Quality of life as patient-reported outcomes: principles of assessment

TLDR

Assessing quality of life as a patient‑reported outcome in adult psychiatry is challenged by conceptual, methodological, and practical issues. This review aims to conceptually outline the QoL construct, its dimensionality, and representation across patient groups. The review examines methodological challenges, principles of instrument development and testing across cultures, and the application of QoL instruments in epidemiological, clinical, health‑economics, and health‑services research. Validated QoL measures exist for depression, psychosis, and anxiety and are increasingly used in research, yet targeted tools are scarce for many conditions and rarely applied in practice, and progress toward ready‑to‑implement instruments offers valuable insight into patient‑reported needs and treatment benefits.

Abstract

Assessing quality of life (QoL) as a patient-reported outcome in adult psychiatry poses challenges in terms of concepts, methods, and applications in research and practice. This review will outline conceptually the construct of QoL, its dimensionality, and its representation across patient groups. Methodological challenges are examined, along with principles of QoL instrument development and testing, as well as across cultures. Application of instruments in epidemiological, clinical health economics, and health services research is reviewed based on pertinent literature. Validated measures for depression, psychosis, and anxiety disorders are available in adult psychiatry, and are increasingly used in research. Still, targeted measures are lacking for many mental health conditions and only rarely are tools applied in the practice context. Progress has been made in the development of instruments that are now ready for implementation. The information to be gained is valuable for identifying patient-reported needs for and benefits of treatment.