Needs and quality of life among patients with schizophrenia in five European centres: what is the impact of global functioning scores?

BACKGROUND: Global assessment of functioning, quality of life (QOL) and patient needs have been discussed as inter-related domains important for care planning and outcome assessment in care for the severely mentally ill. The study was conducted to investigate relationships of functioning level, subjective QOL and unmet needs in a cross-sectional study of 404 patients with schizophrenia spectrum disorders in five European centres with a focus on the patient group with low function scores.
METHODS: Patient groups with low, medium and high function scores were compared with regard to subjective QOL and unmet needs. QOL variability was assessed in subgroups according to function scores. Regression analyses were used to examine the impact of illness-related and other unmet patient needs on QOL. The influence of individual needs in the low and medium/high function score subgroup was compared.
RESULTS: QOL increased and unmet needs decreased from the low to high function score subgroup. There was greater QOL variability in patients with low function scores compared to those with medium and high function scores, with some low-function score patients having relatively high QOL. In the low function score subgroup, both illness-related and other needs had an impact on QOL, whereas non-illness needs influenced QOL in medium and high function score patients.
CONCLUSION: Scores of functioning level, in people with schizophrenia spectrum disorders, are related to QOL in a complex way, and types of unmet need impinge on the relationship. In order to improve QOL in people with low function scores, both illness-related and other needs should be met.