image of medicine viewed from a psychosocial perspective. The concept of Quality of Life has attracted a good deal of interest, not only from a clinical perspective but also from psychosocial, health economics as well as cultural aspects. More recently, the neurobiological brain substrates that modulate many aspects of subjective experiences, which is relevant to quality of life such as affect, mood, cognition, pleasure, reward responses as well as feeling of wellbeing and satisfaction has been explored and elucidated. Such increased interest in HRQL is highlighted by the large number of recent publications. Over the past 10 years at least 350 papers were published describing aspects of HRQL in the psychiatric and mental field. Among them 78% dealt with HRQL in schizophrenia and schizoaffective disorders, 21% with major depression, 14% with anxiety disorders and 4% with bipolar disorder. It is gratifying to witness the enhanced interest and popularity in HRQL research and publications, yet the field continues to suffer from conceptual inconsistencies as well as a good deal of methodological limitations. It is worrisome that we still do not have a clear understanding of the concept itself as applied to mental health and illness as well as the complex array of its determinants. Similarly there is a lag in the application of quality of life data in improving clinical practice.

Key Methodological Issues.- The Distress/Protection Vulnerability Model of Quality of Life Impairment Syndrome.- Role of Dopamine in Pleasure, Reward and Subjective Responses to Drugs.- Neuroendocrine functions, mood and quality of life.- In the mind of the Beholder Neuronal mediators for the effect of emotional experience on~quality of life.- Cross-cultural Quality of Life Research in Mental Health.- Measuring the value of health-related quality of life.- Comparison of instruments for measuring the quality of life impairment syndrome in severe mental disorders.- Integrative bottom-up approach to HRQOL measurement.- Quality of Life Impairment Syndrome in Severe Mental Disorders.- Health Related Quality of Life in Subjects at Risk for a First Episode Of Psychosis.- Quality of life impairment syndrome in schizophrenia.- Insight and quality of life in chizophrenia spectrum disorders.- Quality of Life and Major Depression.- Quality of life impairment in bipolar disorder.- Quality of Life Impairment in Anxiety Disorders.- Quality of Life in Obsessive-Compulsive Disorder.- Treatment and Rehabilitation Issues.- Antipsychotic Medications, Schizophrenia and the Issue of Quality of Life.- Quality of life outcomes of ECT.- Quality of Life in Mental Health Services.- Subjective Quality of Life in Relation to Psychiatric Rehabilitation and Daily Life.- Cost-Utility Analysis.