LONGITUDINAL ASSESSMENT OF QUALITY-OF-LIFE IN ACUTE PSYCHIATRIC-INPATIENTS - RELIABILITY AND VALIDITY

This study examined the reliability, validity, and responsiveness of L ehman's Quality of Life Interview (QOLI) as an outcome measure on 981 acutely ill psychiatric inpatients assessed longitudinally at admissio n and discharge. Patients were stratified into five diagnostic (DX) (d epressed bipolar, depressed unipolar, schizophrenia, mania, and other diagnoses) and two substance use disorder (SA) strata (with and withou t concurrent substance abuse/dependence) based on DSM-III-R criteria. There was good replication of the factor structure, excellent internal consistency, overall and within DX and SA groups. Intercorrelations s howed that the functional and satisfaction indices measure unique aspe cts of the quality of life. The construct consistency of the QOLI was dependent upon psychiatric diagnosis and life domain. Intercorrelation s of functional and satisfaction indices for patients with depression were greater than for manic patients. We demonstrated strong consisten cy of construct validity for family and social relation domains, but n ot safety or leisure activities. Construct validity was shown to hold ion gitudinally. Analyses of DX and SA group differences on satisfacti on and functional indices of the 8 life domains supported discriminati ve validity: Depressed patients reported the most dissatisfaction, fol lowed by schizophrenic patients, and manic patients reported the great est satisfaction in most life domains. Patients with concurrent substa nce abuse generally reported less satisfaction and lower quality of li fe than patients without a dual diagnosis. Examination of longitudinal changes in satisfaction indicated the QOLI is responsive to changes i n global life, leisure activities, living situation! and social relati ons from hospital admission to discharge (an average of 2 weeks). This study supports the use of the QOLI as an outcome measure to assess qu ality of life in acutely ill hospitalized psychiatric patients.