Judgments of quality of life of individuals with severe mental disorders: Patient self-report versus provider perspectives

Objective: This study was an investigation of judgments regarding quality of life of individuals with severe mental disorders from two different perspectives: patient self-report versus provider. Method: Judgments on several dimensions of quality of life were collected from a convenience sample of 37 schizophrenic patients and their primary clinicians by using the well-known Quality of Life Index of Spitzer et al. and the more recently developed Quality of Life Index-Mental Health. Both indexes capture judgments on a number of dimensions. Patterns of concordance for the patient-provider pairs were tested by using Cohen's kappa and Pearson correlation coefficients. Results: The results suggest that patients' and providers' judgments are more likely to coincide on clinical aspects, such as symptoms and function, than on social aspects. Specifically, there was moderate agreement on symptoms and function, less agreement on physical health, and little to no agreement on social relations and occupational aspects of quality of life. Conclusions: Such differences support the notion that treatment strategies and mental health services should address a wide range of needs reflecting different aspects of quality of life perceived as important by different patients.