Changes and predictors of change in objective and subjective quality of life: multiwave follow-up study in community psychiatric practice

BACKGROUND:There is little knowledge of the predictors of objective and subjective quality of life.AIMS:To describe changes at 2 and 6 years in objective and subjective quality of life in 261 individuals attending a community mental health service and to identify predictors of change in each life domain.METHOD:Prospective study of demographic, diagnostic and service utilisation characteristics, psychopathology, functioning, disability, self-esteem, affect balance and service satisfaction.RESULTS:Female gender, unmarried status, older age, less education and greater disability predicted a worsening of objective quality of life over time, but explain a small amount of variance. The variance in subjective quality of life was higher (>40%). Greater clinician-rated anxiety and depressive symptoms had a negative effect on satisfaction with health and general well-being. Psychological status, self-esteem and satisfaction with service were the most important predictors in almost all subjective domains; these variables should be important targets for treatment.CONCLUSIONS:This study is the first to provide information to enable clinicians to make prognostic judgements about quality of life and plan effective therapeutic strategies to improve quality of life.